Provider - the origins of this word and how we must remove it in medicine.
Why we should remove this term "provider" from our medical vernacular. Looking through a different lens let us undress this term.
The word "provider" originates from Latin, and its development can be traced through several linguistic stages:
Etymology of "Provider"
Latin Root:
Verb: prōvidēre
Meaning: "to foresee, to provide for"
prō- = "before"
vidēre = "to see"
So, prōvidēre literally meant "to see ahead" or "to look out for in advance."
Late Latin to Old French:
From Latin prōvidēre came the Late Latin providere, which was adopted into Old French as provider or pourvoir, with meanings like "to supply" or "to furnish."
Middle English:
Entered English in the late Middle Ages (14th–15th century) as "provide" (verb), meaning to supply or make available.
Modern English – Noun Form:
The noun "provider" (someone who provides) emerged in English in the early 17th century.
Originally referred to someone who furnishes or supplies something (like food, services, medical care, or necessities).
By the 19th and 20th centuries, it also took on more figurative meanings, such as a breadwinner or someone who financially supports a family.
In modern times, it's also used in technical contexts: "service provider," "healthcare provider," etc.
It is the healthcare provider that I have issues with and we will explore.
Summary:
Provider = from Latin prōvidēre = "to see ahead"
Noun form first recorded in early 1600s
Originally meant someone who supplies/furnishes necessities
Evolved to include financial supporters and professional/technical service roles
The word "provider" itself has no inherent or historical connection to Nazism
Misuse or Propaganda Use in Nazi Germany
The Nazi regime did often portray the state or Hitler himself as the "provider" of stability, jobs, and national pride. Nazi socialist propaganda framed Hitler as the "father" or "provider" of the German people, reinforcing a paternalistic image.
In this sense, the concept of a provider was co-opted in state propaganda.
Possible Connection
In Nazi Germany to distinguish gentile German doctors from those who take care of the Jewish population or are Jewish doctors themselves, the regime gave those doctors a new name/title.
Ancient Origins (Prehistoric – ~500 BCE)
Healers and Shamans:
In prehistoric societies, healing was often the responsibility of shamans, spiritual leaders, or tribal elders. They combined spiritual rituals with rudimentary herbal medicine and physical treatments (like bone setting or wound care).Ancient Civilizations:
Egyptians had medical papyri (like the Edwin Smith Papyrus) documenting surgical and medicinal practices. "Swnw" were early physicians.
India's Ayurveda system (around 1500 BCE) described organized medical theory and practice.
China’s Traditional Medicine emerged with early texts like the Huangdi Neijing (~2nd century BCE).
In Mesopotamia, temple-based healers used spells and drugs together.
Classical Antiquity (~500 BCE – 500 CE)
Hippocrates (Greece): Often called the "Father of Medicine," he promoted observation-based diagnosis and ethical medical practice (Hippocratic Oath).
Roman Medicine:
Built on Greek traditions.
Had military medics and public health systems.
Galen advanced anatomy and physiology through dissection.
Medieval Period (500 – 1500 CE)
Religious Institutions:
Monasteries preserved medical knowledge and provided basic care.
Hospitals emerged, often run by monks or nuns.
Physician-Surgeon Divide:
Physicians were often university-educated (focused on theory, diagnosis).
Surgeons and barber-surgeons performed manual treatments and surgeries, considered lower status.
Renaissance to Enlightenment (1500 – 1800)
Scientific Advancements:
Vesalius revolutionized anatomy through dissection.
Paracelsus introduced chemical medicine.
Growing emphasis on evidence and observation.
Formalization of Roles:
Medical schools trained physicians.
Licensing and professional standards began to emerge.
Modern Era (1800 – Present)
19th Century:
Germ theory (Pasteur, Koch) reshaped understanding of disease.
Rise of hospitals as centers of care and training.
Formal nursing profession emerged (Florence Nightingale).
20th Century:
Specialization of providers (e.g., cardiologists, anesthesiologists).
Licensing bodies and medical associations (e.g., AMA).
Rise of nurse practitioners, physician assistants, and allied health providers.
21st Century:
Expansion of provider roles (telemedicine, AI-assisted care).
Focus on interdisciplinary teams: physicians, nurses, therapists, pharmacists, etc.
Global recognition of diverse types of medical providers, not just doctors.
In Summary
The medical provider evolved from tribal healers and priest-physicians into a wide variety of trained professionals today, including:
Physicians (MDs/DOs)
Nurse Practitioners (NPs)
Physician Assistants (PAs)
Nurses
Therapists (PTs, OTs)
Pharmacists
Allied health professionals
In Nazi Germany, the term "provider" (originally the German word Krankenbehandler) was used to devalue and demote Jewish physicians, who were stripped of their title "Arzt" (doctor) and forced to use this term on their official documents, including signs, letterheads, and prescription pads, often with a Star of David, to indicate they could only treat Jewish patients, a process that preceded their mass deportations and persecution during the Holocaust.
From: Scarff JR. What's in a Name? The Problematic Term "Provider". Fed Pract. 2021 Oct;38(10):446-448. doi: 10.12788/fp.0188. PMID: 34733063; PMCID: PMC8560107.
Health care has been dramatically transformed and influenced by medical and technological advances, insurance companies, state and federal legislation, and medical ethics. Amid these changes, including crises such as the ongoing coronavirus pandemic, earning the trust of patients to care for their mental and physical health remains a priority and a privilege.
It is troubling that federal health care agencies, in addition to hospitals, clinics, pharmacies, insurance companies, and administrators, often use the term provider when referring to clinicians on the multidisciplinary health care treatment team, which has become the predominant model for health care delivery. The word provider does not originate in the health care arena but from the world of commerce and contains no reference to professionalism or therapeutic relationships.1 Therefore, it should be replaced with more appropriate terminology that acknowledges clinicians’ roles and expertise and values our unique relationship with patients.
WHY IS PROVIDER A PROBLEM?
First, the origin of the term provider is deplorable. During its ascent to power in the 1930s, the Nazi Party promoted the devaluation and exclusion of Jews in German society, including the medical community. Due to its eugenics campaign, the Nazi Party first targeted pediatrics, a specialty in which nearly half of its practitioners were Jewish.2 Beginning with female pediatricians, all Jewish physicians were redesignated as Behandler (provider) instead of Arzt (doctor.)2 This is the first documented demeaning of physicians as providers in modern history. Jewish doctors were soon restricted to treating only Jewish patients and were further persecuted during the Holocaust. Knowing this background, what health care organization would use a term once associated with Nazi ideology?3
Second, using provider changes the treatment relationship. The nomenclature shift in the United States also seems to have originated in political and legislative circles. Although the reasons for this shift are unclear, the terminology became more pervasive after the government first used the term provider in Title XIX of the 1965 Social Security Amendments that established Medicare and Medicaid. Paydarfar and Schwartz noted it was used “in the sense of a contractor being paid for delivering any health-related products and services.”4 Ironically, a 1967 medical student health organization grant proposal discussed the role of a patient advocate in facilitating communication between “health care provider and patient.”5 A journalist for the New York Times used the word to describe a 1970 New York Senate debate surrounding the sale of Medicaid bills to collection agencies, but it is unclear whether the senators themselves used the term.6 Provider was later used in the National Health Planning and Resource Development Act of 1974.7
Ultimately, the adaptation of this terminology led to medicine being thought of only as a business, a commoditization of care, and reinforced by referring to patients as consumers, clients, or customers.3 This terminology suggests that the clinician-patient relationship is a commercial transaction based on a market concept where patients are consumers to be serviced.1,8 Emphasis is placed on following algorithms and treating symptoms rather than patients.9 Despite a goal of minimizing cost, a mismatched referral to a provider may actually compromise patient safety and cost-effectiveness due to missed diagnoses or excessive diagnostic testing.10
Treat a SYMPTOM or an ORGAN or body part and not a human being or patient. This was a change from patient to consumer, commercializing this as a transaction for money, not as a humane personal healing relationship. The first steps at dehumanization and making it impersonal.
In addition to government, other nonclinical entities (eg, insurance companies, advocacy groups, pharmaceutical companies and pharmacies) and some clinicians may prefer the generic term provider. Besides health care commoditization, reasons may include convenience, simplifying health care nomenclature, or removing distinctions among health care professionals to reduce costs and/or increase autonomy.
However, our value as health care professionals is not simply what we can “provide.”11 We seek to know patients as people, putting their needs ahead of ours.1 We serve as confidants and advocates and not merely providers of medications, tests, or procedures.11 This personalized nature of health care depends on trust and professionalism rather than dispassionate delivery of commoditized services.1 Using traditional terminology acknowledges the true nature of the treatment relationship—one that is established not on market concepts but on medical ethics of autonomy, justice, beneficence, and nonmaleficence. These principles are at the top of the list when it comes to the Catholic Medical Association (CMA) and also the new Independent Medical Alliance (IMA). Honest Medicine. Truthful and transparent practice of medicine.
Third, provider is inaccurate and potentially disrespectful and harmful. The word doctor is derived from Latin doctus or docere, meaning to teach or instruct—a valued function in our interactions with patients, families, students, and colleagues.12,13 In contrast, provider refers to commercial transactions or the provision of shelter, food, and love within families and communities.1,14 Things must be transformative, not transactional. Transform a sick patient to a well patient.
Although there are no studies assessing the impact of this terminology on individual clinicians, the term provider may have a negative impact on both individual clinicians and on the health care system. Health care professionals may feel they are being disrespected by being portrayed as dispensers of services rather than as individuals.13,15 Furthermore, provider does not acknowledge the specialized training and qualifications of multidisciplinary treatment team members. The historical and theoretical foundation, degrees awarded, and scopes of practice for physicians, physician assistants, nurse practitioners, dentists, psychologists, optometrists, physical therapists, or social workers are different yet valuable, and their expertise and accomplishment should be recognized.
The use of this term has potential for causing moral injury and reduced self-worth, sense of purpose, and meaning in our daily work; this could threaten satisfaction and commitment and lead to demoralization and burnout.1,16 It may impair effective team dynamics, as it makes no reference to professional values and may lead patients and clinicians to place lower value on professionalism and conduct.10 It may negatively impact primary care specialties by propagating the connotation that primary care is simple care and promoting low compensation, lagging recruitment, and diminished respect. 10 Finally, it is detrimental to patients by changing the nature of the relationship and failing to evoke the compassion and support that sick people (that is, patients) need and deserve.3
Last, the use of this term can mislead patients. By law, a health care provider is defined as “a doctor of medicine or osteopathy who is authorized to practice medicine or surgery… or any other person determined by the Secretary [of Labor] to be capable of providing health care services,” which includes podiatrists, dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse-midwives, clinical social workers, and physician assistants.17
When clinicians are categorized as providers rather than by their degrees and roles/responsibilities, patients may assume that all team members have equal training, interchangeable skills, and uniform expertise and knowledge and may conclude they can receive the same level of care from anyone.8,10 Potential for confusion is increased by the nearly ubiquitous white laboratory coat in clinical settings and doctoral degrees attainable in different health care disciplines (eg, medicine, nursing, psychology, pharmacy, physical therapy). Patients deserve to know who does what on the team of professionals who care for them and may not be fully informed when requesting or receiving treatment if they are not provided important information, such as a clinician’s title, training, and scope of practice.8,16
Modern medicine use of “Provider” is dehumanizing and breaks the cherished fiduciary relationship between clinician and patient. This was exaggerated by the implementation of ACA (Obamacare) and continues to ‘‘get in the way’’ of the administration of good quality healthcare.
So, we should not refer to clinical practitioners (MDs, FNPs, etc.) as providers but rather clinicians or practitioners. This is one step towards divorcing ourselves from the nomenclature that carries with it racist, dehumanizing, and hateful ideals.