“What’s in a name? That which we call a rose

By any other name would smell as sweet…”

[Romeo and Juliet, Act II, Scene II].

When Juliet uttered those words, she was referring to the rival house of Montague that Romeo belonged to, thus implying that a different name was unimportant to her: Romeo was still the love of her life. It is beautiful poetry, but it is also untrue. As suggested by the Latin saying Nomen Est Omen, names do matter. In fact, they reflect the way we see the world.

In scripture to know the name of someone meant to know the character of that person. And so, Moses was the “one delivered from waters”; Esau the “hairy” one; and Rachel’s last son (and reason for her childbirth death) was Ben-oni: “the son of my sorrow.” “Adam” itself originated in the Hebrew term “Adamah,” earth; hence, Son-of-the-Earth—an apt reminder of our species’ obligations towards Mother Earth. God then gave Adam authority upon other living beings, including the right to name everything he was told to care for. Yet, God also reminded Adam of his limitations, insofar as name changes in the Bible could only occur as a result of a divine intervention that transformed the very essence of the individual. Thus, Abram became Abraham, Jacob became Israel, and Simon became Peter. Which brings us to how doctors became “providers.”

That, of course, was not the result of divine intervention, but a human-driven decision which over the past 60 years turned US physicians into “providers” of medical services, patients into “consumers,” and the sacred patient-physician relationship into another economic transaction.1 Of interest, it is an almost exclusively American phenomenon,2 and thus says more about us as a society than about doctors themselves. Hence the need for introspection.

One way to understand the problem is to see how physicians are named (and so, considered) in other cultures. In this regard, a cursory review of a few languages reveals that doctors are typically seen as wise and learned societal leaders, blessed with healing powers that almost border on the divine.

For instance, one of the words used by Arabic to indicate physicians is “Ḥakīm,” which means “wise or learned person.” In fact, Ḥakīm is such a revered Muslim name that many parents give it to their children (hard to imagine the term “provider” being used to name American kids). The idea of physicians as cultured individuals is similarly expressed by the Latin word “doctor,” which means not only teacher but also “learned person.” In fact, the term is rooted in the Indo-European dek, meaning something acceptable as useful. This yielded not only the Latin “docere” (i.e., to teach) but also “discere” (to learn), and thus disciple. Hence, the importance of learning and teaching for the medical profession—a fact reiterated by the Arabic term Ḥakīm.

Al-Ḥakīm is actually one of the 99 names of God in Islam, meaning “the all-wise.” And so is Al-Shāfi (“the healer”). Even in Hebrew the concept of “divine healer” is embedded in the term for physician, which is “Rophe” (Jeremiah 8:22). This is the participle of “Rapha” (to heal), and in Exodus 15:26, God gives Himself the name of Jehovah-Rapha: “I will put none of the diseases on you that I put on [Egypt], for I am the Lord, your healer.” Jehovah-Rapha, has the power to heal physically (2 Kings 5:10), emotionally (Psalm 34:18), mentally (Daniel 4:34), and spiritually (Psalm 103:2–3).3

In Gujarati and most Indian languages, the word for physician is Vaidya (Vaid). This derives from Vedas—a large body of ancient Indian religious texts whose name is rooted in Vid, “to know.” Hence Vaidya indicates an “all-knowing person,” follower of Vedas and thus an expert. Urdu language (often referred to as “Old Hindi,” since it’s a mix of Sanskrit, Persian, Arabic, and Hindi) uses instead the Arabic term “Tabib,” which means “Someone Who Cures the Sick”—a healer.

The Persian (Farsi) language also uses “Ṭabīb,” which has similar Arabic origins and indicates those who practice “the science of medicine” (or “علم طب”). In fact, Tabib is how physicians are commonly referred to in Arabic. Farsi also uses “دكتر” (pronounced “Doctór”)—i.e., healers who devote their professional life to the relief of suffering. Another Farsi term is “پزشك” (pronounced “Pezesh-k”), which has the same meaning but Persian roots. Lastly, Farsi uses “حكيم” (pronounced “Hakeem”). This is the same Arabic term we encountered before, and describes someone who is thoughtful, well-rounded, and highly knowledgeable in both philosophy and science.

In proto-Germanic language, a physician was referred to as lekjaz, which meant not only “healer and enchanter” but also “speaker of magic words”—both apt descriptions of the shaman. The term eventually yielded “læce” in Old English and “lake” in Middle Dutch. In fact, physicians are still named “læger” in Danish and “läkare” in Swedish. All of these words evolved from the old Indo-European stem “leǵ,” a term associated not only with collecting and gathering but also with knowledge and wisdom. Hence, the doctor as knowledge repository. “Leǵ” eventually yielded the Greek word logos and its corresponding verb légein, both having the same implication: physicians as people who say wise things (lecture and logic are similarly rooted in “leǵ”).

The Old English “læce” ultimately led to “leech,” a term used for centuries in England to indicate doctors, and which implied knowledge, wisdom, and almost magic powers (by assimilation leech might have then been extended to the hirudo medicinalis used by physicians to bleed their patients).4 In the end, the English term for doctors did become “physicians,” which originated in the Old French Fisicien, in turn based on the Latin Physica (natural science) and the Greek “Phúsis” (nature). Hence, “one who’s knowledgeable of nature.”

Lastly, the modern German term of “Arzt” comes from the Greek Άρχι, which also yielded the Latin “Archīāter,” implying not only a doctor but also a “supreme chief” and “leader”—thus providing another interesting connotation to physicians as societal leaders. The Greek term eventually evolved into ἰατρός (iatros), which not only meant “healer,” but was also used to translate one of the Hebrew names for God as “supreme healer” (i.e., Jehovah-Rapha).

And so, by judging how doctors are named in other languages, both current and old, we seem to share a tradition as wise and cultured healers with societal responsibilities and even shades of the divine. It is just in the USA that physicians’ identity recently transmogrified into mere providers of medical services. This is a demeaning term that was first introduced by the Nazis when trying to demote German physicians of Jewish descent.2 It not only influences the way the public sees us, but in turn degrades how we see ourselves. In fact, it downgrades the sacred patient-physician relationship to a mere economic transaction,5,6 which may impact on healing and even cause moral injury. Hence, it should be rejected.

This is why recent pushbacks have offered a glimmer of hope that something might be finally changing. For instance, in 2021, the editorial board of the Western Journal of Emergency Medicine pledged not to use the term “provider(s)” when applied to doctors.7 Hopefully, this will inspire other editors and medical organizations. Some state medical societies have already banned the term “provider(s)” (the Medical Society of Delaware did so in 2022). Of even greater interest was the position paper recently published by the Association of Family Medicine Residency Directors, which not only committed to the term “physicians,” but also implored “all who read this article to do the same. Our members, our trainees, and most importantly our patients deserve the clarity and specificity that using the correct word to describe a physician provides.”8 In fact, two family medicine academics have even suggested that debasing us to “provider(s)” might be responsible for the burnout epidemic.9 Hence, their call for graduate medical education to reject the term. Hopefully, internal medicine organizations will draw inspiration.

That family doctors are protective of their professional identity should not come as a surprise. In our own literature search, the Annals of Family Medicine was the American medical journal that used “providers(s)” the least.2 This might reflect a different way family physicians see themselves, which probably goes back to the founding of the field as a reaction to the fragmentation of health care.10 Since family doctors rekindled the role of general practitioners, they often struggled to receive the same status of better remunerated specialists. Perhaps it is for this reason that they have also been more resistant to the incursion of disrespectful terms such as provider(s). After all, they have been quite aware of the power of language in conferring prestige, having had to defend the rationale for their specialty by even changing its title from family practice to family medicine.

Either way, these physicians are correct. Reducing us to providers is an insult to the honorable tradition of our profession, and thus should be abandoned.