New terminology has cropped up over the past few years, seemingly coined by the insurance industry. I am no longer a doctor or a physician, but am now regarded as a health care provider. Patients are no longer patients—but are now called consumers. These are cold, generic, and impersonal terms that I loathe.
I am a medical doctor whose job is to take care of patients. As a physician, I am not a wizard, a miracle worker, or a deity. I cannot magically fix all the aches and the pains, traumas and tribulations, and conditions—both benign and malignant—that plague mankind. I am simply a human being, imperfect and fallible, who gives my best effort to promote good health and manage illness.
One of the most enjoyable aspects of my medical practice is the meaningful relationship that I have developed over the years with many of my patients. Engaging their trust and respect through our interactions—central to our relationship—is one of the most satisfying aspects of being a physician. They have shared much personal information with me and have given me a wealth of knowledge that is not to be found in any medical textbook, journal or hospital grand rounds.
The term provider brings to mind Star Trek characters—the three non-humanoid beings who controlled the planet Triskelion, appearing as disembodied brains contained in a device giving them life support and communication abilities. Captain Kirk and his crewmates were brought to this planet to fight as gladiators to entertain these Providers, who gambled on the fights.
I am NOT a provider to consumers, but a doctor to my patients! What is the problem with the terms doctor and patient anyway? Doctor is a very meaningful word—derived from docere, meaning “to teach”—insofar as patient education is so fundamental to the health care process. Patient is derived from patiens, meaning “bearing an affliction.” Terms like provider and consumer ignore the humanistic, emotional and psychological aspects of the doctor-patient relationship and diminish the professionalism that is the foundation of this relationship. The term provider seems to suggest that medical doctors are interchangeable cogs in a wheel.
Clearly, the “industrialization,” “corporatization,” and “commoditization” of medicine has engendered this new terminology. Medicine has become a business, and insurance companies now view relationships between doctors and patients as commercial transactions. Unquestionably, there has to be a financial aspect to medicine, but the practice of medicine goes way beyond economics. Over the course of day-to-day interactions with patients—whether in the office or operating room—the last thing on my mind is the “business” aspect of medicine. I am focused on the basics of primum non nocere (first doing no harm) and the act of doing “good” for my patients.
Consumer and provider are demeaning terms for both patient and doctor. They disregard the essence of medical practice—the warm, meaningful, humanistic and caring relationship between doctors and patients that transcends both the science and business of medicine.
Andrew Siegel, M.D.
October 29, 2011
“The New Language of Medicine,” written by Pamela Hartzband, M.D. and Jerome Groopman, M.D.
N ENGL J MED 365;15 October 13, 2011