When a physician pushes back on being called a “provider,” the objection is rarely about the word itself.
Clinical and workforce leaders told Becker’s the deeper issue is whether an organization takes the time to name the training each clinician earned. The tension runs in more than one direction: Some physicians reject “provider,” and some nurse practitioners and physician associates reject being grouped as “advanced practice providers.”
Titles alone don’t drive burnout, leaders said. But when organizations get them wrong, it can become one more reason a clinician feels undervalued, and one more reason not to join or stay.
The debate has picked up this year. In February, the American College of Physicians argued in Annals of Internal Medicine that “the words physician and provider are not interchangeable.” In June, the AMA House of Delegates voted to formally oppose calling physicians providers. The term traces back to Medicare and Medicaid law from 1965, which used “provider” for institutions that bill the federal government.
Here is what four leaders said about how titles land with their teams.
A term for what clinicians can do, not who they are
Peggy Duggan, MD, executive vice president, chief physician executive and chief medical officer of Tampa (Fla.) General Hospital, said “provider” describes a set of permissions, not a background.
“The use of ‘provider’ is just to help set some guardrails around activities people can do,” Dr. Duggan said. “They’re licensed independent providers, but it doesn’t speak to their historical training at all.”
APPs also report through her division, and she said they deserve the same precision. When she speaks to a room of physicians and APPs, she doesn’t say “providers.” She says “physicians and advanced practice.”
“I just feel like we can take the extra minute … to really just use the title that people have earned through their education,” she said. “I don’t think that’s a lot to ask of people.”
Dr. Duggan, a former breast cancer surgeon, said specific titles also serve patients. On her surgical teams, patients knew who their surgeon was, who the physician assistant was and which resident was in their third year.
“If we use a vanilla term, I don’t think that serves anybody,” she said. “The patients really deserve to know who’s at their bedside.”
‘Just trying to be respectful’
At Phoenix-based Banner Health, the goal is to use the most descriptive title for each role: physician, nurse practitioner, PA, CRNA. Marjorie Bessel, MD, chief clinical officer of Banner, said some physicians dislike “provider” because it doesn’t accurately describe their training.
She was candid that the system has not reached full adoption.
“I am sure if you go out to our website and poke around, you will find other descriptors out there,” Dr. Bessel said. “So it’s not like a wholesale, ‘We’ve absolutely done it,’ but we’re just trying to be respectful.”
She compared it to how people prefer to be addressed.
“Some people like their full formal name. Some people like their nickname,” she said. “We try to be respectful to the individual or the group of individuals of how they prefer to be called.”
Dr. Bessel said every role is essential, but they are not the same: “They do come from different backgrounds of training, and they do fill different roles within a healthcare organization.”
The APP side of the debate
The umbrella term “advanced practice provider” draws its own mix of reactions. Toby Brower, DMS, PA, APP ministry lead for Mishawaka, Ind.-based Franciscan Physician Network and vice president of the Indiana Academy of PAs, said context matters.
Most PAs and NPs on his team welcome “APP” as a group label, he said, especially compared with older terms such as “mid-level provider” or “physician extender.” It also saves time when referring to six professions at once: PAs, NPs, certified nurse midwives, CRNAs, clinical nurse specialists and certified anesthesiologist assistants.
But when the language faces patients or the public, or shows up in statutes, bylaws and legal documents, specific titles matter more.
“When we get to specifics, [it] really has to do with the role that they’re serving to the public,” Dr. Brower said. “That’s when people really prefer to be identified by the professional title, such as nurse practitioner or physician associate.”
The catch-all terms can also be confusing. Dr. Brower said administrators sometimes refer to “providers and APPs” when they mean physicians and APPs.
“Well, the second P is ‘provider,'” he said. “So it can be confusing.”
He has also seen job descriptions list “advanced practice provider” as a profession, which he called technically misleading: “There is no licensed profession of advanced practice provider. That’s just a generic term.”
‘One more thing in the con list’
Leaders were split on how much titles affect morale.
Dr. Duggan said the link to burnout is “a stretch” for her. She pointed instead to friction in the system.
“I haven’t met a physician or an advanced practice provider who doesn’t want to work hard,” she said. “I think the friction in the system makes it difficult, and that’s probably our bigger barrier.”
Dr. Bessel, who leads well-being work at Banner, said the system recently finished its annual surveys on engagement, burnout and safety. Preliminary physician scores are “incredibly good,” which she credited to Banner’s well-being investment. That investment, she said, “goes far beyond [what] we call individuals.”
Dr. Brower sees the effect in recruitment and retention. Get titles wrong, he said, and “you could dissuade professionals from joining your organization or potentially retaining them.”
“When we get it wrong, that can be one more thing in the con list that could affect your institution’s ability to provide access to care,” he said. He recommended each profession have a leader who can weigh in on terminology in job descriptions, bylaws and other materials.
Kerry Appleton, BSN, RN, director of workforce well-being at Robbinsdale, Minn.-based North Memorial Health, said being grouped under an umbrella term can make clinicians feel their education was minimized.
“It could diminish value for sure,” she said. “Especially when things get boiled down to data points, it can feel very easily that we’re lost in the shuffle.”
‘I’m just a nurse’
The title debate also points to a broader hierarchy in healthcare, Ms. Appleton said. Nurses, she said, are “infamous for diminishing their own contribution,” and she has done it herself.
“You know that phrasing of, ‘Well, I’m just a nurse,'” she said. “I’ve worked hard for my career as well. And I shouldn’t be diminishing my own contribution to the team, and nor should anybody else.”
For Dr. Duggan, the fix is simple, even if it takes a few more words.
“Everybody’s worked hard to earn these roles and titles,” she said. “The physicians and advanced practice providers are not considered interchangeable, and they don’t feel that way. So we owe it to them to really take a second to recognize who they are and what they do.”
