A Team Effort?>
Be Well

A Team Effort

by John Swartzberg, M.D.  

A registered nurse, Pamela Ching-Bunge, wrote to us recently to complain about the way we always say "talk to your doctor" and "see your doctor" in articles.

"Wouldn't it be more appropriate to use the term 'health care provider,' since many people today use physician assistants or nurse practitioners (and other professionals) as primary care providers?" she asked. "It seems out of touch and perhaps inadvertently demeaning to nonphysician providers that you only use the term 'doctor'. . . Please take off your blinders to the 21st century: health care delivery is changing."

She makes a good point. When we say "consult your doctor," we mean "contact your doctor's office," where you'll usually be treated by a team of professionals. We've avoided using "health care provider" because it sounds clunky and impersonal and could even be taken to include, say, naturopaths and faith healers. What's more, we've always tried to write in a concise but colloquial style, and very few people would say, "I'm going to see my health care provider."

When we say "doctor," we certainly don't mean to show disrespect for nonphysician medical professionals. Nurse practitioners and physician assistants are trained to diagnose and treat patients and prescribe medication, usually under the general supervision of a physician. (In 18 states, nurse practitioners can practice independently.) Their numbers are growing, fortunately, since there's a shortage of primary care doctors, which will only worsen when the Affordable Care Act allows millions more Americans to get health care coverage. In particular, nurse practitioners are invaluable in rural areas, where there are few doctors, and for other underserved populations.

During my 25 years in practice, I always had great experiences working with nurse practitioners and physician assistants. They're a boon to both patients and doctors. Research shows that patients usually do as well when treated by these professionals as by physicians. Plus, they deliver health care at lower cost than doctors and help make medical offices and hospitals function more efficiently. Nurse practitioners and physician assistants usually spend more time with patients than doctors can. Partly because of that, they tend to be better at providing advice about how to stay well and how to treat chronic conditions (like diabetes or obesity) with lifestyle changes. The ones I worked with were as good as the best physicians at diagnosing common problems like upper respiratory infections, bronchitis, and urinary tract infections. Just as important, they were trained to recognize the things they did not know, when they had to call in a physician. On top of this, they almost always had a wonderful bedside manner, and my patients loved seeing them.

Going forward, we'll use "health care provider" more often. But when we do still say "consult your doctor," we mean "your health care team."