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Who Should Be Called “Doctor”?

Who Should Be Called “Doctor”?
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Not everyone who calls themselves “doctor” has the letters “M.D.” behind their name. More and more, the medical professional in the white coat who introduces herself or himself as “Dr.” may not be a physician but a nurse, pharmacist or physical therapist.

Nurses with doctorates can qualify for high-level hospital administrative positions and are seen with more respect. But physicians are, not surprisingly, loathe to give up the title that has been theirs for centuries and not only for matters of prestige. Right now, physicians command higher fees from insurers and also have more authority in prescribing medications. In the days of managed health care, the treatment of patients is increasingly seen as that of a “team,” with a number of specialists and practitioners including nurses — but physicians are arguing that it is they who should lead the team.

That is, who gets called “doctor” is a “proxy for a “larger struggle” about who plays what role in health care today. Physicians say that, due to their training — twice as a long as the six to eight years of collegiate and graduate education required for nurses, pharmacists and physical therapists to earn a doctorate — they alone should diagnose illnesses. Nurses point out that they are more than capable of identifying illnesses. In twenty-states, and in particular in areas where there is a shortage of physicians (the mountain West and northern New England), nurses can practice without a physician’s supervision or collaboration. Nurses have indeed long been lobbying for more states to pass such provisions.

Physicians, for their part, have also been turning to legislative efforts, as the New York Times notes:

A bill proposed in the New York State Senate would bar nurses from advertising themselves as doctors, no matter their degree. A law proposed in Congress would bar people from misrepresenting their education or license to practice. And laws already in effect in Arizona, Delaware and other states forbid nurses, pharmacists and others to use the title “doctor” unless they immediately identify their profession.

Dr. Kathleen Potempa, dean of the University of Michigan School of Nursing and the president of the American Association of Colleges of Nursing, says the new doctoral degree, doctor of nursing practice, is necessary to help nurses stay current at a time when “knowledge is exploding.” She does note that nurses with master’s degrees are as prepared to treat patients as those with doctorates. Studies show that “nurses with master’s level training offer care in many primary care settings that is as good as and sometimes better than care given by physicians.” Nonetheless, there is still no evidence that nurses with a doctoral degree provide better care than those with doctorates.

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96 comments

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6:02PM PDT on Oct 5, 2011

Laura, I have a great term for the regular physician: APL. That means: "A Pharmaceutical Lackey".

5:34PM PDT on Oct 5, 2011

It's probably time we came up with a new term to refer specifically to a medical physician with a PhD. The term "Doctor" originally never meant a physician specifically as can still be attested to today with scientists, mathematicians, and other positions that hold the title of doctor. For some odd reason, society has come to associate "doctor" with "medical doctor". Perhaps Physicians need a new set of letters following their name and a new title.

I have no problem with Medical and Nurse Practitioners and see them myself. They often *do* know as much as doctors and in some cases more. Other times, they don't. It's the same with lawyers. Some lawyers are abysmal and you wonder how they passed the bar. Sometimes the people that work under them know more. Not always, but sometimes. Still, if I have a specialized disease, I will see a physician that has a specialty in that disease, such as a cardiologist or neurologist. For a routine check up, pap smear, blood work etc, there is nothing wrong with seeing a MP or NP.

5:32PM PDT on Oct 5, 2011

In a medical setting, I think only a physician should be called Doctor. In an academic or other setting, the title Doctor can be used, because then we aren't assuming physician, a Ph. d more likely...

11:48AM PDT on Oct 5, 2011

Why focus only on the medical profession? Anybody with a PhD in anything gets to use the title "Doctor", an astronomer, an urban planner, an off-the-wall occupation that some college gives a PhD for. Ask anybody what the first thing that comes to mind with the word "doctor" and close to 100% will say somebody with a medical degree. Anybody else who uses the word simply creates confusion.

4:38AM PDT on Oct 5, 2011

Micheal, You are correct 100%

4:19AM PDT on Oct 5, 2011

Laura M

In the UK, surgeons never use the title of Doctor. Usually, it is Ms or Mr, sometimes Professor (in some teaching hospitals) Some very senior ones - past Presidents of the Royal College of Surgeons - have knighthoods, in which case it is "Sir John --" or "Dame Jane --"

3:53AM PDT on Oct 5, 2011

Thank you Diane B.

3:40AM PDT on Oct 5, 2011

@ Veronica C

A hospitalist is an MD. It's a relatively new specialty. In "olden" days, patients would be visited on a daily basis by the physician who admitted them, often their primary care physician. No longer. Google "hospitalist" for more info.

2:50AM PDT on Oct 5, 2011

It is a matter of honesty and openness - if I go to a doctor, I do expect them to have a doctorate in medicine. This doesn't mean that I would not go to a qualified nurse with some problem, it just means that I don't want the nurse to missrepresent their educational background.

This is not about the quality of care at all - it is about the extensiveness of the medical education the practitioner has, and about being honest about it to the patient. I'm sure nurses can do a great job at treating most complaints, but if I have something truly serious (like my father currently has been found to have a brain tumour), I definitely want to see an actual doctor who's specialized in the ailment I have. And I don't want to be guessing whether the person calling themselves a doctor is actually a doctor, or some other health practitioner.

2:36AM PDT on Oct 5, 2011

I see a PAC on a regular basis. She is just as good as the Dr. , also in the same practice. She is allowed to treat & prescribe drugs in my state of IL. Only difference is she probably gets paid less.

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