Wednesday, November 11, 2009

I Know You Are, But What Am I?

By Bill Benda, MD

Dictionary Uno

Photo by dotjdotsmith via flickr under the Creative Commons License.

There is a lexicon war going on this year, have you noticed? The first shots were fired last February at the Institute of Medicine Summit on Integrative Medicine in Washington, DC, where non-MD practitioners (specifically nurses and social workers) lined up at the microphone during the public commentary sessions to insist on the substitution of “healthcare” for “medicine” in all future language. Then, over the summer, the American Medical Association launched the first wave of its Scope of Practice Partnership, intent upon preventing doctorate-level professions from calling themselves “doctors” and “practicing medicine” and defining exactly what a “physician” is. On the other hand, a few short weeks ago, the US Department of Labor confirmed the legislative validity, among other things, of the official titles “naturopathic physician” and “naturopathic doctor.” So in general it appears people are happy being called “doctor,” unless they don’t want to be, or aren’t legally qualified, or someone else doesn’t want them to be, and that “healthcare” is the politically correct phrase from now on, unless we are talking about naturopathic “medicine” or Traditional Chinese “medicine,” in which case “medicine” doesn’t mean MDs, unless we are talking about the AMA, in which case “medicine” or “doctor” can only mean MDs. Or DOs. Or dentists.

Sheesh. What ever happened to Why Can’t We All Just Get Along? Where has the egalitarian, its-about-the-patient-not-us, change-the-paradigm conversation gone? If we agree that we all want a new definition of healthcare, why are we arguing over old classifications of entitlement? Don’t get me wrong – classifications are essential in the bureaucratic world of reimbursement and such. But doesn’t this war of the words seem a bit childish when so much is at stake in both the national and global arena?

I am, by all traditional criteria, a doctor who practices medicine. And I actively discourage anyone knowing this particular fact before they first get to know me as a person, as I usually will encounter one of two reactions – either an undeserved deference or an equally undeserved dismissal as likely being a jerk (which, by the way, if true is unrelated to my medical degree). In fact I propose that anyone making a restaurant reservation using the title “Dr,” whether medical or naturopathic or veterinarian, should be immediately seated next to the bathroom and then ignored.

The fact is that none of us is actually a doctor, or a nurse, or a naturopath, or an acupuncturist. We are simply human beings who have chosen a particular profession in our desire to help other fellow human beings, which is by definition the antithesis of entitlement. And to fight over a title while denigrating the AMA for its aggressively jealous obsession with that particular idiom is not simply childish; it’s hypocrisy.

And anyone that confused needs to see a doctor.

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