Med school prestige, MD vs DO, specialty arguments are completely toxic

[Matthew9Thirtyfive]

Have you considered that we tend to see extremely different patient populations at our schools? The vast majority of people around here don't even know what a DO is relative to an MD, let alone various midlevel credentials.

Keep throwing that shade though, it's hot out here in July

Completely irrelevant. That wasn’t the argument. The argument is that a nurse practitioner or a physician assistant introducing themselves as a doctor in a clinical setting is inappropriate for multiple reasons, including being confusing to patients and misleading.

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[Bonne Nuit]

You don't see anything weird about claiming "doctor" is a title reserved for those with legitimate medical schooling and a proper residency, but then awarding the title to naturopathic quacks?

And, do you really think anything about your dad's care would be different if that slip went uncorrected?

I see nothing wrong with people who have earned doctorates calling themselves “doctor” in their own turf - this could be anyone from an academic to a pastor to a psychologist to, yes, a naturopath. I think it’s pompous and silly when someone waves around their credentials after earning an online doctorate in divinity or whatever, but I don’t really care if they’re not trying to represent themselves as medical doctors.

I see everything wrong with the field of naturopathy as a whole, but the professional titles they choose to give themselves is at the very bottom of my list of grievances.

To answer your question about my dad - yes, hearing his provider taking an extra moment to say “I’m not your doctor, Dr. Jones is your doctor, I’m the practice PA and I’m responsible for XYZ” fosters trust and clarity. She does this in all aspects of their patient/provider relationships, and that’s why she’s a great PA. There is no question that this is better care for my dad. None.

 

[Matthew9Thirtyfive]

It's when the state has an independent NP functioning identically to a MD or DO that I think the title is just as applicable.

Do you not understand that there is a difference in knowledge and skill between an NP and an MD/DO? When you call yourself a doctor, patients think you are an MD/DO and have the knowledge and skills that come with that.

 

[Mass Effect]

Your view on NDs (in states where they can prescribe etc)? They learn pseudoscience and don't even need a residency at all. But they've got it in their name and they've got states that let them prescribe/order

So because NDs (who have a legit doctorate) call themselves doctor, an NP should too?

 

[slowthai]

@efle's just enjoying this, lol

 

[efle]

Your patients go out of their way to ask more questions as to what an NP / PA does? I worked at a safety net hospital that was pretty much the catching net for everyone and anyone.

A simple, "I'm Jenny Mcjenerson NP and I work directly with Dr. Bones in ortho. I see patients with him and we work together to take care of you." and then after that the response is usually..."oh, ok.."

Just the opposite, they literally couldn't care less, anyone in a white coat is "doc" and they mostly won't know what NP or PA or DO are even acronyms for anyways. But good for you if you'd take the time to explain! Also, agree about supervised NPs in specialty practices, that's different in my mind to an independent PCP using the term with patients.

Completely irrelevant. That wasn’t the argument. The argument is that a nurse practitioner or a physician assistant introducing themselves as a doctor in a clinical setting is inappropriate for multiple reasons, including being confusing to patients and misleading.

Do you not understand that there is a difference in knowledge and skill between an NP and an MD/DO? When you call yourself a doctor, patients think you are an MD/DO and have the knowledge and skills that come with that.

NDs though! If it's really about the training and transparency to patients, shouldn't we all be hating on that kind of credential for "doctor" 10x more?

So because NDs (who have a legit doctorate) call themselves doctor, an NP should too?

If a quack with no residency training and a fake degree can get "doctor" to come out of your mouth, then yes an independently practicing NP ought to meet that bar too.

@efle's just enjoying this, lol

Hush up now

 

[Lawpy]

@efle's just enjoying this, lol

I like stirred pots too

I'm just going to rebel against the physicians who actively defend midlevels and file professional complaints against trainees who question them.

 

[Matthew9Thirtyfive]

NDs though! If it's really about the training and transparency to patients, shouldn't we all be hating on that kind of credential for "doctor" 10x more?

I don’t think they should be calling themselves doctor in a clinical setting either. Psychologists often aren’t allowed to, so I don’t know why an ND should either.

 

[PTPuser]

Just the opposite, they literally couldn't care less, anyone in a white coat is "doc" and they mostly won't know what NP or PA or DO are even acronyms for anyways. But good for you if you'd take the time to explain! Also, agree about supervised NPs in specialty practices, that's different in my mind to an independent PCP using the term with patients.



NDs though! If it's really about the training and transparency to patients, shouldn't we all be hating on that kind of credential for "doctor" 10x more?


If a quack with no residency training and a fake degree can get "doctor" to come out of your mouth, then yes an independently practicing NP ought to meet that bar too.


Hush up now

I don't explain that to the pt. I'm trying to tell you that many times, is how the interactions are played out.
And rightfully should be for an NP / PA even if they have a doctorate.

 

[Kardio]

@efle's just enjoying this, lol

ITT: efle takes on the world

 

[ciestar]

My psychiatrist is a DNP and doesnt ever call herself doctor.

 

[MLNS]

My psychiatrist is a DNP and doesnt ever call herself doctor.

? a nurse practitioner can’t be a psychiatrist, as a psychiatrist is a physician trained in psychiatry...

 

[Neopolymath]

ITT: efle takes on the world

View attachment 312057

I'm gonna be honest here. I will ALWAYS refer to him as an elf-dude in my head. That will not change. Thanks.

 

[slowthai]

I'm gonna be honest here. I will ALWAYS refer to him as an elf-dude in my head. That will not change. Thanks.

LOOOOOL

 

[slowthai]

I'm gonna be honest here. I will ALWAYS refer to him as an elf-dude in my head. That will not change. Thanks.

ITT: efle takes on the world

View attachment 312057

I won't lie, I originally thought this was supposed to be a depiction of efle with a dunce cap on, and I was like man, that is harsh Kardio looool

 

[LutGholein]

My psychiatrist is a DNP and doesnt ever call herself doctor.

You mean she’s an MD with DNP? The term Psychiatrist is only MD/DO

 

[Kardio]

I won't lie, I originally thought this was supposed to be a depiction of efle with a dunce cap on, and I was like man, that is harsh Kardio looool

LOL.

For anyone else who thought it was a dunce cap - it’s actually just the elf meme from Runescape. No actual offense intended. All in good fun.

 

[ciestar]

? a nurse practitioner can’t be a psychiatrist, as a psychiatrist is a physician trained in psychiatry...

You mean she’s an MD with DNP? The term Psychiatrist is only MD/DO

Whatever. The person that prescribes my medication.

ive gotten so into the habit my husband does not know the difference.

 

[efle]

You mean she’s an MD with DNP? The term Psychiatrist is only MD/DO

Whatever. The person that prescribes my medication.

ive gotten so into the habit my husband does not know the difference.

Oh, how the turntables have turned

 

[MedicineZ0Z]

Have you considered that we tend to see extremely different patient populations at our schools? The vast majority of people around here don't even know what a DO is relative to an MD, let alone various midlevel credentials.

Keep throwing that shade though, it's hot out here in July

Lol dude I literally meet people ALL the time who think medical doctors have a PhD in medicine. And these are often people who are college educated!
People have no clue what a PA or NP is.

I would have a much harder time respecting an ND using the title, compared to an NP! That's a very interesting take to me.

I totally agree a specialist situation like that would be confusing, because they're not going to be the one with their name at the bottom of the chart managing your horrible arrhythmia. It's when the state has an independent NP functioning identically to a MD or DO that I think the title is just as applicable.

Kind of disagree. NDs are quacks. Their market is different and the people they see are the types you only meet in modern medicine once **** hits the fan and they need bulldozer treatments/admission. NPs are direct competitors who are fooling people into thinking they're equivalent to doctors.

 

[ciestar]

Oh, how the turntables have turned

She isn’t my husband’s care provider. So, it’s easier to say “i have a doctor’s appt”. I know the difference, it makes no difference in my husband’s life.

But to your comment before that people don’t know the difference, I assure you, people do ask for a “real doctor”.

 

[efle]

She isn’t my husband’s care provider. So, it’s easier to say “i have a doctor’s appt”. I know the difference, it makes no difference in my husband’s life.

But to your comment before that people don’t know the difference, I assure you, people do ask for a “real doctor”.

I know, I'm just giving you a hard time for defending an MD/DO title and then immediately misusing an MD/DO title. Wonderfully timed example of how your relationship with your provider has little to do with the title and everything to do with their role for you. And I'm guessing if they had referred to themselves as your psychiatrist, you wouldn't have felt misled, let alone endangered.

 

[ciestar]

I know, I'm just giving you a hard time for defending an MD/DO title and then immediately misusing an MD/DO title. Wonderfully timed example of how your relationship with your provider has little to do with the title and everything to do with their role for you. And I'm guessing if they had referred to themselves as your psychiatrist, you wouldn't have felt misled, let alone endangered.

To be honest i dont think she ever has..
She became my provider after my psychiatrist left the practice.

and yeah, relationships matter. But, she to my knowledge has never misrepresented herself and that matters.

 

[M&L]

I know, I'm just giving you a hard time for defending an MD/DO title and then immediately misusing an MD/DO title. Wonderfully timed example of how your relationship with your provider has little to do with the title and everything to do with their role for you. And I'm guessing if they had referred to themselves as your psychiatrist, you wouldn't have felt misled, let alone endangered.

To be honest i dont think she ever has..
She became my provider after my psychiatrist left the practice.

and yeah, relationships matter. But, she to my knowledge has never misrepresented herself and that matters.

as someone who worked in the field of psychiatry, it is very different than "regular" medicine. In psyche NPs, therapists (who are not MDs - just master's degree holders), counselors are the ones who provide absolute majority of the services. so, @ciestar did not screw up, - what Ciestar said makes perfect sense. In psyche field the lines are different. Honestly, only someone who has been a patient/client in psyche, or worked in psyche would probably understand what i mean (i am probably not explaining myself well). I worked in psyche field for YEARS and actually only once worked for an actual MD/DO psychiatrist (i think she was an MD).

 

[efle]

as someone who worked in the field of psychiatry, it is very different than "regular" medicine. In psyche NPs, therapists (who are not MDs - just master's degree holders), counselors are the ones who provide absolute majority of the services. so, @ciestar did not screw up, - what Ciestar said makes perfect sense. In psyche field the lines are different. Honestly, only someone who has been a patient/client in psyche, or worked in psyche would probably understand what i mean (i am probably not explaining myself well). I worked in psyche field for YEARS and actually only once worked for an actual MD/DO psychiatrist (i think she was an MD).

Did you pronounce it sīkē like you're spelling it the whole time you worked in the field?? Someone who has an NP as their PCP might have zero contact with anybody besides them too

 

[Lawpy]

Midlevels should stop functioning as replacements for physicians in any specialty.

 

[hamstergang]

as someone who worked in the field of psychiatry, it is very different than "regular" medicine. In psyche NPs, therapists (who are not MDs - just master's degree holders), counselors are the ones who provide absolute majority of the services. so, @ciestar did not screw up, - what Ciestar said makes perfect sense. In psyche field the lines are different. Honestly, only someone who has been a patient/client in psyche, or worked in psyche would probably understand what i mean (i am probably not explaining myself well). I worked in psyche field for YEARS and actually only once worked for an actual MD/DO psychiatrist (i think she was an MD).

As a psychiatrist, I have no idea what you're talking about. If you're not a physician, you're not a psychiatrist.

In other news, NDs should not be licensed to do what they do, imo, much less call themselves doctors. I'm not sure why more weren't saying this earlier.

 

[M&L]

As a psychiatrist, I have no idea what you're talking about. If you're not a physician, you're not a psychiatrist.

In other news, NDs should not be licensed to do what they do, imo, much less call themselves doctors. I'm not sure why more weren't saying this earlier.

I am not saying that at all . I am just saying that in Outpatient psyche there are so many pther providers - nurses, therapists, technicians, that it is easy for someone who receives services to accidentally Call their NP or therapist “doctor”. That’s all I am saying .

 

[LutGholein]

I am not saying that at all . I am just saying that in Outpatient psyche there are so many pther providers - nurses, therapists, technicians, that it is easy for someone who receives services to accidentally Call their NP or therapist “doctor”. That’s all I am saying .

Any reason why you keep calling it “psyche“?

 

[M&L]

Any reason why you keep calling it “psyche“?

No idea .... that’s what I always called it . What’s wrong with that ?

 

[LutGholein]

No idea .... that’s what I always called it . What’s wrong with that ?

I’ve just never heard anyone call it that — maybe it’s a regional thing?

 

[M&L]

I’ve just never heard anyone call it that — maybe it’s a regional thing?

What do you call it ?

 

[goatmed]

Even if an NP introducing themselves as a doctor is legally fraud in your state, is the transgression or its result (patients were misled, but presumably no bad outcomes we know of or wouldn't expect from an NP hired by a hospital) really entail ruining somebody's life and sending them to prison? Would an institutional action not accomplish deterrence all the same? I mean, I don't read malice from the way the story is told and in the scope of ways laypeople can be misled this seems like one of the least significant for the law to use its might against. Maybe I'm missing something about the act or retaliation that is egregious enough to put someone in an orange jumpsuit and prevent them from using their degree ever again (I would agree retaliation of any kind against a good faith student concern is bad on both the MD and the NP, but also not prison-worthy)

 

[LutGholein]

What do you call it ?

Psych in the NE.

 

[libertyyne]

Even if an NP introducing themselves as a doctor is legally fraud in your state, is the transgression or its result (patients were misled, but presumably no bad outcomes we know of or wouldn't expect from an NP hired by a hospital) really entail ruining somebody's life and sending them to prison? Would an institutional action not accomplish deterrence all the same? I mean, I don't read malice from the way the story is told and in the scope of ways laypeople can be misled this seems like one of the least significant for the law to use its might against. Maybe I'm missing something about the act or retaliation that is egregious enough to put someone in an orange jumpsuit and prevent them from using their degree ever again (I would agree retaliation of any kind against a good faith student concern is bad on both the MD and the NP, but also not prison-worthy)

State boards do not have the power to imprison someone, and its unlikely a prosecutor would actually levy charges, and even if they did it is very unlikely it would result in any jail time. Plus it is not my job to determine what the punishment should be, we have a legal system. I am responsible for reporting transgressions against professional and legal conduct.

You have a really high expectation of Nursing Boards if you think they would actually do anything besides a proverbial slap on the wrist to an NP for this infarcation, the same way chiro boards would do anything to chiro's misrepresenting themselves.

 

[ciestar]

What do you call it ?

Just “psych”

 

[ciestar]

No idea .... that’s what I always called it . What’s wrong with that ?

How do you pronounce it?
Psych like “sike”
Or Psyche like “sike-e”

 

[Ho0v-man]

NPs call themselves doctors so patients don’t question their legitimacy. There are patients who do not want to see a midlevel at all or will at the very least push back against something major a non-physician wants. But both of these things are within a patients rights. So an NP misrepresenting themselves as a physician does take that choice away from patients and should be considered fraud imo. I’ve personally seen this go further when certain NPs or CRNAs use phrases like “Back in med school...” or “I remember this one time in residency...” which only adds further obfuscation. I can’t believe there’s not more pushback about this.

Go ahead and let chiros call themselves doctors. You’re there to get your back popped ffs. You know what this is about.

NDs can call themselves whatever they want. They can be Doctor Ultra Dragon Wizard Supreme for all I care. Someone going to an ND is too far gone to ever listen to a real doctor anyway.

 

[ciestar]

NPs call themselves doctors so patients don’t question their legitimacy. There are patients who do not want to see a midlevel at all or will at the very least push back against something major a non-physician wants. But both of these things are within a patients rights. So an NP misrepresenting themselves as a physician does take that choice away from patients and should be considered fraud imo. I’ve personally seen this go further when certain NPs or CRNAs use phrases like “Back in med school...” or “I remember this one time in residency...” which only adds further obfuscation. I can’t believe there’s not more pushback about this.

Go ahead and let chiros call themselves doctors. You’re there to get your back popped ffs. You know what this is about.

NDs can call themselves whatever they want. They can be Doctor Ultra Dragon Wizard Supreme for all I care. Someone going to an ND is too far gone to ever listen to a real doctor anyway.

Pharmacists too. They have a doctorate. Ive rounded with pharmacists on the team before.

 

[PTPuser]

NPs call themselves doctors so patients don’t question their legitimacy. There are patients who do not want to see a midlevel at all or will at the very least push back against something major a non-physician wants. But both of these things are within a patients rights. So an NP misrepresenting themselves as a physician does take that choice away from patients and should be considered fraud imo. I’ve personally seen this go further when certain NPs or CRNAs use phrases like “Back in med school...” or “I remember this one time in residency...” which only adds further obfuscation. I can’t believe there’s not more pushback about this.

Go ahead and let chiros call themselves doctors. You’re there to get your back popped ffs. You know what this is about.

NDs can call themselves whatever they want. They can be Doctor Ultra Dragon Wizard Supreme for all I care. Someone going to an ND is too far gone to ever listen to a real doctor anyway.

As someone who used to be a nurse, that is a whole new level of tacky.

 

[Mass Effect]

Lol dude I literally meet people ALL the time who think medical doctors have a PhD in medicine. And these are often people who are college educated!

Quite the Algonquin round table you're referring to.

 

[Mass Effect]

as someone who worked in the field of psychiatry, it is very different than "regular" medicine

Psychiatry is (hold your hat) "regular" medicine.

In psyche NPs, therapists (who are not MDs - just master's degree holders), counselors are the ones who provide absolute majority of the services

No they don't. Are you referring to social workers doing therapy? The vast majority of NPs in psych (who almost always operate under an MD) prescribe and don't do therapy.

In psyche field the lines are different

As a psychiatrist, I assure you, no, they're not.

Honestly, only someone who has been a patient/client in psyche, or worked in psyche would probably understand what i mean

I don't understand what you mean and I'm a psychiatrist.

I am not saying that at all . I am just saying that in Outpatient psyche there are so many pther providers - nurses, therapists, technicians, that it is easy for someone who receives services to accidentally Call their NP or therapist “doctor”. That’s all I am saying

Someone who calls their NP a doctor is wrong. The NP is not a doctor nor is the NP a psychiatrist. The NP is...an NP.

 

[KnuxNole]

So put yourself in their shoes. You're the PCP and you want to introduce yourself. You are a fully independent practitioner. You're not willing to spend the first two minutes with every patient discussing the intricacies of your state's various PCP credentials.

What do you say? Hello I'm what?

Hi! I'm your provider today!

 

[slowthai]

Hi! I'm your provider today!

Hey, so can you give me a discount? I don't use cable anyway

 

[Dr. Rafiki]

Even if an NP introducing themselves as a doctor is legally fraud in your state, is the transgression or its result (patients were misled, but presumably no bad outcomes we know of or wouldn't expect from an NP hired by a hospital) really entail ruining somebody's life and sending them to prison? Would an institutional action not accomplish deterrence all the same? I mean, I don't read malice from the way the story is told and in the scope of ways laypeople can be misled this seems like one of the least significant for the law to use its might against. Maybe I'm missing something about the act or retaliation that is egregious enough to put someone in an orange jumpsuit and prevent them from using their degree ever again (I would agree retaliation of any kind against a good faith student concern is bad on both the MD and the NP, but also not prison-worthy)

Misrepresenting yourself as a doctor is considered practicing medicine without a license here. Should practicing medicine without a license go unpunished?

 

[goatmed]

State boards do not have the power to imprison someone, and its unlikely a prosecutor would actually levy charges, and even if they did it is very unlikely it would result in any jail time. Plus it is not my job to determine what the punishment should be, we have a legal system. I am responsible for reporting transgressions against professional and legal conduct.

You have a really high expectation of Nursing Boards if you think they would actually do anything besides a proverbial slap on the wrist to an NP for this infarcation, the same way chiro boards would do anything to chiro's misrepresenting themselves.

Dr. Rafiki, who introduced this topic into the thread, said that what the NP in question did was a felony and was going to face jail time. Hence my question.

Misrepresenting yourself as a doctor is considered practicing medicine without a license here. Should practicing medicine without a license go unpunished?

This is qualitatively different from the janitor stepping into a patient room with a borrowed white coat and providing patient care. What the NP did was presumably legal except for the fact she introduced herself as a doctor. Whether the law groups both cases under the same legal umbrella wasn't my question, my question was whether it's ethical to ruin someone's career and life over how they introduced themselves provided the patient was not harmed and the transgression can be avoided in the future with an institutional action.

 

[Splenda88]

Pharmacists too. They have a doctorate. Ive rounded with pharmacists on the team before.

Ironically, pharmacy education is arguably more rigorous than NP, but they are not jumping in the 'I am Dr so and so' bandwagon...

 

[ciestar]

Ironically, pharmacy education is arguably more rigorous than NP, but they jumping in the 'I am Dr so and so' bandwagon...

Yeah i have a few friends that are pharmacists and you’re right about that. They even can do residencies to specialize in one field of pharm. Person I know is doing a two year thing in ID.

 

[Lawpy]

Dr. Rafiki, who introduced this topic into the thread, said that what the NP in question did was a felony and was going to face jail time. Hence my question.


This is qualitatively different from the janitor stepping into a patient room with a borrowed white coat and providing patient care. What the NP did was presumably legal except for the fact she introduced herself as a doctor. Whether the law groups both cases under the same legal umbrella wasn't my question, my question was whether it's ethical to ruin someone's career and life over how they introduced themselves provided the patient was not harmed and the transgression can be avoided in the future with an institutional action.

It's extreme but necessary response as long as aggressive midlevel campaigning exists and physicians keep losing their jobs to midlevels.

 

[PTPuser]

Dr. Rafiki, who introduced this topic into the thread, said that what the NP in question did was a felony and was going to face jail time. Hence my question.


This is qualitatively different from the janitor stepping into a patient room with a borrowed white coat and providing patient care. What the NP did was presumably legal except for the fact she introduced herself as a doctor. Whether the law groups both cases under the same legal umbrella wasn't my question, my question was whether it's ethical to ruin someone's career and life over how they introduced themselves provided the patient was not harmed and the transgression can be avoided in the future with an institutional action.

We need standards and repercussions. I'm old school. You want to eat at our table, you gotta work for it. Every physician is held to a certain standard and if you want to call yourself "Doctor" in a clinical setting like that, you better bare the responsibilities too just like us and not run the opposite direction when **** hits the fan. And I will bet that most of these mid-level would not be willing to gamble that.

Because I hear it at their school tours all the time when they come to our hospital, "It's like all the fun of being a doctor without all that responsibility LoLZZZZ".

You think you can come into our turf, with your fig scrub, lab coat, working 3 12 hrs shift, taking 2 classes and getting your DNP online with your fake research "capstone" studies, while my comrades and I are in 300K debt, haven't bought new clothes in 2 years, in before the break of dawn, out 14 hrs later and have to answer to higher ups when you f**k something up and get burden of your mistakes? No...I refused to accept that and every future physician should be just as furious.