By Rachael Robertson

Physicians should not be referred to as "providers," according to a new position paper from the American College of Physicians (ACP).

"Language in healthcare has ethical and practical implications. Physicians should be referred to as physicians, not providers," according to the ethics statement, which was developed by the ACP Ethics, Professionalism and Human Rights Committee.

And when describing other professionals who care for patients, "the terms clinicians or healthcare professionals, not providers, should be used," it continued.

The term provider "undermines the physician's ethical obligation, clinical integrity, and accountability, as well as trust in the patient-physician relationship," concluded the statement, which was authored by Lois Snyder Sulmasy, JD, director of the center for ethics and professionalism at ACP, and Jan Carney, MD, MPH, president-elect of ACP.

Sulmasy and Carney noted that use of the term "provider" has been extensively discussed in other published papers, and other professional groups, have advised against the term provider.

Still, its use had not been reviewed through the lens of ethics and professionalism, they noted.

They highlighted several implications of language for care, ethics, and professionalism, including the fact that the use of provider "lumps in impersonal entities with humans," such as institutions and insurers, and "obscures differences in clinical training and expertise."

Also, a physician's duty differs from that of other entities and individuals. The physician-patient relationship "is not transactional but rather relational, with the patient seeking care from a physician who is trained to help and bound by ethical duties to do so," they wrote.

In addition, the term provider "undermines ethics and professionalism," they wrote. While the mission of hospitals was once aligned with the ethical duties of physicians, that has changed, the statement noted. "Altruism and the desire to help people need to be fundamental motivators in this ethical endeavor that is committed to the welfare of patients."

Finally, language affects the perception and value of what's being provided, as well as one's professional sense of self, and can influence behavior. Terms such as "covered lives" and patient "leakage" should be avoided, they noted.

"Patients still want trusted, compassionate relationships and care by humanistic physicians who exercise independent clinical judgment and profess to heal when possible and to comfort always," the statement concluded. "Physicians should strive to fulfill these expectations, and language should recognize and support their individual and collective ethical responsibilities to serve patients."