DNP (doctor of nursing practice) vs. DO/MD

[deleted6669]

I'm curious. Do you feel the same about other non-physicians who have doctorates and work in a clinical setting alongside physicians? I'm thinking of psychologists, audiologists, clinical pharmacists, etc. I see these individuals refer to themselves as doctor in inpatient and outpatient settings very regularly. They always say "I'm Dr. X, the pharmacist/psychologist/podiatrist/etc". If they refer to themselves as doctor, is that also just ego? Or is it only ego if an NP or PA does it?

a psychologist, audiologist, etc has a defined and readily understood scope of practice. if someone says " I am dr smith the audiologist, I am here to do your hearing test" no one will think they are a cardiologist. if jane doe, np says " I'm dr smith smith, one of the nps from the cardiology dept" and starts talking to them about their stress test, echo results, etc it's likely the pt will think they are speaking to an md/do cardiologist. in 2014 many pts still don't know what a pa or np is and their scope of practice overlaps very closely with the docs they work with. there is a significant potential for confusion. I introduce myself as a PA, have PA written all over my name tag, scripts, etc and many folks probably still think I am a doc because I function interchangeably with one as the only provider in the ER on most of my shifts. Add in me calling myself a doc and they would be even more confused.
in a hospital dr smith = physician to the vast majority of the public. in a private office everyone knows john doe, dds is a dentist, tim arnold, dpm is a podiatrist, and walter green PsyD is a psychologist. If an NP/PA wanted to open their own office and call themselves dr smith , the pa/np outside of the hospital I would be ok with that. If someone goes out of their way to schedule an appt with a non-physician doctor, they know they are not seeing a physician and won't be confused. I never think my dentist is an ent surgeon because I know I scheduled the appt for a dental cleaning, not an ent surgical procedure.

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[JoBreeze]

Long live the millenials.

 

[Makati2008]

a psychologist, audiologist, etc has a defined and readily understood scope of practice. if someone says " I am dr smith the audiologist, I am here to do your hearing test" no one will think they are a cardiologist. if jane doe, np says " I'm dr smith smith, one of the nps from the cardiology dept" and starts talking to them about their stress test, echo results, etc it's likely the pt will think they are speaking to an md/do cardiologist. in 2014 many pts still don't know what a pa or np is and their scope of practice overlaps very closely with the docs they work with. there is a significant potential for confusion. I introduce myself as a PA, have PA written all over my name tag, scripts, etc and many folks probably still think I am a doc because I function interchangeably with one as the only provider in the ER on most of my shifts. Add in me calling myself a doc and they would be even more confused.
in a hospital dr smith = physician to the vast majority of the public. in a private office everyone knows john doe, dds is a dentist, tim arnold, dpm is a podiatrist, and walter green PsyD is a psychologist. If an NP/PA wanted to open their own office and call themselves dr smith , the pa/np outside of the hospital I would be ok with that. If someone goes out of their way to schedule an appt with a non-physician doctor, they know they are not seeing a physician and won't be confused. I never think my dentist is an ent surgeon because I know I scheduled the appt for a dental cleaning, not an ent surgical procedure.

I agree but I have seen some people sneak around this in the private practice setting by placing Dr. X minus the credentials( as far as NP/PA). I think that's inappropriate from a PA/NP standpoint because out of the numerous examples you used, our scope is the closest to an actual MD/DO.

 

[criticalelement]

Except that you are a med student who can't fire anybody.

oh yeah? You are fired.

 

[deleted432032]

Look at the curriculum, it's not clinical

This is what my questions to this argument/discussion are asking. What constitutes a "clinical" doctorate? If your degree does not constitute a "clinical" doctorate then in a "clinical" setting one should not introduce themselves as "doctor". Just because the majority of people on this forum and those that work in the healthcare filed know the difference does not mean the mass majority of patients know the difference.

 

[deleted6669]

This is what my questions to this argument/discussion are asking. What constitutes a "clinical" doctorate? If your degree does not constitute a "clinical" doctorate then in a "clinical" setting one should not introduce themselves as "doctor". Just because the majority of people on this forum and those that work in the healthcare filed know the difference does not mean the mass majority of patients know the difference.

The DNP is a doctorate in nursing, but is mostly management and public health coursework. it offers very little clinically over a MS level NP program. compare a few msn fnp and dnp/fnp programs to see what I mean.

 

[Boatswain2PA]

I've hired and fired plenty of people in my life...at some point both are likely to happen again

Unfortunately, as a future physician, you probably WON'T be in a position again to hire and fire again. Physicians are losing control of the business of medicine to the lawyers and their bureaucratic flunkies (ie: administrators). Unless you are going to go into private practice in a rural area, you will likely not have so much control. Not saying it's right, but....

As to deciding whether it's a "clinical doctorate" or not.....NO. If you are a physician, then you have earned the right to call yourself a "doctor" in a hospital/clinical setting. Anyone else who does so is just pretentious.

People today keep trying to change the definitions of words because they feel "slighted" by not being able to include themselves in the existing definition. There is no slight in being a nurse - it's a noble profession. Same with Pharm, PT, Aud, PA, CNA, EMT, housekeeper, or janitor. All noble professions. However you're not a doctor (which patients equate to being a physician), so you shouldn't call yourself one. Another example of this in today's culture is the "gay marriage" debate. Marriage has, for millenia, been defined as one man and one woman. It's not bigotry that makes many of us want to maintain that definition.

 

[JoBreeze]

double post

 

[JoBreeze]

The DNP is a doctorate in nursing, but is mostly management and public health coursework. it offers very little clinically over a MS level NP program. compare a few msn fnp and dnp/fnp programs to see what I mean.

What do you mean by "public health coursework?"

 

[deleted6669]

What do you mean by "public health coursework?"

epidemiology, biostats, community health, occupational med, etc.

 

[deleted6669]

If you are a physician, then you have earned the right to call yourself a "doctor" in a hospital/clinical setting. Anyone else who does so is just pretentious.
.

I'm ok with a podiatrist doing it. they are foot and ankle SURGEONS after all.

 

[sarjasy]

I'm ok with a podiatrist doing it. they are foot and ankle SURGEONS after all.

But the problem is, no matter the criteria setup for defining who can call themselves "doctor," it will be contradicted by some profession in health care that already calls themselves "doctor" in which their use of the title is widely accepted. If you broaden the criteria to include non-physicians, it makes it impossible to exclude the DNP.

If you say that only physicians can use the title, then it must be explained why optometrists and clinical psychologists use the title, with virtually no opposition from the ophthalmologists and psychiatrists they work along side, often treating the exact same patients. If you counter those are exceptions to the rule, then you undermine the "patient confusion" argument.

 

[fab4fan]

I've hired and fired plenty of people in my life...at some point both are likely to happen again

Perhaps, but physicians do not fire hospital employees. You may have fantasies of bellowing, "I'll have your license" to nursing staff, but it aint gonna happen.

As an aside, I can't believe this thread is still alive and well 8 years after its beginning. Think about it: in that time, some of the members here have finished med school as well as their residency programs.

 

[deleted480308]

Perhaps, but physicians do not fire hospital employees. You may have fantasies of bellowing, "I'll have your license" to nursing staff, but it aint gonna happen.

As an aside, I can't believe this thread is still alive and well 8 years after its beginning. Think about it: in that time, some of the members here have finished med school as well as their residency programs.

I don't have fantasies about it, one of the things I'm considering for specialty choice is if I want to deal with the hassle of being the business owner.

 

[jenRNFNP]

We are on the cusp of change in the field of medicine, nursing, and health care in general. I have been in healthcare for 22 years. I am a RN, will have my MSN in the spring, and am seriously considering going on for my DNP. I had over 700 clinical hour for my RN, will have over 600 for my FNP, and will need an additional 500 hours for my DNP. I worked at the bedside (full time) for 10years. DNP does not equal MD/DO. How can it? These are two different disciplines under the same healthcare umbrella. I recognize that my education and experience prepares me to care for patients with common ailments/conditions in the primary care setting. There has never been any insinuation or assumption that I will be as qualified or educated as a physician when I complete my program. We are taught when to refer to the physician specialist. That does not negate what I will be able and qualified to do safely. There is alot of ignorance out there. There is alot of hatred and fear as well. If I earn my DNP, then is being called doctor an unreasonable expectation? (I don't think I would btw-too down to earth) The law in Michigan does not allow a APRN to use the title they have earned unfortunately. In some states, the DNP may use the title with the explanation of their role in the care of the patient. This is more than fair. The analogy between optometry and ophthomology was fantastic. We are a team. We each have something valuable to offer a patient.

 

[foreverLaur]

The concern isn't with the DNP. It is with the push for the DNP to make nurses equal to a MD/DO. There's a push for DNP prepared NPs to have full autonomy with zero oversight required. They function 100% autonomously. As a master's prepared nurse in a DNP program, that is really frightening. I also do not think the DNP should be considered a clinical doctorate. I am getting my DNP in educational leadership at Case Western. There is not even the slightest hint of clinical in my program.

I also do not think anyone outside of the physician should use the title doctor while doing direct patient care. Patients think doctor = physician. Can you imagine how confused patients would get if their NP, physician, pharmacist, OT, and PT all introduced themselves as "doctor"? Most people in all those professions have doctoral degrees so they have the "right" to use the title. What if lawyers started referring to themselves as doctor since they have a doctorate degree?

I may sometimes make my husband call me doctor for fun when I graduate, but in the real world, I'll still be on a first name basis. Like you, I'm down to earth. I don't need a fancy title to validate myself.

And yes, we are all a team. Without each member, the entire team would break down and patient care would suffer.

 

[Makati2008]

We are on the cusp of change in the field of medicine, nursing, and health care in general. I have been in healthcare for 22 years. I am a RN, will have my MSN in the spring, and am seriously considering going on for my DNP. I had over 700 clinical hour for my RN, will have over 600 for my FNP, and will need an additional 500 hours for my DNP. I worked at the bedside (full time) for 10years. DNP does not equal MD/DO. How can it? These are two different disciplines under the same healthcare umbrella. I recognize that my education and experience prepares me to care for patients with common ailments/conditions in the primary care setting. There has never been any insinuation or assumption that I will be as qualified or educated as a physician when I complete my program. We are taught when to refer to the physician specialist. That does not negate what I will be able and qualified to do safely. There is alot of ignorance out there. There is alot of hatred and fear as well. If I earn my DNP, then is being called doctor an unreasonable expectation? (I don't think I would btw-too down to earth) The law in Michigan does not allow a APRN to use the title they have earned unfortunately. In some states, the DNP may use the title with the explanation of their role in the care of the patient. This is more than fair. The analogy between optometry and ophthomology was fantastic. We are a team. We each have something valuable to offer a patient.

Personally I think the term doctor should be for MD/DO only in the hospital setting. If you want to be called Dr. then you might want to consider medical school as the route to achieve that goal.

 

[FutureD0C17]

The fight to be called "doctor" seems like an ego stroking drive to compensate for what they couldn't achieve. Why not get name tags that say "Doctor of nursing" or "nursing doctor"? Be proud of your profession.

Nurses are great and it's a respected career, but you aren't doctors, you are nurses.

 

[Boatswain2PA]

We are on the cusp of change in the field of medicine, nursing, and health care in general. I have been in healthcare for 22 years. I am a RN, will have my MSN in the spring, and am seriously considering going on for my DNP. I had over 700 clinical hour for my RN, will have over 600 for my FNP, and will need an additional 500 hours for my DNP. I worked at the bedside (full time) for 10years. DNP does not equal MD/DO. How can it? These are two different disciplines under the same healthcare umbrella. I recognize that my education and experience prepares me to care for patients with common ailments/conditions in the primary care setting. There has never been any insinuation or assumption that I will be as qualified or educated as a physician when I complete my program. We are taught when to refer to the physician specialist. That does not negate what I will be able and qualified to do safely. There is alot of ignorance out there. There is alot of hatred and fear as well. If I earn my DNP, then is being called doctor an unreasonable expectation? (I don't think I would btw-too down to earth) The law in Michigan does not allow a APRN to use the title they have earned unfortunately. In some states, the DNP may use the title with the explanation of their role in the care of the patient. This is more than fair. The analogy between optometry and ophthomology was fantastic. We are a team. We each have something valuable to offer a patient.

700 clinical hours as an RN does not count as clinical hours as a provider. Two different beasts. Do RNs count the "clinical hours" of a CNA program as equivalent of nursing? Of course not. Neither were my 50 "clinical hours" as a medic student, nor my THOUSANDS of hours AS a medic, count as "clinical hours" toward being a PA.

600 hours for your FNP is 100 hours more than the minimum required, and would likely count for the 500 hours required for the DNP (correct me if I'm wrong here, please).

Niether the 600 clinical provider training hours you have (or the 1100 you would potentially have at the end of your unusually rigorous DNP program) would come close to the clinical hours that a medical student will have at the end of medical school.

And then they get a residency. A REAL residency, not a half-baked "advanced nursing residency" that allows the "advanced nursing student" to choose what shifts and days s/he is available that week so it doesn't conflict with their usual work schedule...but they get a REAL residency. One where for the first year they eat, sleep, and breathe their specialty, and then the next two-five years they fine tune their knowledge and skills in that residency.

Yes, being called "Doctor" is an unreasonable expectation in a clinical setting. Want to be called Doctor? Go into Academia. Want to be called Doctor in a clinical setting because you have a (soft) Doctorate? Okay, but you will then be expected to call me "master". Or, since I have two masters degrees, you may call me "master master". And you can call the BSN/RN "bachelor", and the associate/LPN "associate". Sound okay to you? Me neither....so how about we only call physicians "Doctor" in the clinical setting.

Sorry Jen, it's not ignorance, nor hatred or fear that drives me in my beliefs. It is, instead, an understanding that physicians have gone through a training/educational program that FAR, FAR, FAR exceeds anything you have done. If you want patients (and other providers) to call you Doctor, then take chemistry (not "chemistry for nursing" that many nursing programs take), take organic chemistry I, organic chemistry II, biochemistry, physics I, physics II......and then study your ever-loving A$$ off to take the MCAT. If you pass the MCAT, then do all of the research and legwork to figure what MD programs you want to apply to, and then do the work to apply to them. If you get into them, work two to three to four times as hard at school as you have EVER even THOUGHT about working so you can graduate. Then, your senior year, subjugate yourself into the match.....and then hope and pray that you are able to match into a residency program (because if you don't, your four years of medical school don't mean anything....which is why those medical students work harder than any nursing student ever thought about working).

And before you lash back at me for being a "nurse-hater" or any other such nonsense, I love nurses. I married one, and then supported her as she got her BSN. Nurses are a vital member of any healthcare team. But they are not physicians, and if they ever want to be called "Doctor", then they should do the work to earn that title.

 

[Boatswain2PA]

Personally I think the term doctor should be for MD/DO only in the hospital setting. If you want to be called Dr. then you might want to consider medical school as the route to achieve that goal.

Yeah, same with PAs. If you want patients to call you "doctor", then you should go to medical school. I think I know a few people (at least, I "know" their online personae) who did that.

 

[Boatswain2PA]

.....
I also do not think anyone outside of the physician should use the title doctor while doing direct patient care. Patients think doctor = physician. Can you imagine how confused patients would get if their NP, physician, pharmacist, OT, and PT all introduced themselves as "doctor"? .......

I may sometimes make my husband call me doctor for fun when I graduate......

Had some friends/family over for dinner tonight. Great friend of mine is retired Air Force reservist who is suffering some emotional stuff from being over in the hot zone. He was telling me about his appointments last week. Met with a bunch of people, but didn't know who was a "doctor", who was a counselor, or who was what. This is an really smart guy, but he didn't know who the hell was who during the six hours he was at the VA seeking help.

Doctors = physicians in patient eyes. If you aren't a physician (MD/DO) and you ever present yourself to any of my patients as a "doctor", be prepared to look like a blithering freaking idiot right in front of everyone because I will call you out on it on the spot.

foreverLaur - I was going to make some comment about the legs in your avatar, and if those were your legs then your husband should call you whatever you want to be called....but figgured that would be completely unprofessional so decided against it.

 

[deleted6669]

I finished my doctorate a few months ago. At work I am still Emedpa, not Dr Emedpa. I'm going to reserve that for teaching, research positions, or journal writing.