1. Jones, Shelby MSN, AG-ACNP, CCRN (Doctor of Nursing Practice Program)

Article Content

Each time I drive into my work parking deck, I am greeted and bemused by a large sign overhanging the parking deck entrance, which reads "Physician Parking." But therein lies the problem-I am not a physician; I am a nurse practitioner (NP). This is not a matter of simple semantics but rather a broader issue of professional inclusivity, understanding, and a need to reframe the mindset of the health care industry to understand and appreciate the diversity of professional roles and backgrounds among the health care providers in the United States.


The parking deck is a large six-story structure with several entrances intended for specific personnel parking; there are entrances for patients and visitors; staff including nurses, pharmacists, clerical and clinical employees, executives, technicians; and "physicians." My designated parking area is for health care providers. So, why is the entrance labeled "Physician Parking?" What a narrow and exclusive phrase. The signage is confusing, discrediting, antiquated, and begs for reevaluation of organizational culture to foster professional inclusivity, diversity, and awareness of the variety of health care professionals who form a rich tapestry full of expertise, innovation, and talent in their craft.


Unfortunately, health care provider exclusion and marginalization are spread among a wide array of facilities, settings, and contexts within health care organizations. For example, many health care organizations have a "doctors" (or "physicians") lounge, yet this is where a myriad of health care professionals commonly convene, eat, or take a break from their workday. Furthermore, many health care companies' and institutions' automatic phone systems will prompt the caller "if you are a physician, press 5," but all health care providers may press this number to proceed with their call request.


Advanced practice registered nurses (APRNs) such as NPs, nurse midwives, certified nurse specialists, and certified registered nurse anesthetists; physician assistants, and physicians are considered health care providers. These professionals are independently licensed, specially trained, and skilled to care for patients and communities they serve. As full practice authority for APRNs becomes increasingly prevalent in the United States, the vernacular must be broadened to better describe the positions and titles of health care professionals who deliver care. Understanding that we all offer unique contributions to health care is just the start in this bigger-than-a-parking-deck matter.


So, how do we choose the most inclusive and fitting lexicon for the parking deck entrance? The term "provider" seems most inclusive. However, some physicians and medical organizations are reluctant to replace the title "physician" with "provider," feeling it is nondescript, offers little association to health care, and conveys the connection between the provider and patient as similar to a commercial transaction rather than an intentional, quality health care relationship (American Academy of Family Physicians, 2018; Bruce, 2019; Dhand & Carbone, 2015). Similarly, many NPs and the American Academy of Nurse Practitioners (AANP) feel "mid-level provider," "nonphysician provider," and "physician extender" are inaccurate and imply inferiority. These terms suggest a hierarchical relationship in clinical practice exists, dismissing the fact that the scope of practice of NPs is not designed to extend the care delivered by a physician counterpart (AANP, 2015). There is inherent irony in using the term "nonphysician provider" to describe an NP because the literal language is correct, pieced together, the words suggest nonparallel professional potential and are an inappropriate description of my role. Using this logic, it would be equally unacceptable to call physicians "non-nurse providers."


If a more generic term is required, some feel "clinician" is most apt (Dhand & Carbone, 2015). Or perhaps "medical staff" is appropriate. But NPs are no more "medical" than physicians are "nursing." The circular conundrum and one slippery slope of semantics is the obvious difficulty in identifying an acceptable term to apply to all health care professionals. There will likely never be an all-inclusive term that fits the partiality of all. However, by employing understanding of health care provider role diversity, inclusiveness, and compassion in the care we provide to our patients and within our relationships among professional counterparts, we can move beyond interprofessional silos and cultivate an environment of cohesion, inclusion, and diversity and celebrate our unique contributions to health care.


Rather than getting hung up on the language of our titles, let us invest our time and energy into our professional rigor and integrity and into understanding individual interprofessional uniqueness. Perhaps the most appropriate answer to the best parking deck signage would be to allow all employees, regardless of role, seniority, position, or title, to have access to all parking entrances and choose where they would like to park. Although individuals' professional training may differ, their parking areas should not.




American Academy of Family Physicians. (2018). Provider, use of term (position paper). Retrieved October 5, 2021, from [Context Link]


American Academy of Nurse Practitioners. (2015). Position paper: Use of terms such as mid-level provider and physician extender. [Context Link]


Bruce L. Y. (2019, May 5). Time to stop labeling physicians as providers. Retrieved October 5, 2021, from [Context Link]


Dhand S., Carbone W. J. (2015, November 5). Physicians are not providers: An open letter to the AMA and medical boards. Retrieved October 5, 2021, from [Context Link]