Eliminating the Term Primary Care “Provider”: Consequences of Language for the Future of Primary Care

open access
  Published online March 31, 2016. doi:10.1001/jama.2016.2329

 The term “provider” first appeared in the modern health care lexicon as a shorthand referring to delivery entities such as group practices, hospitals, and networks. More recently, its use has expanded to encompass physicians, nurse practitioners (NPs), physician assistants (PAs), and perhaps others, especially those engaged in delivery of primary care.¹ On one level, this expansion is both logical and convenient, as it reflects the importance of a multidisciplinary approach to modern primary care delivery, extending beyond the traditional dyad of patient and physician.^2- 4 Being designated as a “primary care provider” also denotes qualifying for payment of services rendered,¹ a designation long sought and highly valued by advanced-practice nurses and PAs.³ Although useful in these contexts, the term “provider” has the potential for adverse consequences for primary care, calling into question the wisdom of its expanded use.

From the patient’s perspective, getting to the right primary care team member becomes problematic if all practitioners are indistinguishably designated as “providers,” which implies they are interchangeable. The term obscures their differences in depth and breadth of training, knowledge, and clinical experience as well as the particular and often unique contributions they make to a team-based effort. In well-structured, high-performance primary care practices such as the patient-centered medical home,⁴ care is taken to define and communicate the roles and responsibilities of team members according to their specific competencies.....