Hospital policy on nursing doctorates/titles

[Man o War]

Our med exec is discussing and voting on a motion soon brought forth by a large group of multi specialty physicians concerning how nurses with doctorates are addressed in the clinical setting. Their motion includes the assertion that more and more hospitals are making such policies so patients are clear on when they are being treated by a physician and when they are being treated by a nurse with a doctorate degree. How do you all handle this at your hospitals, given the nursing doctorate is a relatively new concept?

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[Mman]

DNPs may not refer to themselves as Dr. in a clinical setting with a patient in our hospital. Various penalties from warnings to suspensions for repeated violations.

 

[IlDestriero]

We also have badges with clear bold color differences. One for attending physicians, one for physician trainees, one for all nurses, and one for everyone else. They get an explanation of the colors when admitted and a sheet that references the colors and explains what an attending, NP, PA, etc are.

 

[jthedestroyr]

We also have badges with clear bold color differences. One for attending physicians, one for physician trainees, one for all nurses, and one for everyone else. They get an explanation of the colors when admitted and a sheet that references the colors and explains what an attending, NP, PA, etc are.

I like this, but I wonder how many people read the sheets. I think we often forget most people don't even understand attending, resident, let alone PA. They often see white coat and automatically think physician, period.


We have badges like this, but unfortunately our hospital also just passed color coded scrubs system and guess what? APRN, PA get to wear same color scheme as physicians, but floor nurses wear different colors. Mhhmm....

 

[urge]

We also have badges with clear bold color differences. One for attending physicians, one for physician trainees, one for all nurses, and one for everyone else. They get an explanation of the colors when admitted and a sheet that references the colors and explains what an attending, NP, PA, etc are.

We have that as part of a State campaign but I have seen new badges that say "Doctor". I have not asked the people wearing it but I'm pretty certain they are nurses. Ours say "Physician".

 

[aimedicine]

I think UF has the best system...every badge has bold big letters identifying the staff with tittle such as "DOCTOR" for physicians, "ARNP" for np, "PHARMACIST", "DENTIST", PA etc...

 

[Man o War]

Great ideas guys/gals, and I will bring them up as part of this discussion. The motion as I read it is more specifically about how they are allowed to introduce themselves to patients. Do you have such a policy in addition to the badges/scrub colors? How is it worded and how does it apply to dentists, podiatrists, psychologists, and pharmacists?@Mman thanks for also including the penalties, as I'm sure that will be the other part of the discussion.

 

[Psai]

We have that as part of a State campaign but I have seen new badges that say "Doctor". I have not asked the people wearing it but I'm pretty certain they are nurses. Ours say "Physician".

That is pretty obnoxious. Do they have such little pride in their field that they have to pretend to be someone else?

 

[Man o War]

That is pretty obnoxious. Do they have such little pride in their field that they have to pretend to be someone else?

Agreed. It seems silly that we even have to write a policy on this, I'd think any provider with common sense would know that in a clinical setting only physicians should use doctor when interacting with patients.

 

[PainDrain]

I know several states that have "clinical setting ID" laws where physicians, DPM, and dentists are the only ones allowed to dentist themselves as doctors. It's state law, check your state and if you don't have a law on the books lobby for one.

 

[jthedestroyr]

Open up your ehr and you'll see almost every single mid level has their alphabet letter titles. My favorite are the nurses that always add Silly ANCP-BC, FNP-BC. That BC thing always makes me laugh.

 

[deleted126335]

I know several states that have "clinical setting ID" laws where physicians, DPM, and dentists are the only ones allowed to dentist themselves as doctors. It's state law, check your state and if you don't have a law on the books lobby for one.

Do you know of any states where this actually became law as opposed to proposed legislation that didn't make it through? I don't.

 

[PainDrain]

Do you know of any states where this actually became law as opposed to proposed legislation that didn't make it through? I don't.

Massachusetts chapter 112, section 8A. "Section 8A. No person may, directly or indirectly, use the title ''physician'' or display or use the term physician in any title, advertisement, listing of affiliations, communication with the public or in any other manner to indicate or imply in any way that such person offers to engage or engages in the practice of medicine or in the provision of health care services to patients within the commonwealth who is not registered by the board of registration in medicine as a physician under section 2. This section shall not apply to use of the term ''chiropractic physician'' by individuals licensed and practicing under sections 89 to 97, inclusive, or the use of the term ''podiatric physician'' by individuals licensed and practicing under sections 13 to 22, inclusive, or the use of the term ''physician assistant'' by individuals licensed and practicing under sections 9C to 9K, inclusive. A person who violates this section shall be punished by a fine of not less than $100 and not more than $1,000 or by imprisonment for not less than 30 days and not more than 1 year in the house of corrections, or by both such fine and imprisonment."

 

[deleted126335]

Massachusetts chapter 112, section 8A. "Section 8A. No person may, directly or indirectly, use the title ''physician'' or display or use the term physician in any title, advertisement, listing of affiliations, communication with the public or in any other manner to indicate or imply in any way that such person offers to engage or engages in the practice of medicine or in the provision of health care services to patients within the commonwealth who is not registered by the board of registration in medicine as a physician under section 2. This section shall not apply to use of the term ''chiropractic physician'' by individuals licensed and practicing under sections 89 to 97, inclusive, or the use of the term ''podiatric physician'' by individuals licensed and practicing under sections 13 to 22, inclusive, or the use of the term ''physician assistant'' by individuals licensed and practicing under sections 9C to 9K, inclusive. A person who violates this section shall be punished by a fine of not less than $100 and not more than $1,000 or by imprisonment for not less than 30 days and not more than 1 year in the house of corrections, or by both such fine and imprisonment."

Doesn't quite get there. Note the protection is for the term "physician". Not "doctor".

For example, Jane Doe, CRNA PhD or Jane Doe CRNA, DNAP is not prohibited by this statute from referring to herself as Dr. Jane Doe.

 

[aneftp]

I think UF has the best system...every badge has bold big letters identifying the staff with tittle such as "DOCTOR" for physicians, "ARNP" for np, "PHARMACIST", "DENTIST", PA etc...

What about a podiatrist? Do they have podiatrist written on their badge?

Surprise about "dentist". DDS and newer DMD even though we all know there is no difference. Traditionally no one ever had any quarrels about dentist being called Doctor. I have never had any issues. What about those with integrated 6 year oral maxillary/MD degrees?

 

[aimedicine]

What about a podiatrist? Do they have podiatrist written on their badge?

Surprise about "dentist". DDS and newer DMD even though we all know there is no difference. Traditionally no one ever had any quarrels about dentist being called Doctor. I have never had any issues. What about those with integrated 6 year oral maxillary/MD degrees?

So everyone still has their titles at the end of their name (written in normal fonts) but in addition to that there are big bold letters that identify who you are even from afar...so i.e
John Doe DDS
DENTIST

John Dee DMD
DENTIST

John Lee M.D
DOCTOR

John Tree D.O
DOCTOR

John Wee DPM
PODIATRIST

 

[Promethean]

I like this, but I wonder how many people read the sheets. I think we often forget most people don't even understand attending, resident, let alone PA. They often see white coat and automatically think physician, period.


We have badges like this, but unfortunately our hospital also just passed color coded scrubs system and guess what? APRN, PA get to wear same color scheme as physicians, but floor nurses wear different colors. Mhhmm....

Heck... a lot of people just see that I'm male and assume that makes me the doctor and any female attending that I may have entered the room with is a nurse. Even if I have on nurse colored scrubs and badge and she has the white coat and a doctor badge.

 

[Random Anesthesiologist]

Heck... a lot of people just see that I'm male and assume that makes me the doctor and any female attending that I may have entered the room with is a nurse. Even if I have on nurse colored scrubs and badge and she has the white coat and a doctor badge.

True story. The biggest offenders are other females (usually nurses), too.

 

[gmbz]

When I was a nurse I could count on 2-3 times a shift that I would be called a doctor due to being a male. Hence I went into medicine.

 

[Promethean]

When I was a nurse I could count on 2-3 times a shift that I would be called a doctor due to being a male. Hence I went into medicine.

It certainly isn't why I decided to go to med school, but it will be one less minor frustration. I wish the same comfort were somehow available to women who are physicians. We still have a long way to go.

 

[aimedicine]

Heck... a lot of people just see that I'm male and assume that makes me the doctor and any female attending that I may have entered the room with is a nurse. Even if I have on nurse colored scrubs and badge and she has the white coat and a doctor badge.

Then those people that make that assumption even after seeing your nurse badge are illiterates

 

[Promethean]

Then those people that make that assumption even after seeing your nurse badge are illiterates

Yes, some of them are. Many of them are older, can't see well, cognitively impaired in some way. That actually describes a huge proportion of the census in most inpatient clinical settings.

But a heck of a lot of them are perfectly literate adults who should know better. Cognitive dissonance is a powerful thing. People see what they expect to see. When they see a middle aged man walk into a patient room with a young, pretty woman, they assign roles based on pre-existing biases, not name tags. The name tags could be LED illuminated posterboards and the mistake would still happen.