“Hi Sulagna, we’re looking for locums in your area…”
I replied to that one even though I don’t do locums. “It’s Dr. Misra. I am a Physician who attended medical school and earned this title. It is part of my name.” Then I blocked them.
“Hi Miss Misra, exciting opportunity for a qualified practitioner…”
Delete. Block.
“Hi Misra, we wanted to reach our…”
Didn’t even finish reading. Delete. Block.
Every Physician I know has a version of this story. We all get these emails or some version of this vernacular. A lot of us complain about it to each other, in group chats, on social media, in break rooms But I want to talk about why this is so important, because this is not a small thing and it is not about ego.
When someone calls me Doctor, there is an implicit understanding behind that word. It means this person went through four years of college, four years of medical school, years of residency, board examinations, and made a lifelong commitment to continuing education and recertification. It means this person follows a code of ethics. It means this person earned a title that carries weight, trust, and accountability while sacrificing a large part of their lives.
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When you strip that title away or “water it down”, or you reduce me to a first name or a last name or a generic label, you are stripping away the very thing that tells a patient they are in safe hands.
Let me be clear about one thing because this drives me insane. If you are cold emailing a Physician you have never met, you do not have the right to call them by their first name. You would not email a judge and say “Hi Karen.” You would not write to a senator and say “Hey Mike, got an opportunity for you.” So why do people think it is acceptable to do that to a Physician? It is audacious. And it tells me, before I’ve read a single word of yours, exactly how much you value my profession. And usually the compensation reflects the same level of disrespect, but I will save that tantrum for another time.
This brings me to the P word.
Not THAT P word. (though honestly, both P words make me equally uncomfortable because both are reductive and dehumanize. One does it to women. The other does it to Physicians. I won’t say either of these ugly words.)
I’m talking about “provider.”
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The Word That Launched a Thousand Eye Rolls:
If you are a Physician and you haven’t felt your soul leave your body the 42nd time someone called you a “provider” in your clinic, hospital, in legislation or any other way, I don’t know what to tell you. You might want to check your pulse. Because that word is not just annoying. It is a weapon. And it was designed to be one.
The word “provider” entered the medical lexicon through the 1965 Medicare and Medicaid legislation, which used the phrase “any provider of services” to describe billable entities.
Let me say that again.
Entities. Not people. Not Physicians. Entities. It was bureaucratic language for reimbursement purposes and it should have stayed buried in policy footnotes. Instead it was emphasized and metastasized. By the 1990s, insurers and health systems had adopted it as a catch all, a convenient way to lump Physicians together with everyone else under one interchangeable, cost neutral, corporate friendly marketable umbrella. A ploy to confuse patients and charge the patient as if they saw a doctor, but pay for someone cheaper. Confuse the public just enough that they don’t ask questions. And replace the language and us physically from the exam room while continuing to bill as if we still exist.
And here we are.
I hate that word so much I have scrubbed it from my vocabulary. I refuse to make it a part of me in any way. When I need to describe non-physicians I say exactly that-non-physician. I even hesitate with clinician. I might say alternative health care professional. I will find any other language before I let that word come out of my mouth in reference to a Physician. The word “provider” does not just annoy us. It demeans us and is irreverent. It removes the profession from the professional. It dilutes decades of training into a single generic term that could apply to literally anyone. And worst of all, it confuses patients. Patients do not know who is taking care of them anymore. They cannot tell if they are seeing a Physician or someone with a completely different level of training who happens to wear a white coat in the same building.
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As of only recently (and over a decade of us collectively screaming) February 10, 2026, the American College of Physicians has finally said out loud what so many of us have been screaming into the void for years. In a new ethics policy paper published in Annals of Internal Medicine, the ACP declared that Physicians are not providers. The term is “derogatory.” It “diminishes the physician-patient relationship.” It reduces a sacred, relational partnership to a transaction.
ACP President Dr. Jason Goldman said it plainly. “A restaurant is a food provider. A store provides you with goods and services. We are not in that category.” Former ACP President Dr. Robert McLean started the “P-word pledge” years ago, asking Physicians to stop using the word about themselves or each other.
But here is my issue. The ACP published this paper in February, 2026. The AMA weighed in on the California ruling in October, 2025. You know who has been fighting this fight for years, long before the big organizations decided it was fashionable? Us. Physicians. And groups like Physicians for Patient Protection. PPP has been on the front lines of scope creep, title confusion, and the systematic erosion of the Physician’s role since before any of this was trending on social media. The people who sounded the alarm, who got called difficult and territorial and elitist for saying what needed to be said? That was PPP. I am a member. I support the mission and I bring it up because credit belongs where credit is due. The big organizations are celebrating now. They are publishing papers and issuing press releases. But the work was done by Physicians who stuck their necks out when it was not popular. The AMA in particular, has never fought scope-creep and this is one of the reasons I have removed myself from membership. They have a pattern of showing up late to the fights that matter and then taking a bow on the backs of those who actually did the work.
When you strip the title of Physician away or “water it down”, or you reduce me to a first name or a last name or a generic label, you are stripping away the very thing that tells a patient they are in safe hands.
What’s in a Name? Ask California:
In October 2025, a federal court in California proved exactly why language and titles matter. Three nurse practitioners who held “doctorates” in nursing practice sued the state, arguing that California’s law restricting the titles “Doctor” and “Dr.” to licensed MDs and DOs was unconstitutional. The U.S. District Court dismissed their case.
The judge cited that patients are confused and will wrongly believe that a person with a doctorate in nursing practice is a Physician with the same training. Nearly half of patients, 45 percent, said they could not easily identify who is or is not a licensed medical doctor based on titles and credentials in advertising. And 91 percent said they strongly prefer a Physician led health care team, saying that years of medical education and training are vital to optimal care, especially in the event of a complication or a medical emergency.
Patients want Physicians. They just cannot always tell who one is anymore. And that confusion is not an accident. It is a feature of a system that profits from blurring the lines.
California’s truth in advertising law has been on the books since 1937. It exists because titles create trust, and trust should never be manufactured.
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The Bridge to Nowhere:
There is a joke that now makes its rounds in Physician circles. Someone proposes a “bridge program,” or a four year pathway for nurse practitioners to become MDs. And every Physician in the room says the same thing.
You mean medical school?!
It is funny because it’s true! The difference between a Physician’s training and everyone else’s is not a gap you can bridge with a shortcut. Four years of medical school. Three to seven years of residency. Ten thousand to sixteen thousand hours of clinical training. Boards. Recertification. CME. A professional identity forged in decades of sacrifice, sleep deprivation, and the relentless expectation of excellence. And near bankruptcy.
A Physician’s degree is never terminal. That is what people do not understand. Having your doctorate does not mean you are finished. It means you have earned the right to keep learning for the rest of your life. You are expected to stay current, to grow, to evolve with the science. The degree is not the finish line.
The newer generation of Physicians worries me sometimes. Some of them feel like they have been brainwashed, and I do not say that lightly. They are being trained by non-physician practitioners during residency. Then they are asked to supervise them after they graduate without knowing what that entails. They are entering a system that already blurred the lines before they got there. They do not know what it looked like before. They do not know what Grand Rounds used to feel like.
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Standing Up:
My mother was a Physician in NY. When I was a kid she would sometimes drag me to work with her at the hospital. (I hated it.) I was a child, I did not want to sit in a hospital under fluorescent lights with monotone voices. But I remember Grand Rounds. I remember walking in with her. She was an attending. She was the Director of Allergy and Immunology. And when the Chairman or Directors like her walked into that room, people literally stood up.
The nurses stood. The residents stood. Everyone filed in and they rose when the attending entered. The same way you stand when a judge enters a courtroom. It was not about fear or hierarchy for the sake of hierarchy. It was reverence. It was a recognition that this person, this Physician, had sacrificed something enormous to be in that room. This person gave up years of their life. Their twenties and thirties. Sleep. Money. Time with family. Their own health, sometimes. The sacrifice it takes to become a Physician is something most people will never fully understand, and that is okay, but it should be respected. That act of standing was an acknowledgment of sacrifice. It was an honor. You stand because the knowledge in that room was earned.
I do not see that anymore. That reverence is gone. And the P word helped kill it.
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The ER You Trust Might Not Have a Doctor in It:
Here is what most patients do not know. There is a growing chance that when you walk into an emergency room, you will not see a Physician. Depending on the facility, you may be seen entirely by a nurse practitioner or a physician assistant. No Physician on site. In the emergency room. The place you go when something is seriously wrong with you.
That should terrify everyone…it certainly terrifies me!
We follow the rules. We study, we train, we do things by the book. And then we are told it does not matter because the system found someone cheaper. You do not get to mess with the process and then act shocked when the outcomes suffer.
The Doctor Is Being Pushed Out:
The week I am writing this, the U.S. Senate Special Committee on Aging held a hearing titled “The Doctor Is Out: How Washington’s Rules Drove Physicians Out of Medicine.”
Read that title again. The Doctor Is Out. That is the title of a United States Senate hearing in 2026. Physicians are being pushed out. Crushed by administrative burden. Demoralized by declining reimbursement. Stripped of language, titles, autonomy resulting in the ever-popular term “burnout”. And then everyone looks around and wonders why there is a shortage. Why burnout is everywhere. Why Physicians are literally leaving medicine.
I myself left the traditional system. I am a Direct Primary Care Physician. I have been in and out of the system, and I chose DPC because it was the only way I could practice medicine the way it is supposed to be practiced. With the patient. Without a corporation telling me what to call myself.
And I will say something that a lot of us in the DPC world have been saying for a while now. The name itself is wrong. It should not be Direct Primary Care or Direct Specialty Care. It should be Direct Physician Care. Because that is the whole point. The entire reason this movement exists is to re-establish the patient-Physician relationship. To ensure that when a patient comes to us, they know, clearly and without confusion, that they are seeing a Physician. A real one. Someone who went to medical school. Someone who did residency. Someone who earned the title and continues to earn it every single day.
Re-establishing that language, making sure patients see a Physician and know they are seeing a Physician, is something we fight for in DPC every day. It is part of why we left. And it is part of what we are trying to rebuild.
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Physician, with a Capital P:
We are at a moment where language matters more than it has in a very long time. AI is a large language model. Language is in our DNA. Language is how we communicate trust, competence, authority, and care. We have already lost cursive. We are losing the ability to write by hand (so important!). The way we speak to Physicians, with Physicians, and about Physicians needs attention too. Because when you erode the language around a profession, you erode the profession itself and then-well, you lose us.
I write Physician with a capital P on purpose. I started doing it when the word “doctor” became so muddied, so confused by non-physicians using it, that it stopped meaning what it was supposed to mean. So I made a choice. I switched to Physician and I capitalize it as much as I can.
Here is why. We capitalize Judge. We capitalize Senator. We capitalize Justice. We do it because those titles carry institutional weight, earned authority, and public trust. Physician deserves the same. A proper noun names something specific. It names something that has been earned, that carries meaning, that is not interchangeable with something else. When you see Physician with a capital P, it says something. It says this person went through something most people would not survive. It says this person passed exams and this person has a baseline of complex knowledge. It says this person is still learning, still growing, still showing up, because a Physician’s doctorate is never terminal. It is a lifelong commitment to being better for the people who trust us with their lives.
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So here is my ask.
Don’t call me the P word. Don’t call me “provider.” Don’t call me Sulagna in a professional email when you have never met me and do not know me. You do not have that right and it is audacious to assume you do. Do not presume a familiarity you have not earned with someone who has spent decades earning a title that you could not be bothered to type.
This simple term change, this one word, “provider,” has helped drive Physicians out of the system. It is not a small thing. It is not semantics. It is demeaning. It erases us. And we are leaving because of it, along with everything else it represents.
Call me Doctor. Call me Physician. Capital P.
And if you are a patient reading this, ask. Ask who is treating you. Ask if they went to medical school. Ask if they are a Physician. You have the right to know. You deserve to know. Because your care depends on it.
The difference between a Physician’s training and everyone else’s is not a gap you can bridge with a shortcut. Four years of medical school. Three to seven years of residency. Ten thousand to sixteen thousand hours of clinical training. Boards. Recertification. CME.
