This has never happened to me in the hospital. I think, generally, patients see so many providers we all start to run together, and I'm probably mistaken for a physician a lot. Plus, if I'm consulted for a patient in the ER or ICU, they likely don't care what provider I am as long as I can take care of them. And in clinic, when patients schedule, they are well aware they are seeing the NP. If they have questions about what a NP is the office staff has a spiel they give. This is also posted in each exam room. Honestly, it's never been a problem.