Health

Docs, Nurses Weigh in on Use of Terms ‘Providers,’ ‘Consumers’

The term “provider” bothered physicians in a recent Medscape poll much more than it bothered nurses.

The poll also asked readers whether they view patients as “consumers”, and nurses and advanced practice registered nurses (APRNs) were more likely than physicians to agree with that characterization (27% vs 10%).

The poll questions were posted on June 5 after medical ethicist Arthur Caplan, PhD, director of the Division of Medical Ethics at the New York University School of Medicine, said in a
Medscape video commentary
that patients should not be viewed as consumers. He also argued that physicians should not be referred to as providers.

“In our healthcare system, more and more the language of business is shaping and changing descriptions of what doctor–patient encounters are all about,” Caplan said.

He explained that patients are not in a position to shop for options or do the research that would match market-driven behavior. He added that referring to physicians as providers makes them feel more like pawns without the respect and authority that go with the profession.

In this poll, physicians were more likely than nurses to agree with those points of view.

Responses to Term “Provider”

Physicians felt much more strongly than nurses/APRNs that the term “provider” should not be used to describe clinicians.

Table 1. When referring to physicians, nurses, and other clinicians, do you find the term “provider” desirable; neither desirable nor undesirable; or undesirable?

Response Physicians Who Selected Answer, % Nurses/APRNs Who Selected Answer, %
Desirable 8 17
Neither desirable nor undesirable 27 59
Undesirable 65 25

Values may not add up to 100% because of rounding.

 

A family physician/geriatrician responded in poll comments: “I am not crazy for money. Patients’ satisfaction is my top priority. However, the amount which I receive from them for my service is good enough for me. I am happy and satisfied when my patient smiles after recovery.”

Age Makes a Difference

Younger physicians and nurses/APRNs were more likely to view patients as consumers. For physicians, 13% of those younger than age 55 took that view and just half as many of those 55 years and older (7%) agreed. The same trend was seen for nurses/APRNs. Although 30% of those under age 55 viewed patients as consumers, only 25% of those age 55 and older did.

Older physicians were more likely than their younger counterparts to view medicine as a profession only (86% vs 75%). The same age trend held for nurses/APRNs: 74% of older nurses viewed medicine as a profession only (as opposed to a business) compared with 66% of their younger counterparts.

Physicians and nurses/APRNs across the board were much more likely to view medicine as a profession rather than a business.

Table 2. Do You View Medicine as a Profession or Business?

Response Physicians, % Nurses/APRNs, %
Profession 80 71
Business 2 1
Both 17 27
Neither 1 1
Unsure 0 1

Values may not add up to 100% because of rounding.

 

An aesthetic nurse working with a plastic surgeon responded: “It is about business and marketing in our practice and patient satisfaction is a must. Most of what we do is self-pay and not insurance based. I am providing a service to my patients/clients and they continue to come to me as a provider because of my expertise and their outcomes. So, I think it depends on your specialty area on how you would view these questions.”

However, a pediatrician who responded bemoaned such characterizations and said medicine must push back: “The terms ‘provider’ and ‘consumer’, applied to medicine, represent the drive to commodify medicine, to turn it into a business like any other, ie, the patient is like the ‘consumer’ who purchases online access from an Internet service ‘provider.’ Medicine must resist this trend and remain true to its timeless goal: the care of the patient, not the pursuit of business success/profit. The doctor–patient relationship is special and intimate, based on trust and advocacy, utterly unlike the provider–consumer relationship between, say, a car dealer and car shopper.”

The poll also included the question: “In general, how would you characterize the current amount of emphasis on patient satisfaction outside of direct medical care?”

Most physicians (59%) and nurses/APRNs (60%) said there was too much emphasis; 32% and 27%, respectively, said there was appropriate emphasis; and 9% and 13% said there was not enough emphasis.

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