Richard Feldman
Not uncommonly when my patients are seen, for example, at a specialist’s office or urgent care clinic, they return to my office confused about specifically who provided their care.
I inquire, “So, did you see a physician? Or might it have been a physician assistant or nurse practitioner?”
“Well doc, I’m not exactly sure. The person looked like a doctor.”
The above scenario is disturbing. It should be made perfectly clear to patients who is providing their medical care. Patients can make their best-informed health-care decisions when this occurs. And as a family physician, I can better evaluate the care delivered and the medical decisions made when I know the credentials of the health professional. I’m not saying that patients cannot get high quality medical care from a variety of providers. But there is a difference among providers — especially compared to physicians — in experience, education and training, depth of knowledge, and amount of clinical experience.
Today, there exists a multiplicity of health professionals extending care to patients. And there are various clinical settings from which a patient can choose — retail and urgent care clinics, physician offices, health-care centers, emergency departments, and now virtually through telemedicine. Ideally, health care should be delivered utilizing a physician-led team maximizing the skills of every member including physician assistants, nurse practitioners (APRNs), nurses, pharmacists, and psychologists; each adds to the collective quality of care provided.
A recent study found only half of patients surveyed felt it’s easy to identify who is a physician and who is not by reading marketing materials regarding services offered, their title, licensing credentials, and other qualifications.
In the clinical encounter, the same confusion is prevalent because the type of health professional performing the service is not always clearly disclosed. One in four Hoosiers are not sure if their regular provider is a physician. Eighty-five percent believe that it is important to know the training and education of their health-care provider.
Indiana physician professional groups have formed the Indiana Physician Coalition coordinated by the Indiana State Medical Association to address this uncertainty through public engagement and education as well as legislatively with lawmakers.
The Coalition seeks legislation (HB1113, SB239) this session of the General Assembly to ensure greater clarity and transparency in the identification of providers. Marketing and advertising materials for medical services should clearly and prominently disclose the provider’s license type (physician, nurse practitioner, physician assistant, chiropractor, optometrist, dentist, podiatrist, etc.). All providers should also be identified by prominent posting in the office or clinic setting stating their license type. Providers engaged in direct patient care should wear a badge displaying their license type and if they are still in training. If the title “Doctor” is used, it should be coupled with the license type. Further changes in statute are necessary to reserve physician specialist designations such as dermatologist, cardiologist, endocrinologist, or anesthesiologist only for physicians (M.D.s and D.O.s)
Physician assistants and nurse practitioners can earn academic doctorate degrees. But they should be prohibited from simply utilizing the title of “Doctor” when they introduce themselves to patients during the clinical encounter. Patients particularly confuse nurse practitioners and physician assistants for physicians. As soon as patients hear the word “doctor”, they commonly assume that the person is a physician.
This proposed legislation respects all members of the health-care team and the vital roles they play in providing the best quality care possible to Hoosiers while providing enhanced transparency to patients.
