DNP versus MD?

[Taurus]

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I thought there was a law saying that only MD/DO can use the title of "doctor" in a clinical setting.

 

[Dr_Feelgood]

I don't know if this link has been posted previously, but there's some interesting commentary on the DNP degree here.

One thing that makes me laugh about all of the AACN responses, they quote there own research. In response to everyone asking about how cool I am, according to the American Association of Dr. Feelgood. I have increased in coolness by 37% since I started this post. I have also noticed that I am more attractive to both women and surprisingly men by 95% and 67% respectively. These numbers are not influenced in anyway by my desire to be gain more power and become a moderator.

Seriously, come on.

 

[deleted87716]

One thing that makes me laugh about all of the AACN responses, they quote there own research. In response to everyone asking about how cool I am, according to the American Association of Dr. Feelgood. I have increased in coolness by 37% since I started this post. I have also noticed that I am more attractive to both women and surprisingly men by 95% and 67% respectively.

Honestly, the whole thing makes me laugh. IMO, the nursing profession should be more concerned with all of the lesser-trained medical personnel who are running around calling themselves "nurses" rather than calling themselves "doctor."

By the way...haven't you heard that 96.4% of statistics are made up on the spot? 😉

 

[Dr_Feelgood]

By the way...haven't you heard that 96.4% of statistics are made up on the spot? 😉

I thought there was a law saying that only MD/DO can use the title of "doctor" in a clinical setting.

There was a law that was being proposed. The law listed only MD,DO, and DDS as doctors.

As a DPM student, it would be a slap in the face if a hospital told me I had to go by Mr. Feelgood. Especially if they are giving the title to a DDS, they have no post-grad education requirements (I'm not trying to fire up the DDS members, it is just a fact).

I'm not going to 4 years of medical school and 3 years of residency to be a midlevel practitioner. It would be just as confusing to tell patients that when you see your podiatrist, he is not a doctor No one else wants to deal with your smelly diabetic ulcer or even knows what to do, but make sure you call him Ted.

 

[Adcadet]

I'm not going to 4 years of medical school and 3 years of residency to be a midlevel practitioner.

And you realize some people think that "medical school" should just refer to programs granting MDs, and maybe DOs?

Then again, a while ago I did hear somebody say "she's in law school...she's going to be a legal assistant." People are dumb. I think we can all agree on that.

 

[Northerner]

And you realize some people think that "medical school" should just refer to programs granting MDs, and maybe DOs?

Then again, a while ago I did hear somebody say "she's in law school...she's going to be a legal assistant." People are dumb. I think we can all agree on that.

Agreed. DPM = podiatry school. DDS = dental school. MD/DO = medical school. It's not rocket science.

 

[Dr_Feelgood]

I don't understand the confusion what do you think we learn in podiatry school, magic? If you are going to list DO school than you must list DPMs. The reason I say that is for my didactic education, I sat next to DOs listened to the same lectures and took the same test (minus OMM). The only difference was I checked a box that said DPM and they check a box that said DO.

If we want to split hairs than nothing is medical school. There are allopathic, osteopathic, and podiatric schools.

Also, I don't understand why you always bring in dental school. There are major differences in dental training/school and podiatry (besides the obvious ones). There a very few differences between MD/DO programs and podiatric programs; all of the differences are in the clinical rotations.

 

[Northerner]

I don't understand the confusion what do you think we learn in podiatry school, magic? If you are going to list DO school than you must list DPMs. The reason I say that is for my didactic education, I sat next to DOs listened to the same lectures and took the same test (minus OMM). The only difference was I checked a box that said DPM and they check a box that said DO.

If we want to split hairs than nothing is medical school. There are allopathic, osteopathic, and podiatric schools.

Also, I don't understand why you always bring in dental school. There are major differences in dental training/school and podiatry (besides the obvious ones). There a very few differences between MD/DO programs and podiatric programs; all of the differences are in the clinical rotations.

You supposedly have extensive lower extremity coursework. Where do you think that lecture time, lab time, and study time come from? Unless you're saying the LE stuff is "in addition" to everything the DO students at your school learn? So podiatrists are more knowledgeable and better trained than MD/DO students I guess.

The point is that while I agree that podiatry schools have started going the way the DO has (tailoring their curriculum to mimic the MD curriculum), that doesn't mean you were selected with the same standards, have the same standardized MD/DO coursework, are tested on the same curves, have the same pre-clinical clinical experience, have to pass the same licensing boards, have the same clinical experience, and have to compete for the same competitive residencies. That's it. The DO's have been the most effective at mimicking the above things and have fought for and roughly won total equivalency. Fine. But we see every other profession trying to do or say the same thing and it's concerning.

 

[Adcadet]

As far as I can tell nobody is claiming dental school is the same as med school. At my med school the dental students take many classes with us, but so do the DPT, pharmacology PhD, and a few other random people during the first two years. None of them claims to be in medical school. Sitting in a few, or even nearly all medical school classes does not make on a medical student nor make your school into medical school.

As a reference, allow me to offer Wikipedia. Free, easily accessed, and usually a pretty reasonable source of information...

Check out the Wikipedia entry for "medical school" and note that the section on medical students:

A person accepted into a medical school and enrolled in an educational program in medicine, with the goal of becoming a medical (or osteopathic) doctor, is referred to as a medical student or student doctor. Medical students are generally considered to be at the earliest stage of the medical career pathway.​

Nowhere do I see mention of podiatry, dentistry, nursing, nurse practace chiropractic, doctor of optometry, physical therapy, etc.

Now search Wikipedia for "Podiatry School" - the closest entry is "podiatric medical school":

Podiatric Medical School commonly referred to as "Podiatry School" is the term used to designate the medical institutions in the United States which educate students and train them to be a Doctor of Podiatric Medicine (D.P.M.) or Podiatrist.​

Nowhere do I see Wikipedia referring to the training of podiatrists as "medical school," and the shortened phrase for "podiatric medical school" is "podiatry school."

 

[Dr_Feelgood]

You supposedly have extensive lower extremity coursework. Where do you think that lecture time, lab time, and study time come from? Unless you're saying the LE stuff is "in addition" to everything the DO students at your school learn? So podiatrists are more knowledgeable and better trained than MD/DO students I guess.

The point is that while I agree that podiatry schools have started going the way the DO has (tailoring their curriculum to mimic the MD curriculum), that doesn't mean you were selected with the same standards, have the same standardized MD/DO coursework, are tested on the same curves, have the same pre-clinical clinical experience, have to pass the same licensing boards, have the same clinical experience, and have to compete for the same competitive residencies. That's it. The DO's have been the most effective at mimicking the above things and have fought for and roughly won total equivalency. Fine. But we see every other profession trying to do or say the same thing and it's concerning.

You ask when do we fit in our LE training? When do not take OMM for two years. Podiatry students also have lectures into their third year. I think you are confusing my comments with a desire to be an MD/DO. I am happy with being a podiatrist and not a MD/DO want to be. So to say we must have the same residencies makes not sense. Also, all of my tests had the same curve as the DOs. Boards would be tough b/c we have LE, and I would agree that I was not impressed with our boards. Clinical experience is very very close. We do not do opthalmology and have limited psych and OB-GYN.

I don't understand the peeing match. Why is it so inconceivable that a student that studies podiatry would have a curriculum that is on par with MDs and DOs? Shouldn't you as a referring physician or a physician looking for a consult desire a podiatrist that is well educated? The foot and ankle is not a seperate being, so a pod is cheating his patients if he/she only consider manifestion of disease as local.

But I do agree with you 100%. Podiatric education can be hit or miss. I do not think it is the curriculum as much as some schools are desperate to fill the classes so they will take anyone (with or without a pulse). This is best seen by some podiatry schools willing to take the GRE, DAT, PCAT MCAT, ect for admission. Schools that are more reputable only take the MCAT. A more universal approach to the education of DPMs with assistance from the AMA has been talked about for a long time. What is holding it back is the podiatry big wigs don't want to lose control.

As far as I can tell nobody is claiming dental school is the same as med school. At my med school the dental students take many classes with us, but so do the DPT, pharmacology PhD, and a few other random people during the first two years. None of them claims to be in medical school. Sitting in a few, or even nearly all medical school classes does not make on a medical student nor make your school into medical school.

As a reference, allow me to offer Wikipedia. Free, easily accessed, and usually a pretty reasonable source of information...

Check out the Wikipedia entry for "medical school" and note that the section on medical students:

A person accepted into a medical school and enrolled in an educational program in medicine, with the goal of becoming a medical (or osteopathic) doctor, is referred to as a medical student or student doctor. Medical students are generally considered to be at the earliest stage of the medical career pathway.​

Nowhere do I see mention of podiatry, dentistry, nursing, nurse practace chiropractic, doctor of optometry, physical therapy, etc.

Now search Wikipedia for "Podiatry School" - the closest entry is "podiatric medical school":

Podiatric Medical School commonly referred to as "Podiatry School" is the term used to designate the medical institutions in the United States which educate students and train them to be a Doctor of Podiatric Medicine (D.P.M.) or Podiatrist.​

Nowhere do I see Wikipedia referring to the training of podiatrists as "medical school," and the shortened phrase for "podiatric medical school" is "podiatry school."

First off, wikipedia? Come on. Second, you say that it is called podiatric medical school, right? Did you omit the second word in your argument? Podiatrist got to podiatric medical school to become podiatric physicians.

Just as an FYI to anyone interested, check out the more recent changes in podiatric medicine. When the College of Podiatric Medicine and Surgery was created in Des Moines; it changed how all pod schools structured their education b/c of the integration of classes with the DO students. CPMS curriculum. The latest school that has opened is at MWU in Glendale. A slightly different program without the systems but again integrated with DOs. AZPod curriculum. Western University is also planning on opening an integrated DPM/DO program in 2009 (Opinion ahead!) I foresee this replacing the current pod school in California. Scholl college in Chicago is currently transitioning to a 2+2 curriculum so that they can integrate with the MD program at Rosalind Franklin.

Obviously we will all have our own opinions but don't make your judgments on misinformation or wikipedia.

 

[Adcadet]

As a reference, allow me to offer Wikipedia. Free, easily accessed, and usually a pretty reasonable source of information...

We weren't debating what schools are or should be called in the most technical sense. I was going for reasonable, and something a member of the general public would understand. Remember, we were talking about confusing patients (that was a long time ago, what on page 2!).

Second, you say that it is called podiatric medical school, right? Did you omit the second word in your argument? Podiatrist got to podiatric medical school to become podiatric physicians.

Once again, the reasonable shortened term for podiatric medical school is not medical school (see the wikipedia article on "medical school" and "medical student" that does not mention podiatry) but rather podiatry school, again specifically mentioned in this regard by Wikipedia. In your comment you are using the appropriate terminology yourself, although feel free to shorten "podiatric medical school" to just "podiatry school" for brevity.

Obviously we will all have our own opinions but don't make your judgments on misinformation or wikipedia.

I was not giving an opinion nor judgement, and I certainly wasn't commenting on the the podiatry curricula. I was pointing out that "medical school" does not mean "podiatry school" to most people.

 

[Dr_Feelgood]

We weren't debating what schools are or should be called in the most technical sense. I was going for reasonable, and something a member of the general public would understand. Remember, we were talking about confusing patients (that was a long time ago, what on page 2!).


Once again, the reasonable shortened term for podiatric medical school is not medical school (see the wikipedia article on "medical school" and "medical student" that does not mention podiatry) but rather podiatry school, again specifically mentioned in this regard by Wikipedia.

I have never had a patient refer to my education as podiatry school. They have only said medical school. Should I correct them and explain the differences in the allopathic, osteopathic and podiatric medical schools? Which is more confusing now? It hurts my head thinking about it.

Going back to my previous comments, if that law was passed would I would have to tell them I'm sorry I'm not a doctor I'm a podiatrist. If we are strict talking about patients now, they do not understand that a podiatrist has any difference in education. Heck most people still think that we get MD degrees and just did a podiatric residency. I would assume that they feel this way b/c if their PCP consults a DPM then they must be just as educated if not more.

 

[Northerner]

You ask when do we fit in our LE training? When do not take OMM for two years. Podiatry students also have lectures into their third year.

Whoa, your "specialized" training in LE amounts to the time spent in OMM lab for DO students?! Jesus....DO students are known for downplaying how much time they spend in OMM lab for the exact opposite reason - they want to emphasize that minimal time is taken away from basic science coursework. Interesting.

I don't understand the peeing match. Why is it so inconceivable that a student that studies podiatry would have a curriculum that is on par with MDs and DOs? Shouldn't you as a referring physician or a physician looking for a consult desire a podiatrist that is well educated? The foot and ankle is not a seperate being, so a pod is cheating his patients if he/she only consider manifestion of disease as local.

This paragraph doesn't really make sense, and I don't feel like breaking it down sentence by sentence.

First off, wikipedia? Come on. Second, you say that it is called podiatric medical school, right? Did you omit the second word in your argument? Podiatrist got to podiatric medical school to become podiatric physicians.

Man, I just cringe when you use those terms.

Just as an FYI to anyone interested, check out the more recent changes in podiatric medicine. When the College of Podiatric Medicine and Surgery was created in Des Moines; it changed how all pod schools structured their education b/c of the integration of classes with the DO students. CPMS curriculum. The latest school that has opened is at MWU in Glendale. A slightly different program without the systems but again integrated with DOs. AZPod curriculum. Western University is also planning on opening an integrated DPM/DO program in 2009 (Opinion ahead!) I foresee this replacing the current pod school in California. Scholl college in Chicago is currently transitioning to a 2+2 curriculum so that they can integrate with the MD program at Rosalind Franklin.

1) No one said podiatry wasn't "changing". What this really means is podiatry is designing their curriculum to look like an allopathic medical school (or DO, but DO's designed theirs after the allopathic model too) curriculum. It just seems a really roundabout way to get people to call you doctors and blur the lines between medical doctors and podiatrists by shunting people from the lower end of the admissions game into pod schools (or other peripheral care provider programs e.g. DNP, DPT, DOT, etc.) build lobbying power, modify your curriculum to look just like an MD curriculum, make subtle terminology changes bit by bit, lobby some more, make more changes to blur the lines more, lobby some more, until no reasonable person could argue it's not basically the same thing, except different in conception. Once you get there, when all the prestige you seek is yours, all the respect as MD=DPM is there, when all the prejudice about admissions standards and research funding and prescribing rights and scope of practice and all those other discrepancies are gone, maybe we'll all look around as a society and wonder the same thing then that we now wonder about DO's.....what's the point of having two different degrees for the same thing? And the answer is, of course, that there is no point. What it would mean would be DPM = orthopedist, and there's no way in hell MD/DO wants to ever let that happen.

Honestly, just stick with feet in your scope, stick with the terms "podiatrist" and "podiatry school" and we won't have any problems.

2) What the hell would a "fully integrated program" prove? That you're associated with a weak enough medical school that they're letting you piggyback onto their curriculum, doubling their class sizes, providing an easier route to get the "same" education, so that you can brag that you take the exact same classes as MD/DO students? I don't get it. In fact, since it sounds like pod students are always claiming their education is the same as MD/DO and that podiatry is a "subspecialty of medicine", maybe we should jump onboard. Take over all the podiatry residencies (or just make our own), make podiatry a surgical subspecialty like ophtho or ortho or uro or OB and put MDs into pod residencies. Ortho was getting too competitive anyway, might as well break off F&A and give it the credit its due. Now that would **** you guys over. At least it would make you put your money where your mouth is that your education is the same and that DPMs are the preeminent F&A people. A good old fashioned scrum over the foot.

 

[Adcadet]

I have never had a patient refer to my education as podiatry school. They have only said medical school. Should I correct them and explain the differences in the allopathic, osteopathic and podiatric medical schools? Which is more confusing now? It hurts my head thinking about it.

Maybe they refer to it as "medical school" because that's how you those around you refer to it? Your head hurting isn't a great reason to deceive patients (intentionally or not). I've corrected patients a thousand times about me being a medical STUDENT and not a medical DOCTOR. Which, by the way, I wonder if you do given your SDN name and your claim to being a medical student. But whatever. I'm sure it would take you maybe 10 seconds to explain that you're in pod school. There's no need to get into MD vs DO programs.

"I'm sorry, Ma'am, I'm actually in podiatry school, a 4-year doctoral-level program that focuses on the health of the foot and ankle and related topics."​

I don't see how that would be confusing to most patients, let alone somebody in a doctoral program (if they're still confused try telling them that you're like a dentist, but you focus on the feet, and if you're still confused....well, then there's no hope). Typically patients refer to RN programs as nursing school, DDS programs as dental school, OD programs as optometry school . . . what's so hard about "podiatry school"?

Going back to my previous comments, if that law was passed would I would have to tell them I'm sorry I'm not a doctor I'm a podiatrist. If we are strict talking about patients now, they do not understand that a podiatrist has any difference in education. Heck most people still think that we get MD degrees and just did a podiatric residency. I would assume that they feel this way b/c if their PCP consults a DPM then they must be just as educated if not more.

I really don't care much about the law referenced above, and I'm fine with you being called Dr. Feelgood (when you graduate) or podiatry student Feelgood (now).

 

[50960]

There is no law. This concept of some law being proposed or passed makes no sense on several different levels. Most medical Law is state law, not federal. Hospitals where this plays out all have different ways of doing things, different medical staffs etc.. It would basically be illegal to tell doctors they can't be called doctors. Some hospitals and medical staffs have done this, but it is not a law, not could it be.

 

[Dr_Feelgood]

Whoa, your "specialized" training in LE amounts to the time spent in OMM lab for DO students?! Jesus....DO students are known for downplaying how much time they spend in OMM lab for the exact opposite reason - they want to emphasize that minimal time is taken away from basic science coursework. Interesting.



This paragraph doesn't really make sense, and I don't feel like breaking it down sentence by sentence.



Man, I just cringe when you use those terms.



1) No one said podiatry wasn't "changing". What this really means is podiatry is designing their curriculum to look like an allopathic medical school (or DO, but DO's designed theirs after the allopathic model too) curriculum. It just seems a really roundabout way to get people to call you doctors and blur the lines between medical doctors and podiatrists by shunting people from the lower end of the admissions game into pod schools (or other peripheral care provider programs e.g. DNP, DPT, DOT, etc.) build lobbying power, modify your curriculum to look just like an MD curriculum, make subtle terminology changes bit by bit, lobby some more, make more changes to blur the lines more, lobby some more, until no reasonable person could argue it's not basically the same thing, except different in conception. Once you get there, when all the prestige you seek is yours, all the respect as MD=DPM is there, when all the prejudice about admissions standards and research funding and prescribing rights and scope of practice and all those other discrepancies are gone, maybe we'll all look around as a society and wonder the same thing then that we now wonder about DO's.....what's the point of having two different degrees for the same thing? And the answer is, of course, that there is no point. What it would mean would be DPM = orthopedist, and there's no way in hell MD/DO wants to ever let that happen.

Honestly, just stick with feet in your scope, stick with the terms "podiatrist" and "podiatry school" and we won't have any problems.

2) What the hell would a "fully integrated program" prove? That you're associated with a weak enough medical school that they're letting you piggyback onto their curriculum, doubling their class sizes, providing an easier route to get the "same" education, so that you can brag that you take the exact same classes as MD/DO students? I don't get it. In fact, since it sounds like pod students are always claiming their education is the same as MD/DO and that podiatry is a "subspecialty of medicine", maybe we should jump onboard. Take over all the podiatry residencies (or just make our own), make podiatry a surgical subspecialty like ophtho or ortho or uro or OB and put MDs into pod residencies. Ortho was getting too competitive anyway, might as well break off F&A and give it the credit its due. Now that would **** you guys over. At least it would make you put your money where your mouth is that your education is the same and that DPMs are the preeminent F&A people. A good old fashioned scrum over the foot.

Now you went from professional to personal. So I'm done with you.

 

[Dr_Feelgood]

Maybe they refer to it as "medical school" because that's how you those around you refer to it? Your head hurting isn't a great reason to deceive patients (intentionally or not). I've corrected patients a thousand times about me being a medical STUDENT and not a medical DOCTOR. Which, by the way, I wonder if you do given your SDN name and your claim to being a medical student. But whatever. I'm sure it would take you maybe 10 seconds to explain that you're in pod school. There's no need to get into MD vs DO programs.

"I'm sorry, Ma'am, I'm actually in podiatry school, a 4-year doctoral-level program that focuses on the health of the foot and ankle and related topics."​

I don't see how that would be confusing to most patients, let alone somebody in a doctoral program (if they're still confused try telling them that you're like a dentist, but you focus on the feet, and if you're still confused....well, then there's no hope). Typically patients refer to RN programs as nursing school, DDS programs as dental school, OD programs as optometry school . . . what's so hard about "podiatry school"?


I really don't care much about the law referenced above, and I'm fine with you being called Dr. Feelgood (when you graduate) or podiatry student Feelgood (now).

Same comments. If you want to debate that is fine but personal comments are not debate. Grow up.

 

[deleted87716]

Now you went from professional to personal. So I'm done with you.

Good call. 😉

Play nice, kids.

 

[Northerner]

Now you went from professional to personal. So I'm done with you.

Fair enough. If it's any consolation, I wasn't attacking you, I was making a point. Every "you" I used was the royal "you". The more hostile comments at the end were just a way to demonstrate what's at stake and where we stand relative to one another.

Naturally, I'm positively devastated you're "done with me", but it's just as well. I'm not going to penetrate that shell of yours, you're not going to stop using the terminology you use (even though it offends your colleagues and confuses patients), and I'm concerned enough about the future of my profession that I'm not going to let it go.

...flip a coin?

 

[corpsmanUP]

The reality of the degradation of this post shows how volatile this talk is related to titles. Unfortunately, where this thread went awry was when Dr. Feelgood, who I generally respect and like on this forum and probably would in real life (f-in best avatar on earth!), mentioned that the new legislation that may limit the use of "Dr" in clinical settings, would HAVE to include Podiatrists if it included DO's.

I am a DO. DO's have an UNRESTRICTED medical license to practice full spectrum medicine in any field that they 1)get residency trained in, or 2)or they can be general practitioners and only do an intern year like MD's can do. MD's and DO's both moonlight in areas they are not even training in currently, like rural FP, urgent care, occupational medicine, emergency medicine, etc..etc.. If in fact as a Podiatric doctor you could operate in anything near an unrestricted fashion during or after your residency, moonlight or otherwise, you would by definition be a physician. The only real reason you guys have the title physician in most states is because of lobbying.

In fact, what makes you guys ANY different than say an optometrist who also is a doctor and went to an advanced form of medical training? Please don't say it is because you sat in a class with medical students and took the same tests at times. Because I was a PA student once, and we did that as well, at times. To be open and honest with you and to end the debate, I believe if the powers that be would allow you guys to sit for the USMLE, then all this would be mute. Let the ones who are intelligent enough pass a "general physician" board exam like the USMLE and then let the Pods enter ANY residency they chose. My guess though, just related to known MCAT scores etc..etc.., would be that a high proportion of Pod students would not pass the boards.

Pods represent less than probably a fraction of 1 percent of the care that goes on in hospitals nationwide. It is not unreasonable that you would be able to use the title Dr., but follow it in the same sentence by the word Podiatrist? That is in essence what you are and are proud to be right? Please realize that if you simply introduce yourself as Dr. that you are expecting a patient to make the leap and know that you are something other than the 99.5% of Dr.'s they would likely EVER see in a hospital.

And please don't reply with the statement that Pods are different than OD's because they have a residency that might be 1 year, or could be 3, and might give them priviledges up to the sural nerve root, or might only give them forefoot priviledges versus midfoot and hindfoot and ankle priviledges. In the hospital I worked in as a PA before I was a physician, our own Podiatrist who was an employee in our practice, who had graduated from the California school, who had also done a 2 year residency, could only operate on forefoot issues. He could operate on ankles in the private surgical centers around town but not in the hospital. Ortho and chief of staff refused to allow it. Your hospital decided how much power you truly have unfortunately.

 

[Dr_Feelgood]

The reality of the degradation of this post shows how volatile this talk is related to titles. Unfortunately, where this thread went awry was when Dr. Feelgood, who I generally respect and like on this forum and probably would in real life (f-in best avatar on earth!), mentioned that the new legislation that may limit the use of "Dr" in clinical settings, would HAVE to include Podiatrists if it included DO's.

I am a DO. DO's have an UNRESTRICTED medical license to practice full spectrum medicine in any field that they 1)get residency trained in, or 2)or they can be general practitioners and only do an intern year like MD's can do. MD's and DO's both moonlight in areas they are not even training in currently, like rural FP, urgent care, occupational medicine, emergency medicine, etc..etc.. If in fact as a Podiatric doctor you could operate in anything near an unrestricted fashion during or after your residency, moonlight or otherwise, you would by definition be a physician. The only real reason you guys have the title physician in most states is because of lobbying.

In fact, what makes you guys ANY different than say an optometrist who also is a doctor and went to an advanced form of medical training? Please don't say it is because you sat in a class with medical students and took the same tests at times. Because I was a PA student once, and we did that as well, at times. To be open and honest with you and to end the debate, I believe if the powers that be would allow you guys to sit for the USMLE, then all this would be mute. Let the ones who are intelligent enough pass a "general physician" board exam like the USMLE and then let the Pods enter ANY residency they chose. My guess though, just related to known MCAT scores etc..etc.., would be that a high proportion of Pod students would not pass the boards.

Pods represent less than probably a fraction of 1 percent of the care that goes on in hospitals nationwide. It is not unreasonable that you would be able to use the title Dr., but follow it in the same sentence by the word Podiatrist? That is in essence what you are and are proud to be right? Please realize that if you simply introduce yourself as Dr. that you are expecting a patient to make the leap and know that you are something other than the 99.5% of Dr.'s they would likely EVER see in a hospital.

And please don't reply with the statement that Pods are different than OD's because they have a residency that might be 1 year, or could be 3, and might give them priviledges up to the sural nerve root, or might only give them forefoot priviledges versus midfoot and hindfoot and ankle priviledges. In the hospital I worked in as a PA before I was a physician, our own Podiatrist who was an employee in our practice, who had graduated from the California school, who had also done a 2 year residency, could only operate on forefoot issues. He could operate on ankles in the private surgical centers around town but not in the hospital. Ortho and chief of staff refused to allow it. Your hospital decided how much power you truly have unfortunately.

I don't disagree with much of what you said at all. I am a huge advocate of a more universal approach to medical education. I would love to see the the USMLE used in one form or the other in podiatry (heck if nothing else it will lower our board fees, $900 per sitting). I only mentioned the DO principle b/c I have been with DOs for all of my basic science classes. If I would have sat next to an MD, I would have used them. In no way, shape, or form am i advocating a DPM to become anything more than a podiatrist. But I pose the question to you, why is it so unbelievable that a DPM can have an equal foundation of basic science knowledge? To me that is all medical school gives you, you get a foundation from which you build your true clinical education during your residency.

Now you mention a percentage of hospital work, I must disagree with your amount of work. This will vary per state and region, but many hospitals are hiring podiatrist on staff. With the increasing number of diabetic foot problems, their is a lot of work done in hospitals. I'm not saying it is close to the level of a orthopedist or a general surgeon, but I guarantee that it more than 1%. But using that logic, are dermatologist not doctors? How much work do they do in a hospital?

As for experience as a PA, 1) there are no 1 year residencies; the minimum is two, and the vast majority of residencies are 3 year programs. I do realize that there are pods out there without even 1 year of post-grad training. When the programs changed so did the board certification. A pod that does only 2 years of residency can only sit for the FF surgical boards; you must complete a 3 year program to sit for the RF and the ankle boards. That being said many places (i.e. surgery centers) let pods cut on anyone regardless of boards/training.

I cannot compare podiatry to OD b/c I do not know enough about the programs. I know that newer ODs are advocating for eye surgery privileges. The only comment I can make is podiatry has improved, I would dare to say, more than any other non-MD/DO subspecialty. This b/c MD/DOs allowed it to (maybe due to the fact that most MD/DOs ignore the feet). This is seen if nothing else my MDs and DOs offering fellowships to DPMs, Warren Joseph, DPM is the one of the leading infectious disease doctor for the LE in the world (if you don't believe me go to the www.idsociety.org). Dr. Jordan Grossman, DPM teaches foot and ankle surgery to the orthopedic residents at St Vincent's. Ohio State U takes DPMs applicants for the orthopedic foot and ankle fellowship. Brad Lamm, DPM works with Dryor Paley in Baltimore doing more reconstructive surgery. I could go on and on. So what separates DPM from OD, DC, DDS, ect is that DOs and MDs do invite be part of the patients primary care and do consult pods everyday.

I advocate that as with any medical judge the physician not the training. You can shout from the highest mountain that podiatrist are not physicians and they did not go to medical school, but if they save a patients life or leg. Maybe rethink your approach. There are lots of MDs and DOs out there I would not consider a physician not b/c they didn't have the training but b/c they are *****s. I reserve the title of physician for one who no matter the training is a great doctor.

 

[Northerner]

The reality of the degradation of this post shows how volatile this talk is related to titles. Unfortunately, where this thread went awry was when Dr. Feelgood, who I generally respect and like on this forum and probably would in real life (f-in best avatar on earth!), mentioned that the new legislation that may limit the use of "Dr" in clinical settings, would HAVE to include Podiatrists if it included DO's.

I am a DO. DO's have an UNRESTRICTED medical license to practice full spectrum medicine in any field that they 1)get residency trained in, or 2)or they can be general practitioners and only do an intern year like MD's can do. MD's and DO's both moonlight in areas they are not even training in currently, like rural FP, urgent care, occupational medicine, emergency medicine, etc..etc.. If in fact as a Podiatric doctor you could operate in anything near an unrestricted fashion during or after your residency, moonlight or otherwise, you would by definition be a physician. The only real reason you guys have the title physician in most states is because of lobbying.

In fact, what makes you guys ANY different than say an optometrist who also is a doctor and went to an advanced form of medical training? Please don't say it is because you sat in a class with medical students and took the same tests at times. Because I was a PA student once, and we did that as well, at times. To be open and honest with you and to end the debate, I believe if the powers that be would allow you guys to sit for the USMLE, then all this would be mute. Let the ones who are intelligent enough pass a "general physician" board exam like the USMLE and then let the Pods enter ANY residency they chose. My guess though, just related to known MCAT scores etc..etc.., would be that a high proportion of Pod students would not pass the boards.

Pods represent less than probably a fraction of 1 percent of the care that goes on in hospitals nationwide. It is not unreasonable that you would be able to use the title Dr., but follow it in the same sentence by the word Podiatrist? That is in essence what you are and are proud to be right? Please realize that if you simply introduce yourself as Dr. that you are expecting a patient to make the leap and know that you are something other than the 99.5% of Dr.'s they would likely EVER see in a hospital.

And please don't reply with the statement that Pods are different than OD's because they have a residency that might be 1 year, or could be 3, and might give them priviledges up to the sural nerve root, or might only give them forefoot priviledges versus midfoot and hindfoot and ankle priviledges. In the hospital I worked in as a PA before I was a physician, our own Podiatrist who was an employee in our practice, who had graduated from the California school, who had also done a 2 year residency, could only operate on forefoot issues. He could operate on ankles in the private surgical centers around town but not in the hospital. Ortho and chief of staff refused to allow it. Your hospital decided how much power you truly have unfortunately.

Just to be clear - I think they should use the title "Dr." and should be called "doctors" or "foot doctors", but shouldn't use the word "physician" to describe themselves or "medical school" to describe their education. As I've said, I think "podiatrist" and "podiatry school" are plenty and more accurate terms. Strictly speaking, the word physician refers to a non-surgical medical doctor. You don't hear many surgeons calling themselves physicians, though since everyone's throwing that word around so much these days, it's perverted the meaning a bit.

 

[Adcadet]

Just to be clear - I think they should use the title "Dr." and should be called "doctors" or "foot doctors", but shouldn't use the word "physician" to describe themselves or "medical school" to describe their education. As I've said, I think "podiatrist" and "podiatry school" are plenty and more accurate terms.

Dido

 

[deleted87716]

Dido

I think you mean "ditto."

Unless that's just your way of waving a white flag. 😉

I'm showing my age here, but do you know where the word "ditto" comes from? In the days before Xerox machines, copies were often made using spirit duplicators, called "dittos." Anyone else remember sniffing their elementary school exams? Mmm... 😉

See: http://en.wikipedia.org/wiki/Spirit_duplicator

But I digress...and now, back to our regularly-scheduled discussion.

 

[Adcadet]

I think you mean, "ditto."

Unless that's just your way of waving a white flag. 😉

Do'oh! At least I didn't accidentally hit the "L" key.

 

[Mr. McDuck]

I think you mean "ditto."

Unless that's just your way of waving a white flag. 😉

I'm showing my age here, but do you know where the word "ditto" comes from? In the days before Xerox machines, copies were often made using spirit duplicators, called "dittos." Anyone else remember sniffing their elementary school exams? Mmm... 😉

See: http://en.wikipedia.org/wiki/Spirit_duplicator

But I digress...and now, back to our regularly-scheduled discussion.

That doesn't necessarily mean you're old. We had that crap in elementary school too, and I'm only 23. Maybe I just went to a crappy elementary school...

 

[Mr. McDuck]

Oh, and the DNP thing. I had a patient come in for surgery a little while ago who was a DNP. When the anesthesiologist went to talk to her, he called her Mrs. XXXX. She corrected him: "That's DOCTOR XXXX." 🙄

Apparently she also introduces herself to patients that way. That's a little ridiculous. I don't mind calling someone with a doctorate degree Dr. XXXX, but introducing yourself to patients as Dr. XXXX in a hospital when you're not a physician is a bit misleading.

 

[dilated]

I think a lot of the concern over this is overblown.

As far as ego goes I don't understand it. Whatever ego boost you get from of 100 times calling yourself "Dr X" as a DNP would surely be ruined by the 2 times someone goes "Oh, so you're not actually a doctor then" when they look at your ID.

As far as independence goes, thank the lawyers. If you think the phenomenon of dueling experts produces unfair results, wait until the first DNP to do a surgical procedure doesn't get a perfect outcome and goes to trial where the plaintiff calls MD surgeons who go on and on about their training and then blast the DNP for being underqualified. And when they smell a threat to their livelihood you're not going to see the professional sleazebag witnesses, you're going to see division/department chairs at top hospitals taking the opportunity to shut down the competition in exchange for some sweet cash. One 20 million dollar judgment later, the independent specialist experiment will be over. I can see it now...John Edwards: "The patient is speaking through me to you today, telling you to SEND A MESSAGE not to let this malpractice happen!"

 

[deleted87716]

When the anesthesiologist went to talk to her, he called her Mrs. XXXX. She corrected him: "That's DOCTOR XXXX." 🙄

That reminds me of someone... 😉

"It's Doctor Evil. I didn't go to Evil Medical School for six years to be called 'mister', thank you very much."

 

[jonwill]

I was talking with my wife's nurse/midwife and she stated that they are attempting to move the CNM to a doctoral degree. She didn't think it was necessary (just more expensive) but she says that they are "just trying to keep up with the other mid-level professionals".

I think something has started that probably isn't going to stop.

 

[Dr_Feelgood]

Strictly speaking, the word physician refers to a non-surgical medical doctor. You don't hear many surgeons calling themselves physicians, though since everyone's throwing that word around so much these days, it's perverted the meaning a bit.

I do agree that this is the classic definition, but the term physician has changed. Since Medicare, Medicaid, and insurance companies list "Physician specialty," the term became more synonymous with doctor (in my opinion). If you are to get truly technical, outside of the US only Internal Medicine doctors are physicians which is closer to the classic definition.

Here is an interesting history of the word for an FYI (since it is reasonable to use Wikipedia). http://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Physician I thought it was ironic that they listed DC and ND practitioners as physicians, which to me is much more inflammatory than a DPM. I don't know of one DPM that claims that they want to be a PCP. You can keep your ED and pap smears.

 

[fab4fan]

I think you mean "ditto."

Unless that's just your way of waving a white flag. 😉

I'm showing my age here, but do you know where the word "ditto" comes from? In the days before Xerox machines, copies were often made using spirit duplicators, called "dittos." Anyone else remember sniffing their elementary school exams? Mmm... 😉

See: http://en.wikipedia.org/wiki/Spirit_duplicator

But I digress...and now, back to our regularly-scheduled discussion.

Not only do I remember the smell, I remember the funky purple color of the ink.

Geez Kent, you must be an old geezer if you remember that stuff!

 

[deleted87716]

Geez Kent, you must be an old geezer if you remember that stuff!

Well, I'm not so old that I've forgotten it. 😉

 

[fab4fan]

Well, I'm not so old that I've forgotten it. 😉

LOL. I guess you have a few good years left in you after all. 🙂

 

[deleted87716]

LOL. I guess you have a few good years left in you after all. 🙂

"When I get older, losing my hair,
Many years from now..."

Doh...! Too late. 😉

 

[chimichanga]

I almost never introduce myself as "doctor." I prefer to just use my full name. To each his/her own.

unless you are a 75 year old surgeon, and you introduce yourself as doctor to the Spanish speaking only hired help, and to anyone else that gives a s!!!!T less (including your mechanic, the hostess, the Lemaitre, or any other subservient, subhuman type being)

Kent, you get it...NOBODY CARES (outside of the clinical arena) what you do for a living...



WHAT????

It doesn't say "doctor W" on your birth certificate?

how dare you allow the "help" to address you by your first name...What an OUTRAGE!!!

such collaborative behavior leads to anarchy and a breakdown of the whole caste system that "we" have created...

signed,

PhD mods and other egocentric, old school, need to retire doctors (MD, ND, DO, DPM, DSN, DPT, AuD, et freaking cetera) that take themselves WAAAAY too seriously...





😍

 

[chimichanga]

BTW,

Nurses (DSN and PhD prepared) that call themselves doctors are WAAAAY off base and should be discouraged from such insanity...

go to medical school if you want that privilege...

 

[brightness]

I totally disagree that PhD trained nurses cannot refer to themselves as doctors in non-clinical (teaching, research) settings. All of my professors are called 'doctor', and so are psychologists who have PhDs.

 

[chimichanga]

In non clinical settings, it's allowed...it just sounds weird to me (as it does for doctors of philosophy, education, etc...)

 

[corpsmanUP]

No one cares who you make call you "Doctor" outside the hospital or clinic, but I assure you if I ever hear a non-physician provider introduce themself as "Doctor" in ANY clinical setting where patients would normally expect physicians to work, I will embarass the crap out of them.

Call yourself whatever you want on an airplane, in a classroom, at the mall, on the phone, or in a restaurant, but don't use the title where it can be confusing to patients.

I see this issue being addressed in the future by hospital CEO's who are the backbone of policy in the clinical setting of a hospital. These are the people that approve priviledges at the highest level.

Here is the ultimate explanation:
One day last week was "National Doctor's Day". I received an invitation from our hospital CEO that read, "Please join us to celebrate the job that physicians do for our institution. We will be celebrating all our interns, residents, and staff physicians". You notice there was no mention of DNP's, PharmD's, or any other D's other than physicians. That is because the public thinks of "Doctor" as physician and we all know it. If you don't believe me, pay your own money and hire a team of surveyors to call 10,000 people or stop them on the street. Ask them 1 question only. Ask them what they believe it takes to be a "Doctor",and ask them if they know any "Doctors". Or better yet, ask them when the last time was that they were seen by a "Doctor". None of those questions bias a person or persuade them into saying anything other than what the cultural norm.

My guess is that over 98% of responses could be lumped into a category describing physicians.

If the any of the words following the title Doctor due not include Medicine (the exception being Naturopathic Medicine), then the degree is NOT one that gives the person the right to be called Dr. in a patient care setting.

Someone is likely to argue the audiologist who works for the ENT in a private office, or the optometrist that works in the Ophtho's office, etc...etc.. These are exceptions that are made BY the physicians whom these people work with. People come to these offices to see specialists and it is up to the specialist to determine how their non-physician colleagues are titled in THEIR office. But not in the hospital. And don't get your feelings hurt when physicians refuse to call non-physician's doctor when on the phone, in a letter, or in passive conversation. We don't even call each other that unless it is in front of a patient or in talking about another physician to a nurse or staff member.

 

[Taurus]

The patient wants to know who the "doctor" is so that when something goes wrong they know who to sue. 🙄 This should be a warning to any doc. Midlevels want the income and autonomy of physicians but not the liability. They will do this by finding a physician to "supervise" them. More like, they want a physician to rubberstamp and provide cover for them, even though this physician may be 500 miles away. If they get into trouble, they will claim that they are under your supervision and it is you who is responsible. If a midlevel can claim you as a supervisor, then you should directly supervise them and keep them on a very short leash. It's your license, liability, and reputation at stake.

I wait for the first malpractice trial of a DNP. It will be a wake-up call to lots of docs.

 

[core0]

The patient wants to know who the "doctor" is so that when something goes wrong they know who to sue. 🙄 This should be a warning to any doc. Midlevels want the income and autonomy of physicians but not the liability. They will do this by finding a physician to "supervise" them. More like, they want a physician to rubberstamp and provide cover for them, even though this physician may be 500 miles away. If they get into trouble, they will claim that they are under your supervision and it is you who is responsible. If a midlevel can claim you as a supervisor, then you should directly supervise them and keep them on a very short leash. It's your license, liability, and reputation at stake.

I wait for the first malpractice trial of a DNP. It will be a wake-up call to lots of docs.

I am not sure what mid-levels ever did to you, but looking at your posts it must have been horrible. I am sure in your incredible medical experience you have met most mid-levels and have been able to individually ascertain thier desire for independence. I am not sure what part you play in the medical community since you have neglected to fill out your profile.

In any profession there is a vocal fringe element that desires something far outside the norm. In the PA profession there are people that got into profession and now rebel at the limits imposed on the profession. These are few and far between (but probably over represented on this forum). In the NP profession the drive is either between a few fringe elements or educational or political leaders that are in this for their own agenda. The vast majority of NPP's do not desire independence.

Trust and respect is earned. The relationship between a physician and NPP should be based on respect and trust. It should be based on the understanding of the skills of the respective providers. A NPP with little experience should not be allowed the latitude of an experienced provider. In practice the push to have a NPP exceed thier boundaries is more likely to be intiated by the physician than the NPP. Their are physicians that cannot properly delegate medical decision making and their are physicians that cannot properly supervise medical decision making. These physicians should not employ NPP's. Most physicians that employ NPP's understand the role and limitations of NPP's.

I have already made my position on the "Doctor" clear in other posts.

David Carpenter, PA-C

 

[Taurus]

PA's aren't that bad. They work under the medical model and I think that they respect each person's role.

My issue is more with the nurses. The work under the nursing model, yet some try to perform medicine and claim it's falls under "nursing". I don't like "backdoor" doctors, period. It only requires a small fringe group to cause problems. Once this fringe group is able to lobby for expanded rights for themselves, everyone in that group gets the same rights.

I'll use the CRNA's as an example. They are the most highly paid nurses. Some can make $200k, but the average is like $140k for just a 2 year master's degree. In 14 states, they have successfully lobbied for autonomy. The vocal ones believe that they are just as good as the anesthesiologists. They have just created a new degree for themselves called the "Doctor of Nurse Anethesia Practice" or the DNAP (no joke). With the DNAP, they hope to gain autonomy in all 50 states and equivalence with anesthesiologists. What the nurses are so naive about is that the reason why their salaries are so high right now is because anesthesia has been viewed as a medical specialty. The CNRA's are riding on the anesthesiologists' coattails. What happens when Medicare starts to realize that anesthesia is mostly done by nurses? It will start to look at anesthesia as a nursing profession and the reimbursements will drop off a cliff. What happens to the anesthesiologists? 1) salaries drop 2) jobs will be scarcer. It's already happening. Anesthesiology is getting hit hard by Medicare cuts now and in the foreseeable future. Those bean counters in Washington, DC aren't stupid.

If you allow midlevels to take over your specialty, they will commoditize it. Medicare and insurance companies will start to say, "Gee, this is something that can be done by someone with just 2 years of training. If that's true, then I'm going to adjust my reimbursement levels to match your level of training."

I'll let you use your imagination to predict what DNP's will do to primary care.

 

[deleted87716]

I'll let you use your imagination to predict what DNP's will do to primary care.

No, go ahead...I don't think we've heard that one before. 😉

 

[sunnyjohn]

No, go ahead...I don't think we've heard that one before. 😉

*hands Kent and David the popcorn as they wait for a reply*

 

[50960]

This is getting way off topic. My personal views on the Dr thing in clinical settings are" If you need a doctoral degree for your license then you have every right to the title, none more than others. This includes physicians, pods, dentists, psychologists, who are nearly universally allowed onto medical staffs, but also optometrists, chiros, who may not be allowed medical staff membership.

 

[corpsmanUP]

This is getting way off topic. My personal views on the Dr thing in clinical settings are" If you need a doctoral degree for your license then you have every right to the title, none more than others. This includes physicians, pods, dentists, psychologists, who are nearly universally allowed onto medical staffs, but also optometrists, chiros, who may not be allowed medical staff membership.

I would venture to say the law working it's way through Congress will disagree with you.

 

[50960]

I said it was my opinion. I hear veiled references to this bill, law etc... and have for years, but nobody can ever provide a link or even a shred of info about it. Can you?

 

[deleted87716]

I would not recommend that anyone continue to engage a member who has asked to have their account deleted (e.g., user name is "Guest.") You aren't going to get an answer.

 

[lawguil]

I would love to see a system were the noun doctor is essentially eliminated. Surely, at this juncture, the term has been diluted. Medicine, dentistry, and the like are bachelors level degrees that have already gone through the inflation process. Now we have other less qualified clinicians who want to go through the process that physicians, dentists, and the like invented.

I would much rather see a system were we simply referred to ourselves as physician, surgeon, physical therapist, dentist, podiatrist, nurse, and the like. Would this help eliminate the confusion, inappropriate status and inflated degrees? Surely, it takes time for humans to de-program, but eventually, people would adjust, the system would identify who the real decision makers are and help eliminate this defiant system of political pandering that exists in our current healthcare climate.

Will it ever happen…probably not. It seems that nobody really wants to be viewed at face value.