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"Primary care provider" -- the poor phrase never gets a break

5/3/2016

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It's time for another essay about how the term "primary care provider" elides important differences between MDs, APNs, and PAs, and the phrase is a new foreign import from the bean-counters and box-checkers.

The first point I sort of agree with. Lumping categories does elide differences. The question is whether they elide *important* differences. In common conditions and much primary care, what matters more is not diagnostic expertise but longitudinal care and communicative approach. And literature shows that NP and MD care can be equivalent in such situations.

The second point is just wrong. The phrase "primary care provider" is 40 years old.

Why this piece, which does not cite the literature comparing NP and MD primary care? I think it's not about terminology but about status anxiety. As doctor-led care moves to team-based care (and, concurrently, to shared decision making), physicians have to decide what their new role is. This can be nerve-wracking. But it can provide an opportunity for open and evidence-based discussions about what primary care really means, without depending on a "recency illusion" that terms are new, or nurse practitioners are interlopers, when neither is the case. 

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    The author of Talking To Your Doctor and Making Sense of Medicine blogs about the books, shared decision making, doctor-patient communication, and the redeemable imperfections of healthcare.

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