The authors of the American College of Physicians (ACP) paper began by citing a source from 1999 that said the commercialization of healthcare would lead to a weakening of a medical caregiver’s ability to practice in accordance with standards of medical ethics and professionalism, calling it “deprofessionalization.” Referring to physicians as providers undermines their ethical obligations, clinical integrity, accountability, and trust with patients, they argued. How does terminology affect the perception of physicians and O&P professionals?
The ACP paper addresses the effects—intentional or not—that word choice in healthcare can have, asking, “Has language helped cause these shifts, is language a result of them, or are both true?”
“Provider” can have a cold, institutional feel, which fits its use by the Centers for Medicare & Medicaid Services (CMS). CMS defines a provider as a healthcare professional or facility (hospital, clinic) that has a formal agreement with CMS to provide services to beneficiaries; a clinician is a healthcare professional qualified in the clinical practice of medicine. Using provider in this sense may be an efficient way to identify many kinds of participants in the healthcare system, but it lumps inanimate objects in with human caregivers, which is what the ACP paper authors, and the 26-year-old source, warned against.
In O&P, two ongoing and overlapping topics focus on word choice: separating O&P from durable medical equipment in Medicare’s durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) classification category; and continuing to emphasize the skills required to meet the needs of O&P patients. DME items can be literally supplied, an oxygen tank or crutches, for example, whereas O&P patient care requires extensive education and training. If language matters, what does O&P’s inclusion with DME say to patients? To payers? To other healthcare markets?
Scott Williamson wrote in a Sifted column last year that O&P professionals are still fighting the term vendor that “reinforce[s] the uninformed belief that a device is a device and all you really need is a vending machine,” he wrote. “Will that be a small, medium, or large, ma’am?” The terms provider and vendor may be different sides of the same coin and worth consideration when discussing the status and evolution of the O&P profession.
To read the open-access paper, “Physicians are not providers: The ethical significance of names in health care,” which was developed by the American College of Physicians’ Professionalism and Human Rights Committee, visit the Annals of Internal Medicine.
To read “Device vendors and patient care,” visit The O&P EDGE.
