Two Definitions for the Physician Proceduralist

In previous notes, I have discussed the preceduralist, by which is meant a hospital-based physician who specializes in performing various invasive, skilled procedures such as fluoroscopy, conscious sedation, upper airway endoscopy, and percutaneous tracheostomy (see: The Emergence of the Proceduralist in Hospitals, Cedars-Sinai Medical Center - Hospital innovators 2007). This development is part of the growing specialization of physicians and also the growth of "-ists" such as hospitalist and surgicalist. The latter are hospital employees who assume the previous role of private physicians who admitted their patients to hospitals and provided oversight for their care during the hospital stay (see: The Emergence of the Surgicalist).

I have just become aware of another definition for proceduralist, used almost exclusively in the context of discussions about physician reimbursement (see: On Disparities Between Reimbursement of Primary Care and Proceduralist Physicians). In this latter case, the term refers to any type of medical specialist who performs various "procedures" in contrast with, say, a primary care physician (PCP) whose primary role is to take medical histories, examine patients, treat their patients with drugs, and make referrals. There is a wide income disparity between a PCP and a gastroenterologist who frequently performs endoscopic colonoscopies, a procedure, and profits from the higher reimbursement from third-party payers for such procedures.

It should be relatively easy to understand which definition for a procedurlist is being used from the context of the discussion. Nevertheless, I thought that it would be useful to document these two different uses of the term.