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The Reply

  • Salvatore Mangione
    Correspondence
    Requests for reprints should be addressed to Salvatore Mangione, MD, Associate Professor of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, 1001 Locust Street – Suite 309C, Philadelphia, PA, 19107.
    Affiliations
    Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Penn
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  • Brian F. Mandell
    Affiliations
    Department of Rheumatology and Immunologic Diseases, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio

    Editor-in-Chief, Cleveland Clinic Journal of Medicine, Cleveland, Ohio
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  • Stephen G. Post
    Affiliations
    Center for Medical Humanities, Compassionate Care & Bioethics, Stony Brook University School of Medicine, Stony Brook, NY
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      We welcome the opportunity to address Dr Reinharth's letter because it gives us a chance to also reply to the many appreciative emails we received about our article.
      • Mangione S
      • Mandell BF
      • Post SG.
      The language game: we are physicians, not providers.
      It seems to have touched a chord—or a nerve.
      We agree with Dr Reinharth that over the past few decades physicians have lost much more than a name, which is why we might be long overdue for revisiting our job description. What is “doctoring” in the 21st century?
      • Mangione S
      • Wilson JF
      • Herrine SK.
      The archetypes of medicine: a job description for the 21st century.
      What are the ingredients that go into that unique cocktail that makes a “healer” rather than a mere technician or “provider”?
      As Dr. Bernard Lown told the Boston Globe in 2001, “we go into medicine to make a difference.” If that's the case, what are the personal qualities that allow us to do so? What are the traits we need to recruit for, and then nurture during training? We wrote about these issues in separate articles,
      • Mangione S
      • Tykocinski ML.
      Virchow at 200 and Lown at 100 - physicians as activists.
      ,
      • Mangione S
      • Chakraborti C
      • Staltari G
      • et al.
      Medical students' exposure to the humanities correlates with positive personal qualities and reduced burnout: a multi-institutional U.S. survey.
      but the overwhelmingly positive feedback received by our article suggests that the time might have finally come for introspection, especially if we need to understand what distinguishes us from other health care workers.
      That the tipping point might have been finally reached was also suggested by other articles published in the past year over the use of the term “provider.” We counted at least 3, including a position paper by the Western Journal of Emergency Medicine that not only pledged to ban its use in reference to physicians but also articulated quite eloquently the reasons behind such choice.
      • Phillips A
      • Lotfipour S
      • Langdorf MI.
      WestJEM will no longer use the term “provider” to refer to physicians.
      This is encouraging, because if other editors follow suit, then our profession will be undoubtedly forced to revisit the issue of what defines it, which is, of course, something much larger than a simple title, and yet something we owe not only to ourselves but also to our patients. The alternative is to accept a blanket name that disregards the particular training and dignity of all clinicians.

      References

        • Mangione S
        • Mandell BF
        • Post SG.
        The language game: we are physicians, not providers.
        Am J Med. 2021; 134: 1444-1446
        • Mangione S
        • Wilson JF
        • Herrine SK.
        The archetypes of medicine: a job description for the 21st century.
        Am J Med Sci. 2019; 357: 87-92https://doi.org/10.1016/j.amjms.2018.09.007
        • Mangione S
        • Tykocinski ML.
        Virchow at 200 and Lown at 100 - physicians as activists.
        N Engl J Med. 2021; 385: 291-293https://doi.org/10.1056/NEJMp2103050
        • Mangione S
        • Chakraborti C
        • Staltari G
        • et al.
        Medical students' exposure to the humanities correlates with positive personal qualities and reduced burnout: a multi-institutional U.S. survey.
        J Gen Intern Med. 2018; 33: 628-634https://doi.org/10.1007/s11606-017-4275-8
        • Phillips A
        • Lotfipour S
        • Langdorf MI.
        WestJEM will no longer use the term “provider” to refer to physicians.
        West J Emerg Med. 2021; 22: 1023-1024https://doi.org/10.5811/westjem.2021.8.54452