Hitting a Nerve

Gatekeeper, provider, HCP: The slow degradation of the doctor title


 

References

What’s in a name? A lot, if you’re a doctor.

"Doctor" is our formal title, although technically it means anyone with a higher educational degree. We’re also called physicians, or healers. In other times, we may have been medicine men, witch doctors, or shamans. Or we may prefer a more specific name based on our chosen field: neurologist, internist, or surgeon, for example.

Recently, though, we’ve had specific (and less flattering) names hung on us – health care providers, primary care physicians, gatekeepers – not to mention the alphabet soup that longer names bring (HCP, PCP).

It kind of puts us in a semantic identity crisis. Especially with all the HCPs out there who aren’t MDs or DOs.

But no matter what title they hang on me, I know what I do. I care for people who need me. I provide treatment for those I can help and support to those I can’t. I hold hands. I write prescriptions. I discuss test results. I talk, and I listen. I fill out forms. I argue with insurance companies. I go home each night and in the morning come back and do it all over again.

Somehow saying I’m an HCP doesn’t seem to do the job description justice.

I remember a residency meeting I attended in the mid-90s. I was in training, and the meeting was held to introduce all the residents to the hospital’s new health plan. The insurance lady running it told us not to use the word "patients" but instead call them "lives." Doctors, in her doublespeak, were "providers" unless you were in internal medicine or family practice, in which case you had the even less flattering name of "gatekeeper."

The meeting got increasingly acrimonious, and the insurance lady looked more and more uncomfortable. Finally, a family practice resident named Barb stood up and said, "You can change words all you want, but here’s the truth. We are not providers, or PCPs, or gatekeepers. We are doctors. And we do our best to care for people, even when your company won’t."

Barb stood up, turned on her heel, and walked out with her long skirt swirling. The insurance company lady was obviously angry and left through the exit behind her.

It’s now 20 years later, Barb, and I don’t think anyone could have said it better, then or now. It still holds true.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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