The medical field has always been a realm of various types of specialists. (And when I say “specialists,” I’m including primary care providers, since they too have specialized knowledge compared to a generalist like me.) But in recent years the health care system seems to have added more layers of specialization. We used to say were “going to the doctor”; these days we’re more likely to interact with one or more members of a medical team, each with different credentials and responsibilities.

My most recent surgery is a fairly typical example. When I asked to discuss scheduling arrangements, the surgeon referred me to his scheduler. His physician assistant (PA) was responsible for general medical and procedural questions. His nurse was responsible for preparation for the surgery.

Because I was aware of the team approach, I was not annoyed that the surgeon didn’t take the time to discuss scheduling arrangements with me. However, the division of duties is not necessarily clear to many patients. Hence the growth of professional patient advocates, who help consumers navigate the health care system.

My husband and I could have used a patient advocate a few years ago. When we moved to Indiana, Steve, who has some chronic conditions that require careful monitoring, sought out a physician for his routine medical care. He called a local practice that was accepting new patients and was given an appointment.

When he arrived for the appointment, Steve was informed that he would be seeing “Dr. Joe” instead of the physician whose name was on the practice. “Dr. Joe” continued to be the primary source of Steve’s medical care for the next several years, including a rather harrowing episode of gallstones.

At some point during all this, Steve learned that “Dr. Joe” was not, in fact, a physician, but a physician assistant. And he was the only care provider Steve had seen in that office. So essentially, my husband had not been examined or treated by an actual physician in over three years.

I’m not opposed to receiving care from physician assistants, nurse practitioners, and other medical professionals who are not physicians. But I do want to know exactly what credentials my heath care provider has.

Perhaps “Dr. Joe” had a PhD; I don’t know. But I believe that referring to an individual without an MD as “doctor” in a clinical setting is misleading and inappropriate. It gives the impression that patients are being treated by an individual with a medical degree and the expertise that implies.

Steve and I learned a valuable lesson through this experience. When it comes to the professionals who provide our medical care, it’s our responsibility to know with whom we are dealing.