Why Christians shouldn’t refer to physicians as “providers”
Our medical institutions serve a different purpose than the calling I signed up for - a purpose very much in conflict with a Christian anthropology. The language they use reflects what they value.
Within a few years of finishing my medical training and entering into practice in 1991, the term “provider” slowly started to enter into our medical vernacular, and has increasingly been accepted by the broader culture over the past two decades.
According to Grok, the term gained momentum as healthcare became more bureaucratized. Managed care organizations used "provider" to refer to any individual or entity (e.g., hospitals, clinics) contracted to deliver services, emphasizing cost control over professional distinctions. In the 1990s, use of the term became more entrenched in policy documents, medical literature, and insurance contracts. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 used "healthcare provider" to describe entities handling patient data. Grok notes the term aligned with the business-oriented view of healthcare, where services are commodified, and it simplified contracts and regulations.
For me, the term “provider” was as annoying as fingernails on a chalkboard - a better analogy for younger generations of the irritation it provokes would be prompts to update your password on apps and websites you depend upon that reject whatever you enter because they’re insufficiently short or fail to include sufficient numbers of upper and lower case letters, numbers and special symbols. I found the term incredibly demeaning. Pursuing a medical education is incredibly challenging - intellectually, physically and emotionally. There are now labor laws in place to protect medical residents, but 100 hour work weeks were common early in my residency, and my first “day off” was scheduled after 42 consecutive days of work. I earned the right to be referred to as “Doctor.” Physicians also bear a significantly greater sense of responsibility as a byproduct of the quality and intensity of our training and the oath we take upon graduation from medical school to a profession, calling and trust that has endured since prior to the time of Christ’s earthly ministry.
I’ve come to recognize in recent years that the language used by healthcare institutions has a larger purpose. Much in the same way that the use of one’s “pronouns” in e-mail signatures and social media represents a tool for changing how people think about gender, the language used by persons in positions of power in medicine, the insurance industry and government is intended to advance a very specific agenda. One example of trying to reshape perceptions through language - use of the term “reproductive healthcare” in support of abortion rights. In a similar fashion, the use of the term “provider” is intended to convey a fundamental shift in the way our medical institutions define and understand the purpose of health care.
I would encourage anyone with an interest in medicine, medical ethics and disability to read Dr. Farr Curlin’s book The Way of Medicine. Dr. Curlin is a hospice and palliative care physician and medical ethicist on faculty at the Duke University School of Medicine and Duke Divinity School. The central argument of his book is that the historic purpose of the medical profession has been the promotion of health, but in recent decades, the institutions of medicine have embraced a radical new paradigm regarding the purposes of medicine, fundamentally different in ethical underpinnings than the traditions that have guided the field for two millennia, and a direct challenge to Biblical anthropology and ethics. Central to this new paradigm is the reframing of the physician role as a “provider or services.”
In this “Provider of Service” model, medical practice is dominated by a consumerist understanding in which “well-being” is associated with facilitating the patient’s personal autonomy and desires. From The Way of Medicine:
Every culture gets the medical practice it deserves, and in our culture medical practice is dominated by a consumerist understanding, where well-being is understood in terms of the patient’s desires being satisfied… In the context of an individualist and consumerist environment, however, these efforts all tend to default to three norms: what the law permits, what is technologically possible, and what the patient wants.
Thus, for the provider of services model, if an intervention is permitted by law, technologically possible, and autonomously desired by the patient, then medical practitioners should provide the intervention. Indeed, they may be professionally obligated to do so.
One does not knowingly do violence to the unconsenting innocent, to be sure. But within the boundaries of law and consent, what is technically possible is ethically permissible. That which is permissible and also desired may even be ethically obligatory. Medical ethics reduces to a set of procedures for negotiating noninterference with patients’ wishes to the greatest possible extent. Medicine itself devolves into a powerful set of means to be used to satisfy the preferences and desires of those who are authorized, legally and procedurally, to choose.
Among the many consequences of the provider of services model, the following three loom. First, professional authority has steadily eroded. If there is no objective standard or end for medicine, then physician expertise is merely technical. Thus, instead of exercising the authority of expertise within a sphere constituted by their professional commitments, physicians become increasingly subject to the exercise of power by lobbyists and political advocacy groups. Medical professionals come to work in a highly regulated domain in which the exercise of clinical judgment and prudence is neither possible nor desirable.
Finally, when medicine is understood as the provision of health-care services, the physician’s judgment—and particularly the physician’s claims of conscience—come to be seen in competition with the fundamental, but minimal, norms of the profession. The exercise of physician conscience is treated as the intrusion of “private” or “personal” concerns into transactions that should be governed by physicians’ professional commitment to provide legally permitted services to patients who request those services.
Here’s a way of contrasting the expectations of a physician as opposed to a provider:
A physician bears responsibility for exercising their knowledge, skills and experience for the purpose of promoting the health of their patient in accordance with four established principles of medical ethics.
Autonomy: Respecting the patient's right to make informed decisions about their own healthcare.
Beneficence: Doing good for the patient and promoting their well-being.
Non-maleficence: Avoiding harm to the patient.
Justice: Distributing healthcare resources fairly and equitably
In contrast, a provider is obligated to facilitate the wishes of their patients, as long as their request is legal and technologically feasible. This understanding helps one to make sense of positions and practices endorsed by the leadership of our medical institutions that, on the surface appear utterly antithetical to how we have historically understood the purpose of medicine.
The insistence of the American College of Obstetrics and Gynecology that it’s a duty to facilitate the wishes of patients seeking abortions, and the willingness of medical journals to advocate for a right to “after-birth abortion.”
The declaration by the Ontario Medical Society that physicians who refuse to participate in “MAID” - killing patients who request their assistance in committing suicide, or referring them to colleagues who will facilitate their requests, are committing ethical violations that should jeopardize their licensure. Canada now has a professional association of physicians (Canadian Association of MaiD Assisters and Providers) for whom euthanasia represents a significant component of their practice, who refer to each incident in which they administer lethal drugs to patient as “provisions.”
How a child psychiatrist internationally renowned for his research in adolescent depression can be a leading advocate in the Canadian parliament for extending the right to physician assisted suicide to minors, and persons of all ages suffering the effects of mental illness.
The universal support in our leading pediatric hospitals for the administration of puberty-blockers, cross-sex hormones, and in selected cases, surgical intervention in the guise of providing “gender affirming care” for youth with gender dysphoria, in the absence of any high-quality evidence supporting the long-term safety or effectiveness of these treatments.
Those who use the language are facilitating the agenda behind the language. If you support the aims of the gender revolution, include your pronouns on your LinkedIn profile. If you support this new understanding and ethical framework for healthcare, keep referring to the people who you turn to for medical care as “providers.” But if the new framework is antithetical to your understanding of right and wrong and what it means to “love your neighbor,” reject the paradigm and the language designed to promote acceptance of the paradigm.
In my upcoming posts, we’ll do a deeper dive into the implications of the efforts amongst our medical, political and institutional elites to redefine the purposes of healthcare.