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Our center uses affiliates which I dislike because it sounds like the greeters at Wal-Mart. We generally use PAs and NPs. The problem with physician extender and mid-level is that they lack definition. As Nomadcrna points out it also implies that the care we give is less than that of a physician. Despite the fact that legally it has to be equivalent. There are also a host of other professions that crowd into the area. For example are WOCNs are obviously not "basic-level" providers (whatever that is). Does that make them mid-level providers?
If you have to lump people together the term Non-physician provider (NPP) is defined by Medicare as a PA, NP, CNS (in states with advanced practice privileges) and CNM who has the ability to bill Medicare. Its got a legal definition and a finite number of people that it covers.
I agree with the last poster.
We don't provide a different level of care and are held to the same standard. So why do we put up with the term mid-level provider?
I also want to support my certifying organization.
When the term mid-level comes up, I politely correct them and move on. I've not run into any issues so far. Most people don't even remotely understand our practice. Even RNs and NPs many times have no clue as to our practice. I still occasionally run into an RN who thinks I need "supervision".
My office calls everyone "provider" meaning that patients are asked, "Which provider are you here to see?" The parent company uses the terms physician and non-physician provider, though some people in the head office still use mid-level.
I'm fine with provider or NP, but I don't care for mid-level. I always introduce myself as a nurse practitioner.
I've had patients call me Doctor and I correct them. Some continue to do so and consider it a term of respect. Often, it is futile to correct them. I never hold out myself as being a Doctor, however.
With the DNP coming into play now, many APNs possess that degree and use the title, "Doctor". As pointed out by the previous poster, APNs with a doctorate can (with some exceptions), call themselves, "Doctor XYZ", a Nurse Practitioner or CRNA, etc.
Some states do have laws into effect barring the doctorally-prepared APN from using Doctor in the title (in the clinical area).
APNs must be familiar with their own state Laws.
When I complete the DNP, I will still refer to myself as Linear, but if someone calls me "Dr. Thinker," I won't correct them unless I think they are under the impression I am a physician. So long as I am confident that they know I am a NP, they can call me whatever they want to call me, preferably Linear. For now, legally, I'm Linear Thinker, CFNP. My state is moving to changing the designation to ARNP for everyone. In fact, my new physician employers told me they are going to order my lab coat monogrammed that way in anticipation of the change. As if I care! I'd never be caught dead in that polyester nightmare anyway. Which by the way, lurkers, is a full length job that is going to come all the way to my ankles. I'd look like a hobbit in that thing. Apparently they either aren't aware of, or are unimpressed by, the lab coat length issue. And they are MDs. Imagine.
FWIW, when I earn it, I intend to use Linear Thinker, DNP and sign my name that way. I think it is most appropriate to use one's professional degree.
traumaRUs, MSN, APRN
87 Articles; 21,287 Posts
okay - figured we could use a new thread on what people call us in our everyday work environment.
for me, i work in a large nephrology practice. i practice in the apn role and in my state, (il), you must sign your name and then apn and if want to add some other initials, you can.
the term mid-level and physican extender are used in my practice. mid-level moreso. in our practice we, have pas, nps and a cns. so, the term apn to refer to all of us would not be correct.
personally i don't mind mid-level but think physician extender sounds kinda crass.
what do you guys think?