Know Your Primary Care Provider

In today’s climate it seems there’s an acronym for everything! The government and military are famous for this, but medicine is no different. Besides acronyms for medications, immunizations, treatment guidelines etc., your primary care provider likely has one or more acronyms, initials, or other designations following his/her name. What do you know about that person who is getting ready to exam private areas of your body or recommend treatment for a serious disease? An old joke is still overheard, “Did your doctor get A’s or C’s in medical school?” What is probably more important is understanding the acronyms or initials that define the training and experience of your health provider.
Most people are familiar with “MD”, indicating a medical doctor who attended medical school and some years in a residency. A little less familiar in Indiana (but not unfamiliar in many other states and the military) is “DO”. This indicates “Doctor of Osteopathy”. These days the training of MDs and DOs are extremely similar. DOs get some additional training in musculoskeletal care, including manipulation. MDs and DOs work together in residencies, in the military, and in the operating room and medical office.
Is your physician board certified? This is not indicated by a name-following acronym but may be mentioned on an office sign, advertisement, or business card. Board certification indicates that the physician is “up to date” with his/her specialty board, staying current with multiple requirements for continuing medical education and having passed periodic examinations. It’s OK to ask your MD or DO “Are you board-certified?”
Other acronyms may follow MD or DO on your provider’s nametag, e.g. FAAFP (Fellow, American Academy of Family Physicians) or FAAP (Fellow, American Academy of Pediatrics). The designation of “fellow” indicates the physician has achieved a level of maturity in practice, having met multiple requirements of past and current training, experience, community involvement, impact on health care, and recognition by peers.
NP stands for nurse practitioner. NPs begin their careers as licensed, registered nurses (RN) with a college degree (BSN, bachelor of science in nursing). They then take many additional academic and clinical hours in office settings to earn the NP designation (or APRN, advanced practice registered nurse). NPs can train in family care (FNP, family nurse practitioner), pediatrics (PNP, pediatric nurse practitioner), OB/GYN (WHNP, women’s health nurse practitioner), psychiatry (APRN psychiatry), and others. Nurse practitioners in Indiana have a collaborating agreement with an established physician who consults, oversees their work in general, and reviews 5 percent of the patient visits in which a prescription was written. NPs actually practice quite independently and are often the primary care provider (PCP) for their patients. They do physical exams, discuss disease prevention, diagnose and treat many medical diseases (acute and chronic), do prenatal care, write prescriptions, order and interpret tests, and perform procedures. NPs can be found in medical offices (including many subspecialties), immediate care facilities, hospitals, and other healthcare facilities.
PA stands for physician assistant, another licensed medical professional. PAs work in similar settings as NPs but have shorter and less stringent educational requirements post secondary school. PAs have more supervisory requirements for patient charting and prescription writing. The scope of practice for a PA is similar to an NP, and they can be found in multiple subspecialty practices in offices and hospitals as well as primary care.
It is now recognized that the most effective health care is delivered by health care teams rather than individuals that may not be well interconnected. Teams may be composed of multiple providers from more than one discipline. A common primary health care team might be composed of a physician, NP or PA, pharmacist, and a disease management RN/BSN. Due to the established link between physical health and mental health, a behavioral health specialist (social work, psychology, psychiatry) is often on the team, and ideally the patient’s dentist and eye care specialist participate as well. In most primary care settings, the primary care provider oversees and coordinates the efforts of the team, allowing the focus to be on the patient at all times. Good communication between team members is facilitated when all providers are collocated in the same area with easy access to the patient’s records from all team members.
So now you know a little more about who’s signing those letters or electronic notes to you, or who’s about to take a peek inside! Had a checkup lately? Now would be a great time, and, oh yes, please get a flu shot while you’re there if so advised!

Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (closely affiliated with Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at Or you can write your medical questions to Dr, Fleming at AskDrFleming, 8931 E. 30th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).