What’s my line?

On more than one occasion, I’ve had the experience of dealing with a health care professional whose identity wasn’t very clear.

Is the person checking your blood pressure at the medical clinic a nurse or a medical assistant? Is the person in your hospital room a registered nurse, a nursing assistant, a social worker or a respiratory therapist? Are you being seen by the doctor or by a physician assistant or nurse practitioner?

Health care personnel are generally trained to introduce themselves to patients and families with their name and title. The Joint Commission, which accredits most of the hospitals in the U.S., actually requires organizations to identify anyone coming into the facility, a measure that can extend to hospital visitors as well as employees. ID badges are supposed to be worn both for identification and security purposes.

Impostors are rare, although fakers do tend to pop up from time to time, such as the recent case of a woman in Tampa, Fla., who allegedly pretended to be a doctor and charged $60 an hour to unsuspecting patients. Of more concern to the average patient, though, is when bona fide health care professionals get a little too casual about identifying themselves.

Sometimes they don’t state their name, or they offer a vague disclaimer that they’re “from the lab” or “from X-ray.” Presumably they’re wearing an ID badge, but what if it isn’t visible or isn’t legible? I don’t know about anyone else, but I have a hard time trying to decipher someone’s name and title from a little piece of plastic clipped somewhere near their collar or dangling at hip level from their scrubs, especially if they don’t stand still long enough for my eyes to actually be able to focus on the lettering. As for those strings of initials denoting someone’s professional certification, they might mean something to other health care professionals but not to most laypeople.

Should it matter, as long as they’re properly credentialed, skilled and competent? If patients are going to be expected to be informed consumers, then yes, it does matter.

The proliferation of mid-level and allied health professions has been good in many ways, but it also has generated a certain amount of confusion, an issue that was blogged here recently. The increasing practice of using medical assistants in doctor’s offices, for instance, can leave patients unsure – or unaware – whether it’s a nurse who’s taking their vital signs or whether it’s some other kind of professional.

While this distinction might not seem important from a clinical standpoint, the fact is these are two different professions, each with its own type and amount of training and its own scope of practice. The waters get muddied even further when it comes to physician assistants and nurse practitioners, who are qualified to undertake a level of patient care almost similar to what a physician would offer.

The vast majority of professionals wouldn’t dream of misrepresenting their credentials. As far as most patients are concerned, though, everyone wearing scrubs tends to look the same. It’s not a question of skills or professional authority; it’s a question of clarity. Patients should know who’s taking care of them, and they shouldn’t have to play detective games to find out.

The bottom line for the public is that people need to be aware that health care professionals come in different flavors. A medical assistant isn’t the same as a licensed practical nurse isn’t the same as a registered nurse isn’t the same as a nurse practitioner. There’s a difference between technicians and technologists, between anesthesiologists and certified registered nurse anesthetists. Ideally, the professionals with whom you’re dealing will tell you up front who they are, or at least be wearing an easy-to-read ID badge. If patients and families aren’t sure, they should ask.

The bottom line for health care professionals is that they can’t assume their clientele knows all of this without needing to be told. A little proactive truth in advertising goes a long way.

Image: Guatemalan folk masks. Courtesy of Wikimedia Commons

One thought on “What’s my line?

  1. Pingback: Of ethics, identity and patient choice | HealthBeat

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