I was reminded recently that some of my midwifery peers are referred to as mid-level providers within their hospital environments. In fact, many third party payers or policy-makers refer to Nurse Midwives as mid-level providers as if we are “less than” some other higher standard clinician which has yet to be identified since no other clinicians has better outcomes within the field.
Midwives and other advanced practice nurses are often referred to as “non-physician providers,” “physician-extenders” or “allied health providers,” even “limited license providers” as we are so termed in the state of Indiana. It surprises me in fact, that so many midwives tolerate this.
The American Academy of Nurse Practitioners has drafted a statement in response to the use of such terms and I would encourage Nurse Midwives and Nurse Practitioners to utilize such when drafting hospital by-laws or healthcare policy. I would also encourage advance practice nurses to kindly educate those who continue to use this derogatory language. We are part of a collaborative infrastructure of care. Not one healthcare practitioner holds all the cards. Rather, we all depend on the diversity of knowledge and skills within each of the professions, and midwifery has proven to hold a mighty hand.
Just as importantly, it would behoove nurses to refer to their physician collaborators as “physicians,” just as they refer to advance practice nurses as either “nurse midwife” or “nurse practitioner.” Any and all have the potential to be a doctor, so using the term physician and doctor interchangeably continues to mislead the community and even medical professionals into believing that only medical doctors are doctors. One is a title (doctor) and the other is a credential (physician and/or nurse midwife).