How do you feel about the term mid-level provider?

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**If I am a "mid-level", then I would guess the doctor is a high-level. Then who is the low-level??
**My name is Cindy, I do not answer to Betty or Georgia. I am a nurse practitioner, not a dietician or a "mid-level".
The term mid-level provider is appropriate for distinguishing MDs from NP/PAs. It is the same argument that is being brought up with the integration of Doctorate Nurse Practitioners. Calling them Dr.s is misleading.
doctor
I have been a practicing PA for nearly 10 years, working in emergency medicine and urgent care settings . The term "Mid-Level" has been used at the ED in which I worked and now in the urgent care center in which I am a partner. We currently have both NP's and PA's working in our office. It is my opinion that the term is used appropriately when referring to both NP's and PA's as a whole and when there is a need to differentiate us from the physicians. However, when referring to a specific individual, or if a facility uses only one type of mid-level, I feel it would be more appropriate (and respectful) to refer to them as NP's or as PA's.
Advanced Practice Providers
I believe the term providers is also offensive and confusing. We need to appropriately identify, verbally and on paper our specific credentials which reflect our level of training so that the patient is fully aware of the level of training that the individual caring for them has achieved. It is also helpful to others involved in the care of the patient to know the credentials of the medical personal they are speaking with.
I have been a PA for sixteen years. I do not care what I am called. We are what we are. A term has nothing to do with what we do or the quality of care we give. Instead of worrying about titles we should worry about more important things like taking good care of our patients.
The term "mid-level" can't possibly sound positive to patients. What do they deem "lower-level..." your RN's, MA's...most definitely they are not!
One of the other terms I have thought would be appropriate is Physician Associate, same initials but more likened to the actual practice relationship.
The are mid-level providers why get mad about it?
As a Nurse Practitioner who is working towards a Doctor of Nursing Practice degree; I can say without any reservation that I have never harbored any desire to attend medical school, nor was I "too lazy" to "put the time in". The four years of graduate work necessary to complete the program topped off by a 12 month residency cripples that theory. As a professional health care provider I consider myself fortunate to be a part of a collaborative group that includes Registered Nurses, Physician Assistants, Nurse Practitioners, DNP's and physicians. This entire group is responsible for the provision of care to our patient populations and this should be remain our focus. Mutual respect and understanding of each others roles are of utmost importance to our staff and I am thankful that I practice in an environment such as this. The term Mid Level Provider suggests middle of the road care, (this is a sentiment I have heard from a number of patients who have commented after hearing the term) - and I believe this belies what we all hope to achieve - which is to provide the highest quality of care to our patients.
I feel that the term mid-level provider is all inclusive of nurse practitioners and physician assistants and allows an easy reference to both disciplines.
I am a duly certified Advanced Practice Nurse Practitioner. I provide a level of service comparable to other health care providers I work with and according to the prevaling standard of care. I am not a physician but neither am I "less than", which is what the
term implies to the public.
Mid-level does not bother me. I use "provider" most frequently.
It's not about the provider, it's about what the patient understands.
They are providers. Calling them "mid level" especially in front of patients, might make them feel insecure regarding the quality of care.
I do not think mid-level provider is offensive but Advanced Practice Clinician may be less offensive to those that have the credentials. Patients may be less confused as well.
We as mid-levels play a role in the health-care system. We are exactly that, a level that is above the basic assessment skills and scope of a Nurse but have not been through the training and testing to be equal to the Physician. It is this sense of entitlement and overconfidence that will get some of our peers into situations from which they cannot recover. Accept your role in the medical machine; if you need titles to feel important and elite, then go to medical school.
I struggle with this. As a physician, I do believe my 4 years of college, 4 years of Medical School and 5 years of Residency do add to my expertise above someone with 4 years of college and 2-3 years of additional training. However, I do not wish to insult my APRN and PA colleagues whom I do respect and value.
PAs and NPs are required to complete extensive medical education and training as well as successful completion of board certification examinations in order to obtain licensure to practice as medical professionals. Hence. As duly licensed medical practitioners within the state's where they work, they shod be referred to as clinicians because that is, in fact, the role they play within the health care system. Other terms are too ambiguous and lead to confusion on behalf of patients in my experience.
How 'bout their name...
From all of the NP's that I personally know, they are always offended about terms used to describe us. NP's in my opinion want to be called Doctor, but don't want to go to medical school. They had approx. 500 clinical hours for their NP, 300-400 for their DNP and as I reflect back when I went to paramedic school in the late 70's I had 1200 clinical hours and had to ride with another medic for an additional 6 months before I was turned loose. As a Physician Assistant, I did just under 8000 clinical hours to become a PA. I have a son that is in Medical School and I am proud to be called a PA, Mid-Level, or Phillip, our medical provider because I am confident in my role as a medical provider. I have a former employeer, who is now doing an ONLINE Nurse Practitioner Program and is only required to perform 245 clinical hours and they are ready to write scheduled 2-5 drugs and treat patients, which is very scary to me. He will do as nurses do...write lots of care plans.lol
I believe the term "mid-level" suggests less than FULL level. All three groups (ARNP, PA, MD) have knowledge, skills and strengths that we bring to patient care. One is not a replacement for the other, nor is one better than the other. We work together to bring personalized, thorough, life-enhancing care to those who place their trust in us.
Really what is a mid-level? We see the patient as any provider and prescribe as a provider. Our rx does not say mid level. Mud-level sounds like we are beneath them.
The general public does not understand either term very well. In our state, they are treated equally in terms of privledges and responsibilities, so it makes sense to call them the same thing. We also refer to them along with the physicians as "providers."
Is this really a debate? Of course they are mid levels. If they have a problem with that there is always medical school.
It's a meaningless, offensive term that had to have been invented by some soulless healthcare executive committee. I felt that way from the first time in encountered the phrase as a PA student 20 some yrs ago in a hospital setting. It's got to go!!
As a PA I have no problem being called a midlevel
I certainly do not claim to have the perfect answer to this conundrum, but any title should not be offensive unless duly earned. This has always confused me...to who are Mid-Levels "Mid” to? In addition, if physicians are on one end of the spectrum containing “Mid”, then I guess we should refer to physicians as "High-Level Providers". We mustn't stop there, the specialists who--without a doubt--consider themselves as providing a "Higher" level of care, should be called “Highest-Level Provider". But wait, then we have sub-specialists...were does it stop? Now let's consider Non-Physician Provider (NPP), yes it is an accurate description, but it’s not very descriptive. I guess we should call everyone by what they are not: Non-Nurse, Non-Cardiologist, see my point? Every time the term NPP is used in a conversation, I always respond by saying Non-PA/Non-NP Provider when referring to physicians...it sounds quite silly when the table is turned. The term Clinician works but not it's very descriptive or specific. I agree that a patient should know if they are seeing a physician, PA, NP, or whatever kind of professional that is caring for them and that the professional providing care—because that is what all have in common—is responsible to inform them to the fullest extent needed for the patient to be informed. Since most laypersons think when someone is practicing medicine, in the traditional sense, that they are a physician—albeit the newer professions are rapidly changing this awareness—the onus, in my opinion, is placed upon the ones creating the confusion (newer care providers) to ensure that every patient has a clear understanding of who is caring for them. Advanced Practice Clinician (APC) comes with the same issues as Mid-Level...so is an APC a more advanced clinician than a physician clinician…?

Way too confusing for everyone when care is so fragmented as it is now!
I don't believe that "mid-level" is offensive. However, because some NPs and PAs don't like the term I tend to refer to them as advanced practitioners, non-physician providers or clinicians.
John Jurica, MD, MPH, CPE
Mid level provider is a demeaning term, none of the care we provide is "mid level". If NOs and PAs are "midlevels", does that make RNs low level? What about moonlighting residents? If physicians lack the maturity and verbal skills to address me as a NP, it is truly them who are not only low level providers, but low lifes as well.
I think that this is totally absurd... 1)why would the term be offensive to anyone
2)what should they be called if not mid-levels...there seems to be an undertone in that world, that everyone should be called the samething (ie health care providers).
3)we are already treading on thin ice with calling DNP's "doctor" which is very misleading to patients.
Non physician provider
Advance Practice Providers.
lots of sensitivities here. Some NP take offense at the term Advanced Practice for the PAs. They carved out the APP or APC terminology to distinguish themselves from the other RNs
I am not personally offered by the term "mid leve" but I have to admit advanced practice clinician sounds better.
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