Why You Are Not a Midlevel Provider

Somewhere along the way, someone decided to label us as “mid-level” providers.

The term defined by Title 21, Code of Federal Regulations, Section 1300.01 states a mid-level practitioner is an individual practitioner, other than a physician, dentist, veterinarian or podiatrist, who is licensed, registered or otherwise permitted by the United States or the jurisdiction in which he/she practices. Several types of medical professionals are lumped into this category including physician assistants and advanced practice nurse practitioners. However, by using the term mid-level, it implies that we are “above” another type of health care professional but “less than’ to another type of provider – aka physician. Who is the lowest level provider? A nurse, a medical assistant? It is possible to have a successful medical practice without all of these providers participating in a practice? Why would you spend 6+ years in college to become a mid-level at anything?

We know where we stand in the hierarchy – I don’t think that is the issue. If we had wanted to be at the top of the hierarchy, we should have gone to medical school. But the reality is, patients ultimately don’t care how many initials you have after your name, at the end of the day, they just want to get better and be treated with respect. In the words of the great poet, Maya Angelou, “people do not remember what you did to them, they remember how they made you feel”.

How does being called a mid-level practitioner affect our careers?

I believe the term mid-level locks us into a category that is confusing to patients and medical staff.

If a patient hears us called a mid-level provider, they may feel they are receiving substandard care.

If we are called a mid-level provider in front of our colleagues, will they have they trust in our medical decisions and competency?

Let’s educate our administrators and co-workers that we are Advanced Practice Providers (APP).

We are highly educated and trained providers.

We are valuable parts of health care teams.

How can we educate our colleagues and patient that they are receiving top-notch care?

Speak up!

When a patient asks you when you are going to start medical school, take the time to educate them about why you chose this profession, how you were trained.

Invest in additional training, specialize, make yourself valuable.

Talk up your APP colleagues to patients – let them know how special they are.

Speak up for yourself to your administrators – let them know of your accomplishments, how you handled that challenging case, what your career goals are.

Get involved when you can with state and national organizations that promote APP careers.

Stand beside your new APP colleagues – help them feel confidant, competent, generate trust.

You are educated. You are valuable. You are what the health care system needs!