Physicians dislike being called "providers," but when do we stop calling patients "compliant"?

Names and frames matter for patient experiences.

If you’ve dealt with the American healthcare system for even a minute, it has probably occurred to you that there is a lot going on at the intersection of medicine, healthcare, and corporations.

People tell me their stories about gaslighting, and I often find myself pushing back on the idea that it’s alright to throw doctors under the bus, because there are critical systems in play that affect that happens in clinical settings.

But sometimes it is really difficult to feel sympathetic to physicians— as in this case below.

Fine, we get it. Gone are the days of our friendly family physician Marcus Welby, MD and our family doctor who hangs out their shingle and knows us from cradle to grave.

From IMDB: “Dr. Marcus Welby, a general practitioner, and Steven Kiley, Welby's young assistant. The two try to treat people as individuals in an age of specialized medicine and indifferent physicians.” (1969-1976) (oooo baby James Brolin!)

People have been writing about the medical-industrial complex for decades. This has meant changes to medical professions as physicians became more like corporate employees with the rise in HMOs in the 1980s. We doubled down on these trends after that with the continued rise of for-profit care in related sectors like health insurance. Alongside that, pharmaceuticals have become more prominent and, in the US, direct-to-consumer advertising is legal. Now we are pumping more private equity into healthcare. All of this momentum has steered medicine toward more of a business model—and we feel it at the pump, so to speak.

Somewhere in this business pipeline, physicians started getting called “providers.” Guess what? They don’t care for that at all.

In this article from the Annals of Internal Medicine (February 2026), the authors specifically pitch this as an ethical problem.

A recent journal article on why it’s an ethical problem to call physicians “providers” (Source)

They tell us in laborious detail about the definitions and Latin origins of words like “patient,” “physician,” and “medicine.” My personal favorite is the part about the origins of “compassion” and how it is “essential to the patient-physician relationship” and “refers to supporting the patient in need and acting with and for the patient.”

Medical care is not a mere service. This is especially apparent in the origins of words associated with care. The Oxford English Dictionary defines the origins of the terms patient, physician, and medicine. Patient is from the Latin patiens, for one who suffers. This word refers to the vulnerability often brought on by illness. Doctor comes from the Latin docere (“to teach”). Physick originally meant medical treatment or remedy; one who practiced physick was a physician. By the 18th century, physic referred to the practice of medicine. Compassion comes from the Latin compassio, meaning “to suffer with.” Compassion is essential to the patient–physician relationship; it is not just empathy or kindness but refers to supporting the patient in need and acting with and for the patient. These words help convey the significance of what is at stake in medical care. (Sulmasy and Carney, 2026)

Words are important; I agree. But this sanitized notion of physicians as the compassionate gravitational center of the doctor-patient relationship, as the ones we can count on to “act with and for the patient”? Good grief: check out the comments here and see if people are buying into that.

One issue that is part of the problem, but unacknowledged in these kinds of publications, is that patients get different names too. These words we use around “users” or “consumers” of healthcare matter too.

Here is where we get into my having a beef that goes back years. Bear with me for a minute.

Back in 1997, Baby Karen wrote a PhD dissertation that was all about patient compliance. At the time, I was hot under the collar about a growing body of research that was focused on basically profiling “the compliant patient.” Starting in the 1960s, we searched for psychological, cognitive, and socioeconomic characteristics of patients that would predict how closely they followed medical recommendations— also framed as “acting in one’s own best interest,” which (eye roll) I have always taken as code for “acting rationally.” I felt like the questions getting asked in these fields were versions of: Are compliant patients just more educated? Smart? Motivated? Resourced?

In my study, I was asking: “how do doctors even try to assess how compliant patients are, given they only see them for short periods of time?” I shadowed endocrinologists in two diabetes clinics for most of a year, interviewing, videotaping, and calling patients at home afterwards to find answers. What I concluded was that “compliance” is not just about individual patient characteristics but also about doctor-patient interactions, the kinds of clinics and doctors involved, and the continuity of your care. How closely someone thinks you’re following a treatment plan is connected to social processes happening in healthcare.

After my dissertation, I even published this commentary with a physician, where we called for people to swap the term “compliance” (too paternalistic!) out for “adherence” (more patient agency!). That was 1999, and that little commentary has been cited about 500 times.

At first glance, this Annals paper appears in alignment with these ideas that patients have autonomy and should be partners in their care:

A physician should be a trusted confidant, counselor, advocate, and partner in times of need. Since Hippocrates, physicians have committed to putting the interests of patients first, utilizing their extensive knowledge, training, and experience to benefit patients and help keep them from harm. In contrast, providers provide. Business transactions need not focus on values or consider the interests of consumers before those of stockholders and owners.

But then I went and looked up how often “patient compliance” shows up in research articles these days, and I came up with this:

This is a search on the website www.pubmed.com, which is probably the major NIH-supported search engine for publications in medicine and public health. When I searched on “patient compliance,” this is the graph that came up to show how many articles with those key words were published in each year since 1947.

Keep in mind, back in 1997 I was already paying attention to what appeared, back then, as a big rise in studies on “compliance.” You can see here how many publications appear for each year, but here are some highlights:

2000: 2,063 articles (year I completed my dissertation study)

2024: 13,514 articles

2025: 21,477 articles

2026: 7,933 articles (so far, halfway through the year)

I don’t know about you, but I have some difficulty squaring up these physician complaints about being called “providers” when there is also a need for patients to be called by names that support their autonomy, expertise, and values.

This huge rise in studies using the term “patient compliance” is not pointing in that direction, disappointingly. It hearkens back to all those outdated presumptions about patients being compelled to follow medical directives.

This is about adherence and compliance, still, but so many other names and frames.

What do you notice about the differences between being a customer and a patient?

yours in solidarity✌️

Karen