Midlevels want to be Doctors

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Well, everyone has an ego I guess.

I think NPs using the title "doctor" in a clinical setting is deceptive to patients... I agree with the legislation.
 
If I ever heard a NP or PA call themselves doctors, I'd probably give them an odd look 🙄

Most Dentists don't say they are doctors (at least in my experience), so Im not sure why there is a big argument about that in the article.

I have no problem with them saying they got a doctorate degree but to call themselves doctors just seems like a way to mislead patients and increase their ego
 
They might be the smart ones. They can do a lot now without the debt, schooling and salary drop doctors are having now.
 
Most dentists don't call themselves doctors, but all their staff usually do. Interesting thing I noticed.

I've had DNP's tell me they are doctor so and so. Doesn't gel well when you know there are one year programs that focus entirely on medical ethics. Bleh.
 
I go to a very healthcare oriented school and thus have a lot of friends earning doctorates in the medical field (pharmacy, PT, OT, etc.). The overwhelming consensus even among those students is that they would never feel comfortable being called "Dr. ______."
 
Life Sucks said:
They might be the smart ones. They can do a lot now without the debt, schooling and salary drop doctors are having now.
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Salary Drop? Only for subspecialty doctors. Primary care doctors are actually seeing increased salaries and benefits.
 
wonderdog said:
Really?
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I saw an article recently that said the average salary for FM was up by like 15k over the last year. Not sure about other primary care fields. Also not sure if the trend has any hope of continuing or not. I doubt benefits would increase though.
 
Doctor Strange said:
I go to a very healthcare oriented school and thus have a lot of friends earning doctorates in the medical field (pharmacy, PT, OT, etc.). The overwhelming consensus even among those students is that they would never feel comfortable being called "Dr. ______."
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That's because all these fields did the same thing that nursing is trying to do now. A doctorate is different from being a doctor at a hospital. But the main issue with the DNP degree is that nurses that are feeling inferior are trying to obfuscate the difference between doctors and nurses. The whole point of having a doctorate is to raise the requirements of entry and completion of a degree and to ensure a certain level of training. But now some people just want other people to call them doctor without going through the same hard work and sacrifice.
 
Let's try to be fair to "midlevels" - the disgruntled ones that call themselves "doctor" are definitely few and far between. Most people who are "midlevels" are more than satisfied with their jobs, and I've never heard a "midlevel" call themselves a doctor or try to overstate their job or SOP.

Unfortunately, as in most cases, a few disgruntled individuals can spoil or ruin the reputation of the whole crop
 
def1 said:
If I ever heard a NP or PA call themselves doctors, I'd probably give them an odd look
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I kind of feel like this makes even less sense for a PA. Though I tend think that an experienced PA should be able to complete a residency & become an MD. I probably would have gone down the PA road of it weren't a terminal degree.
 
Doctor Strange said:
I go to a very healthcare oriented school and thus have a lot of friends earning doctorates in the medical field (pharmacy, PT, OT, etc.). The overwhelming consensus even among those students is that they would never feel comfortable being called "Dr. ______."
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agreed. it's culture.

I've an MS. should i start having people call me master?
 
I have no problem with PhD or other doctorate-level practitioners calling themselves 'doctor' *PROVIDED* that they clarify that they are not MDs. Having gone through the training, they have the right; but that right needs to be balanced against the public's right not to me intentionally misled.
 
I don't really see why anyone would have a problem with non-physicians calling themselves "Dr. ___"...if they've completed a PhD, they absolutely have that right, given that they aren't following up with "and I'm your physician!" It seems to me that the "ego" here is coming from the physicians who feel less accomplished by having others use their title (as they and other medical professionals have also complained about everyone using lab coats.)

Maybe I'm just weird, but if someone comes up to me and introduces themselves as Doctor so-and-so, my first reaction (if it's not already completely obvious by context) is to ask them if they're a physician or a PhD grad...there's a pretty big difference between saying "I'm Dr. ___" and "I'm a physician", even though the term "doctor" seems to have a weirdly specific value in the US.

Also, my mom's a PA, and I have to say that I've never heard any of her PA colleagues think about introducing themselves as "doctor." So I feel like this is pretty specific to DNP/NPs...
 
This legislation needs to be extended to more states.
 
Alpha A said:
I don't really see why anyone would have a problem with non-physicians calling themselves "Dr. ___"...if they've completed a PhD, they absolutely have that right, given that they aren't following up with "and I'm your physician!" It seems to me that the "ego" here is coming from the physicians who feel less accomplished by having others use their title (as they and other medical professionals have also complained about everyone using lab coats.)

Maybe I'm just weird, but if someone comes up to me and introduces themselves as Doctor so-and-so, my first reaction (if it's not already completely obvious by context) is to ask them if they're a physician or a PhD grad...there's a pretty big difference between saying "I'm Dr. ___" and "I'm a physician", even though the term "doctor" seems to have a weirdly specific value in the US.

Also, my mom's a PA, and I have to say that I've never heard any of her PA colleagues think about introducing themselves as "doctor." So I feel like this is pretty specific to DNP/NPs...
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This issue is really only important in a clinical context. If a patient is in an emergency room, and an NP in a lab coat introduces him/herself as "Dr. ____," it's extremely deceptive. You'll never have this problem with PhDs/optometrists/dentists because you'll never see one in a clinical environment where you'd expect to see a physician.

I know I'm using absolute terms like "never" a bit loosely, but you get the point.
 
I would like to see some doctors comment on here and see how they feel about this topic. A bunch of pre-meds acting like they know how experienced certain fields are is quite funny.
 
BiologyNerd said:
Most dentists don't call themselves doctors, but all their staff usually do. Interesting thing I noticed.
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This is how you get the power in this world. You have to work hard so other people WANT to call you a doctor.

You wont get anywhere forcing others to call a nurse a doctor.
 
Plue00 said:
I would like to see some doctors comment on here and see how they feel about this topic. A bunch of pre-meds acting like they know how experienced certain fields are is quite funny.
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I'm sure physicians have less trivial things to concern themselves with. But seeing as I'm not one, I get to concern myself with this.
 
Plue00 said:
I would like to see some doctors comment on here and see how they feel about this topic. A bunch of pre-meds acting like they know how experienced certain fields are is quite funny.
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I don't believe there are many attendings lurking the pre-med forums, but I found some related threads in the physician forums:

http://forums.studentdoctor.net/showthread.php?t=981881
http://forums.studentdoctor.net/showthread.php?t=914669

Just generalizing here, but it seems that physicians care more about the quality of care the patients are receiving from mid-levels who demand more and more autonomy in their practice, rather than what they call themselves. A DNP may have the title of a "doctor", but there's a huge difference in their medical training compared to an attending physician.
 
nysegop said:
Salary Drop? Only for subspecialty doctors. Primary care doctors are actually seeing increased salaries and benefits.
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My friend's dad is an OB/GYN and he made $50K less this year...He is not a happy camper.
 
rachelkj said:
Though I tend think that an experienced PA should be able to complete a residency & become an MD.
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Interesting.
You do realize that it is the Medical School that grants the degree right?
PAs have no place in a residency. Though I do understand that some specialize, and call their training a "residency". I've also seen CRNAs who refer to their clinical training months as a "residency" on their CV. I'm not sure who they're kidding. If they want to become physicians, and complete a residency, there is a clear path. The one all physicians take.
As to the title of Doctor, the expectation, in a medical setting, is the person introducing themselves that way is a physician or dentist, not the doctor of nursing practice. Most patients are absolutely NOT savvy enough to know the difference, especially in the setting of distractions (like pain, a family member's illness, etc). You can't even rely on them to be able read IDs either. I've seen CRNAs in the military (where they practice relatively independently) hide their role behind rank. I introduce myself as "I'm Dr. Destriero, I'm going to be your anesthesiologist" A few of them always identified themselves as Hi, I'm Commander Smith with anesthesia..."
Technically correct? yes. Deceptive? Yes. Intentional? Yes, absolutely.
 
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I would encourage you all to write Senator Galvano yourselves -- esp. if from Florida but even if not -- and express the importance of his bill. Let him know he has support. The website is encouraging NPs to have their families, friends, etc. write him; why should we not do the same?

His email address is [email protected]

The talking pts NPs are supposedly to address include:

The title "Dr" is an academic title

Many health care providers who are not physicians and have earned a doctorate use this title. These include: dentists (D.D.S.), optometrists, psychologists, chiropractors, naturopaths, social workers, and mental health counselors



IMO, both are quite weak/baseless; however, it's best to address them PLUS add on to it.
 
sinombre said:
This issue is really only important in a clinical context. If a patient is in an emergency room, and an NP in a lab coat introduces him/herself as "Dr. ____," it's extremely deceptive. You'll never have this problem with PhDs/optometrists/dentists because you'll never see one in a clinical environment where you'd expect to see a physician.

I know I'm using absolute terms like "never" a bit loosely, but you get the point.
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How much of an issue is it really, though? How will a DNP introducing him/herself as "Dr. ___" change patient care? I don't mean that in a belligerent way at all, I'm just genuinely curious, as I don't see how that introduction is deceptive (they've earned it imo) if not followed by "and I'm your physician."

IlDestriero said:
Interesting.
You do realize that it is the Medical School that grants the degree right?
PAs have no place in a residency. Though I do understand that some specialize, and call their training a "residency". I've also seen CRNAs who refer to their clinical training months as a "residency" on their CV. I'm not sure who they're kidding. If they want to become physicians, and complete a residency, there is a clear path. The one all physicians take.
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I think she's more referring to the fact that PAs have, in general, much more extensive clinical experience than their NP counterparts, and often take foundational courses right alongside medical students. I'm not saying that I agree, and this has nothing to do with the whole "doctor" debate, but PAs are highly trained in the actual "practice" of medicine--diagnosis/treatment with functional roles closer to MDs in my opinion--upon graduating.

(I'm obviously pretty biased though...)
 
Alpha A said:
How much of an issue is it really, though? How will a DNP introducing him/herself as "Dr. ___" change patient care? I don't mean that in a belligerent way at all, I'm just genuinely curious, as I don't see how that introduction is deceptive (they've earned it imo) if not followed by "and I'm your physician."
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Because this is implied by the title "doctor." Patients assume (rightfully so) that the doctors treating them have a certain amount of training. This is a big deal because the difference in training between DNPs and MDs/DOs is gigantic. Additionally, I don't think an extra year of ethics classes justify a "doctoral" degree.
 
Alpha A said:
How much of an issue is it really, though? How will a DNP introducing him/herself as "Dr. ___" change patient care? I don't mean that in a belligerent way at all, I'm just genuinely curious, as I don't see how that introduction is deceptive (they've earned it imo) if not followed by "and I'm your physician."



I think she's more referring to the fact that PAs have, in general, much more extensive clinical experience than their NP counterparts, and often take foundational courses right alongside medical students. I'm not saying that I agree, and this has nothing to do with the whole "doctor" debate, but PAs are highly trained in the actual "practice" of medicine--diagnosis/treatment with functional roles closer to MDs in my opinion--upon graduating.

(I'm obviously pretty biased though...)
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It is an issue because some won't follow up with "and I'm your Nurse Practitioner" and patients will think they spoke with the responsible physician when in fact they did not. It's a much bigger issue as in inpatient in the hospital than in an outpatient office visit. People have a right to know who they are speaking to, and who is caring for them. Inpatients have dozens of people coming and going. Shift changes, students, consultants, etc.etc. Our hospital has different colors on our ID badges. Attending physicians are one color, all nurses another, residents and students another. I'm not sure what color the PA badges are. This info is in the patient info packet all inpatients get. Who knows of they read it. They're Italy distracted at the time...
 
IlDestriero said:
It is an issue because some won't follow up with "and I'm your Nurse Practitioner" and patients will think they spoke with the responsible physician when in fact they did not. It's a much bigger issue as in inpatient in the hospital than in an outpatient office visit. People have a right to know who they are speaking to, and who is caring for them. Inpatients have dozens of people coming and going. Shift changes, students, consultants, etc.etc. Our hospital has different colors on our ID badges. Attending physicians are one color, all nurses another, residents and students another. I'm not sure what color the PA badges are. This info is in the patient info packet all inpatients get. Who knows of they read it. They're Italy distracted at the time...
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If it's only about access to information, then should physicians be stripped of the right to call themselves "doctors" in an academic setting then? It is equally deceptive for students who'd think they are faced with a legit science Ph.D when truly that person has only got a professional degree.
 
Doudline said:
If it's only about access to information, then should physicians be stripped of the right to call themselves "doctors" in an academic setting then? It is equally deceptive for students who'd think they are faced with a legit science Ph.D when truly that person has only got a professional degree.
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There's a problem with the bolded part. An MD isn't "only a professional degree," as is evident by the multitude of physicians who opt to do scientific research in lieu of seeing patients.
 
BiologyNerd said:
Most dentists don't call themselves doctors, but all their staff usually do. Interesting thing I noticed.

I've had DNP's tell me they are doctor so and so. Doesn't gel well when you know there are one year programs that focus entirely on medical ethics. Bleh.
Click to expand...

I have no problem referring to dentists or podiatrists as doctor in their setting, because they are the doctor of their practice. When you're in a medical setting, such as a hospital, "Doctor" refers to physicians.

I'm not too concerned about what they're called, but rather the constant increasing scope of practice other midlevels lobby for.
 
To be honest, why are midlevels even getting doctorates? Didn't most of the programs use to be at the Masters level?
 
Doudline said:
If it's only about access to information, then should physicians be stripped of the right to call themselves "doctors" in an academic setting then? It is equally deceptive for students who'd think they are faced with a legit science Ph.D when truly that person has only got a professional degree.
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Fine with me. Though I teach clinical medicine, so I'm keeping the title... 😉
If you feel the need to not refer to me as Dr. Destriero when you're peeking in the door of the faculty club, my ego will survive.
 
The more restrictions you put on the practice of Nurses the less likely they will want to stay in Florida or move to Florida to practice. Can we really afford to antagonize twenty percent of the primary care provider workforce at a time when the Affordable Care Act is planning to be implemented? Shouldn't we instead be looking for ways to attract more primary care providers into our state?
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The implications of this part of the article are hilarious.
 
La Presse said:
To be honest, why are midlevels even getting doctorates? Didn't most of the programs use to be at the Masters level?
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Honestly, I'd suspect it's because they are sick and tired of taking orders from physicians all the time (with no change in sight) and being perceived as inferior to 'Doctors'. If an extra year or two of education gets you that coveted title and a pay bump -- seems like a small price...
 
La Presse said:
To be honest, why are midlevels even getting doctorates? Didn't most of the programs use to be at the Masters level?
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It's all about getting a bigger $lice of the pie, and having independence. And it doesn't matter to their society leaders at all that many of these midlevel practitioners are not interested in independent practice and are unable to provide it safely either.
The cost slashing govt system will welcome midlevel expansion with open arms. Then, as they have already started to do, they will demand "equal pay for (allegedly) equal service." There goes the cost savings BTW if you're keeping track. The CRNAs are already 10-20 years ahead of the game. Just look there, that's where you're all headed.
Become a surgeon.
 
I don't think that nurses care what they are called. Hell, I'm called a c*nt at least weekly by one of the drunks in the ER and that is just passing them by. Haha, and someone thought that I was registration the other day.

I share an office with the PA's and NPs in the ER, and it does get old for them to correct the patients all the time about them not be a doctor even when they ALWAYS introduce themselves as "Hi, my name is Michelle and I'll be your PA today, or hi my name is Dan and I'll be your nurse practitioner today."

IMO, most mid-levels that I've seen just want to coexist peacefully. They only wanted an advanced nursing degree or PA degree because they wanted a family or didn't want to go through all the schooling. There are a few big-headed NP's out there, but they usually don't last long in any given place before everyone (other nurses, patients, and doctors) has had enough with them and they get themselves fired or choose to leave on their own.
 
IlDestriero said:
It's all about getting a bigger $lice of the pie, and having independence. And it doesn't matter to their society leaders at all that many of these midlevel practitioners are not interested in independent practice and are unable to provide it safely either.
The cost slashing govt system will welcome midlevel expansion with open arms. Then, as they have already started to do, they will demand "equal pay for (allegedly) equal service." There goes the cost savings BTW if you're keeping track. The CRNAs are already 10-20 years ahead of the game. Just look there, that's where you're all headed.
Become a surgeon.
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Thanks. Why should I become a surgeon? 😕
 
La Presse said:
Thanks. Why should I become a surgeon? 😕
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Because there's much less for midlevels to take away from surgeons.

Edit: It's easy for midlevels to slowly assume more primary care responsibilities, but you'll never see a midlevel operating independently.

Edit again: well, I shouldn't say never.
 
Midlevels don't want responsibility. If they tried acting like a surgeon, they would have a hard time blaming someone else for their incomplete training.
 
BiologyNerd said:
Most dentists don't call themselves doctors, but all their staff usually do. Interesting thing I noticed.

I've had DNP's tell me they are doctor so and so. Doesn't gel well when you know there are one year programs that focus entirely on medical ethics. Bleh.
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dentists are doctors. they have a doctorate level degree (doctor of dental medicine, doctor of dental surgery,etc). they are not medical doctors or physicians, but they are technically doctors
 
DokterMom said:
I have no problem with PhD or other doctorate-level practitioners calling themselves 'doctor' *PROVIDED* that they clarify that they are not MDs. Having gone through the training, they have the right; but that right needs to be balanced against the public's right not to me intentionally misled.
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agreed. I have a family member who is a psychologist and has a doctorate. he worked hard and for a very long time to earn this degree. he calls himself Dr. all of his patients and co-workers know he is not an MD
 
It's not about taking away doctorates from people who earned them. But other people keep haphazardly bastardizing the Oxford system in an attempt to gain unearned respect. All that nonsense with the alphabet soup behind people's names is ridiculous.
 
yehhhboiii said:
It's not about taking away doctorates from people who earned them. But other people keep haphazardly bastardizing the Oxford system in an attempt to gain unearned respect. All that nonsense with the alphabet soup behind people's names is ridiculous.
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The Alphabet Soup of Credentials and Sorting it All Out

By Patricia Speck, DNSc, APN, FNP-BC, SANE-A, SANE-P, DF-IAFN, FAAFS, FAAN
On The Edge - Summer 2009

Oh my!
Il Destriero, MD, LMFAO
 
IlDestriero said:
The Alphabet Soup of Credentials and Sorting it All Out

By Patricia Speck, DNSc, APN, FNP-BC, SANE-A, SANE-P, DF-IAFN, FAAFS, FAAN
On The Edge - Summer 2009

Oh my!
Il Destriero, MD, LMFAO
Click to expand...

😆
 
This is not so much an issue of description as it is an issue of distinction. Here's what I mean. For example, I am a part-time faculty member in the chemistry department of a state university. I am not technically a "professor" because that word is a distinction given to specific individuals, namely full-time faculty members. Here's the thing, though. Students call me professor because it is descriptive of my duties-- for all they know, I do everything a professor does. They can't tell the difference. As a result, full-time professors are O.K. with the adjuncts being called "professor," because they know it is merely a description used by our students, not our actual title! And our salaries and responsibilities reflect that.

This is exactly how I feel about the use of the word "doctor" in a clinical setting, with the except that special care should be taken so that patients understand who is treating them. If a patient calls her PA, dentist, or NP "doctor" in the context of being treated, no worries. It's just a description, not a distinction. As long as the patient understands the difference between physician and NP, who cares?
 
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I think what the commentators don't realize is how deceptive this is. The main argument I see is about psychologists, dentists, optometrists, etc still being called doctors.

I call my optometrist and my dentist by "Dr. ________", but when I walk into a dentist's office, I don't expect the dentist to be a physician. When I go to an optometrist's office and the doctor is checking out my eyes, I don't expect him to be a physician. The same goes for psychologists.

But when I go into a clinic or hospital, and somebody's checking my heart rate or the like, and they call themselves a doctor, I assume they are a physician.

That's the difference, and it's not really fair to the patients. DNP's maybe have a doctorate, but until it becomes social norm for everyone to associate the term "Doctor" to both physicians and DNP's (or whatever other medical profession), it's not really fair to the patients.
 
At the hospital I work at, I learned to not presume "doctor" status to anyone wearing a white robe. The PA's can be identifiable with their embroidered PA initials on it..usually.

There was a time when I assumed this woman to be a doctor. Since she was asking about a patient that I was currently giving care to and she looked relatively new to the unit, I thought she that was just doing her "swing" or that she was one of the interns. When I was done I said: you can come in doctor. With a slightly antagonistic and shrugged off reply, she said "I'm Mr. X's nurse practitioner." Afterwards she asked me, "Skull Pell, you're his nurse right?" I'm the PCT. Just because I was wearing scrubs...Touché, DNP.
 
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