The language of healthcare often feels like it’s designed to confuse people, healthcare providers and patients alike. There are so many terms you throw out on a daily basis that patients don’t understand — not to mention you probably use terms to refer to yourself that you might not realize can hold you back professionally.
Dr. Nancy Dirubbo, FNP, fellow in the American Association of Nurse Practitioners and founder of Beacon Continuing Education, wrote about this topic recently for the AANP’s journal in an article called “Words Matter.” She sat down with Florence Health to discuss which terms she believes are the most problematic for HCPs and shared how you can revise your language to help your patients — and yourself.
1. “Independent practice.”
According to Dirubbo, the idea that any clinician can practice totally independently is false. “There’s not one person in healthcare now that can deliver all the care a patient needs,” she says, adding the correct term should be “autonomous practice … NPs want to be self-directed, autonomous and practice based on our education.”
NPs and PAs are often referred to as “mid-level” providers because they don’t have the same authority as doctors. Dirubbo explains this is a misnomer because it “makes the assumption that everyone is on the same continuum” with the endpoint being an MD. In reality, though, NPs have achieved the full scope of practice for nurses, and PAs aren’t just aspiring physicians. “It means to patients that you’re not complete whole,” Dirubbo explains. Instead of finding a replacement word, challenge whomever you hear using it.
3. “Provider,” “hospitalist” or any generic term that requires explanation — without explanation.
Because this is such a wide umbrella of terms, Dirubbo’s not suggesting you cut these from your vocabulary. But you should ask your patients if they understant what the titles you use mean. “So many types of professionals can be providers,” Dirubbo says. “The public isn’t always tuned in to all the different flavors of healthcare. Spend a few seconds with patients who don’t know you and say who or what you are.”
4. “Doctor” to refer only to physicians.
Again, this is a problem with generic terminology, Dirubbo says, because many NPs and PAs have earned a doctoral degree. “Physicians have always had this ownership of the term … and people argue that it’s confusing to patients [to call non-physicians ‘doctors’],” she explains. “A patient has a right to know what education their providers have, and what’s most important is that patients understand your role.”
5. “Entrepreneur” to refer to NPs who’ve started their own practice.
Dirubbo believes this terminology implies a degree of risk that isn’t there because entrepreneurs are trying out a novel idea that hasn’t been tested. On the other hand, “an NP who wants to open a primary care practice, urgent care center, house call practice, cosmetic practice, mental health practice, or health coaching practice is a small business owner,” she explains. The model for this type of business exists — and it works.
To Dirubbo, this common term for emotional fatigue from your work suggests that something’s wrong with the people experiencing it or that they are unable to recover. Dirubbo prefers the term “moral injury.” Other experts in this space use the term “compassion fatigue.”
It’s not easy to rethink language constantly, Dirubbo concedes, but doing so is crucial. As Dirubbo explains it, if you don’t advocate for your own professional worth and all the ways your skills benefit society, then who will?
Words Matter, Journal of The American Association of Nurse Practitioners.
Last updated on 10/3/19.