Reality Check 2 Posted July 1, 2016 This morning my doc - who is a very cool laid back DO who is completely collegial and loves working with PAs - got a letter from a local NP who has her own Heart Health clinic. The letter was signed Dr. Jane Doe, DNP, NP, blah blah blah. She signed it Dr. Jane Doe. First, she is somewhat of an unusual person and her clinic doesn't always follow the latest recommendations - lots of million dollar tests and herbs and preventatives and she is not in line with the majority of cardiologists. Her clinic advertises these Screening Exams for $X amount of dollars not covered by insurance and she promises to give you the longevity and immortality plan for heart health. He was miffed that she called herself Doctor. And he felt she did it to be snitty. We had an open discussion about it and how some PTs with DPT are now calling themselves Doctor and PharmDs etc. We agree that in a clinical setting - the title Doctor should be reserved for those with MD/DO because it is confusing to patients. I worked with a PA who got a PhD in sports something or other. He is not a favorite person of mine. He started having his patients call him Doctor in our clinic. I wrote to admin and said that was inappropriate because he is not a clinical doctor. I called him out on it and corrected his patients every single time. He is not a clinical doctor of anything. Anyone can get a PhD in a variety of subjects including English Literature, Biochemical Engineering and French Poetry. In a medical setting - these folks are NOT DOCTORS - in a university lecture hall - go for it, Dr. Whoever. So, what have all of you seen, heard, experienced, discussed? I think it is too confusing for patients to understand the difference between Dr. NP and Dr. DO/MD and all the rest. LOTS of NP blogs and editorials on how they want to be called Doctor and have earned the right, etc etc. I just can't agree at this point....................
primadonna22274 Posted July 1, 2016 Yup...I've worked with a DNP who since she earned her doctorate insists on identifying herself as Dr Sawyer when answering a phone call. I, as the PA who did actually work damn hard to earn my DO degree, make a point of calling her Andrea...which is who she was pre-DNP. I'm pretty sure it burns her biscuits :) And on another note, today I am a PGY3!!! :-) Sent from my SAMSUNG-SM-N910A using Tapatalk
Administrator rev ronin Posted July 1, 2016 Administrator Eh, just call the DNP's "nurse" if they want to try for Doctor. Kind of like calling a LCDR a "lieutennant" instead of "commander" if you're going to shorten it up. :-)
Reality Check 2 Posted July 1, 2016 Author http://www.clinicaladvisor.com/the-waiting-room/state-medical-boards-trying-to-limit-who-can-be-called-doctor/article/284167/ Or the NP can get charged with a crime in some states Interesting..............................
Moderator EMEDPA Posted July 1, 2016 Moderator I have a doctorate and only use the title when lecturing.
gcox87 Posted July 2, 2016 I belive it would be better to drop the title "doctor" all together in the clinic. An md/do would be called physician. Np nurse practitioner and PA.. well PA.
Reality Check 2 Posted July 2, 2016 Author I belive it would be better to drop the title "doctor" all together in the clinic. An md/do would be called physician. Np nurse practitioner and PA.. well PA. Soooo, how does one address the "doctor" in a traditional clinic? It is not going to fly to call someone Physician Smith. In England, doctors are just called Sir or Madam and don't use any title. Not sure what they call nurses or PAs. Some of my patients call my doc by his first name and he has no ego issues that he minds or cares. Some call him Dr. G and some just call him doc. Other docs I have worked with are VERY title oriented and are offended if anyone (including me) call them by their first name. I don't last long with that type of doctor. Again, I think we need to limit the use of the title doctor to the MD/DO in our clinical settings so that patients understand with whom they are working and none of us are seen as representing ourselves as something we truly are not it that setting. Sometimes it is even hard with PhD mental health providers in a clinical setting. But I hold to the above. Maybe someday I will have the most desired title - RETIRED
2234leej Posted July 2, 2016 This morning my doc - who is a very cool laid back DO who is completely collegial and loves working with PAs - got a letter from a local NP who has her own Heart Health clinic. The letter was signed Dr. Jane Doe, DNP, NP, blah blah blah. She signed it Dr. Jane Doe. First, she is somewhat of an unusual person and her clinic doesn't always follow the latest recommendations - lots of million dollar tests and herbs and preventatives and she is not in line with the majority of cardiologists. Her clinic advertises these Screening Exams for $X amount of dollars not covered by insurance and she promises to give you the longevity and immortality plan for heart health. He was miffed that she called herself Doctor. And he felt she did it to be snitty. We had an open discussion about it and how some PTs with DPT are now calling themselves Doctor and PharmDs etc. We agree that in a clinical setting - the title Doctor should be reserved for those with MD/DO because it is confusing to patients. I worked with a PA who got a PhD in sports something or other. He is not a favorite person of mine. He started having his patients call him Doctor in our clinic. I wrote to admin and said that was inappropriate because he is not a clinical doctor. I called him out on it and corrected his patients every single time. He is not a clinical doctor of anything. Anyone can get a PhD in a variety of subjects including English Literature, Biochemical Engineering and French Poetry. In a medical setting - these folks are NOT DOCTORS - in a university lecture hall - go for it, Dr. Whoever. So, what have all of you seen, heard, experienced, discussed? I think it is too confusing for patients to understand the difference between Dr. NP and Dr. DO/MD and all the rest. LOTS of NP blogs and editorials on how they want to be called Doctor and have earned the right, etc etc. I just can't agree at this point.................... I have my clinical doctorate in physical therapy; I have never asked any of my patients to call me Doctor. I have given some lectures to students and they've occasionally addressed me as Doctor so and so. In an academic setting Im okay with it for the most part. I agree that the terms Doctor should be used only for medical Physicians in the hospital. Honestly, physicians should be more mad about chiropractors being labeled as primary care providers or physicians than other health care professionals using the term Doctor. They are blatantly calling themselves something they are not. I've had patients call their providers physicians, only to tell me they were referring to DCs.
Boatswain2PA Posted July 2, 2016 Anybody who is not a MD or DO who calls themselves "doctor" to one of my patients will immediately be called out on it and will look like the idiot they are. Talking to the patient and family, simply say "Nurse Smith has a doctorate in Nursing, but she is a nurse and not a medical doctor. She has not been through four years of medical school, nor has she been through 3-7 years of residency like medical doctors do. I just want to make sure you and your family are clear on everyone's roles as we take care of you."
Joelseff Posted July 2, 2016 What about podiatrist's and Psychologists? They're addressed as "Doctor" in my shop. What do u guys think in those cases? Sent from my SAMSUNG-SM-G870A using Tapatalk
sk732 Posted July 2, 2016 If I want to tune my rather pedantic mother out for awhile, I tell her that if I graduated medical school that the Dr in front of my name would mean more than the one in front of her's...being that she's a subspecialist PhD in Canadian Arctic History. It'll send her off on a rant about how medical and dental doctorates are acutally undergrad degrees and stuff...beyond the first sentence or two I'm back into whatever imaginary world I was in before. In a clinical environment, the only people that should be calling themselves "Doctor" are physicians, dentists, vets, clinical psychologists, osteopaths and just maybe chiropractors and psychiatrists (shrinks actually earned an MD before leaving medicine). If you have a PhD or PharmD, you should be secure enough in yourself to say what you're PhD is in (non-clinical nursing mumbo-jumbo for LCF to pretend I'm a witch doctor or whatever). If you're a PA, same deal - you're not an MD, so you shouldn't identify yourself as a Doctor of anything other than Health Science. This degree creep crap I've noticed you guys have to deal with down in the US and what I'm seeing up here with NP's is utter BS. It doesn't help that you can earn a Master's or PhD from some of these degree mills without even having to defend a thesis or dissertation - they're there to kick out people to fill numbers for those (un)professionals who need a piece of paper to hide behind. If people are that insecure, time for some hard psychotherapy...I know some MD Docs that need it as much as PhD Docs for that very reason. SK
Administrator rev ronin Posted July 2, 2016 Administrator Doctor is fine for everyone but NPs. Despite the direct competition, friendly or less so, between PAs and NPs... I really don't think this is the case. I've related before how my outpatient internal medicine rotation preceptor, a DO who went back to school after being a PT for forever, scoffed at a phone message from a DPT introducing himself as "Dr. So-and-so", and rightfully so. The more 'doctors' there are in medicine, the cheaper the title becomes. There are two separate issues driving degree inflation: money and prestige. Money issues are unfortunately supported by the federal government paying people doing the same job more because they have a 'higher' degree. Prestige... well, that's just human vanity.
UpRegulated Posted July 2, 2016 Anybody who is not a MD or DO who calls themselves "doctor" to one of my patients will immediately be called out on it and will look like the idiot they are. Talking to the patient and family, simply say "Nurse Smith has a doctorate in Nursing, but she is a nurse and not a medical doctor. She has not been through four years of medical school, nor has she been through 3-7 years of residency like medical doctors do. I just want to make sure you and your family are clear on everyone's roles as we take care of you." Calling an NP only "a nurse" -- while technically accurate -- is as misleading as calling a PA only "an assistant." To demonstrate: "Assistant Smith has a master's in medicine, but she is an assistant and not a medical doctor. She has not been through four years of medical school, nor has she been through 3-7 years of residency like medical doctors do. I just want to make sure you and your family are clear on everyone's roles as we take care of you.'"
Moderator ventana Posted July 2, 2016 Moderator 30 years ago maybe Physician=doctor But no way this holds true any more I had a new grad PT introduce themselves as Doctor _____________ Psychologist do it Audiologist do it Some Nurses are doing it Educators do it Weather Men do it Heck every other field besides PA has a doctorate level degree..... I am neutral on it now - Doctor is truly a degree where as PHYSICIAN has meaning, except for all the Chiro's that call themselves physicians (as allowed by state law) So, to have this hard fast, PA can never be a doctor seems to be outdated to some people, and I suspect when the Clinical Doctorate comes out and bridge programs are everywhere (like there was for masters) then it will be less of a worry. This coupled with most doc's now simply being an employee of a hospital system, and times are a changing.....
2234leej Posted July 2, 2016 30 years ago maybe Physician=doctor But no way this holds true any more I had a new grad PT introduce themselves as Doctor _____________ Psychologist do it Audiologist do it Some Nurses are doing it Educators do it Weather Men do it Heck every other field besides PA has a doctorate level degree..... I am neutral on it now - Doctor is truly a degree where as PHYSICIAN has meaning, except for all the Chiro's that call themselves physicians (as allowed by state law) So, to have this hard fast, PA can never be a doctor seems to be outdated to some people, and I suspect when the Clinical Doctorate comes out and bridge programs are everywhere (like there was for masters) then it will be less of a worry. This coupled with most doc's now simply being an employee of a hospital system, and times are a changing..... Did the PT introduce him/herself as doctor over the phone or in person with you? You guys must be running into some vain physical therapists. I don't know any of my colleagues (in hospitals, outpatient clinics, etc.) who address themselves as doctors. In my opinion: -The terminology should fit the context: you do not address yourself as Dr. Smith (degree in communications) when seeing your physician in the office. -Calling a pharmacist "doctor" in the pharmacy is just as appropriate as calling someone doctor in the dental or psych clinic (for a dentist or psychologist). It fits the bill. -For someone who is personally obtaining board certification as a nurse practitioner, if someone asks me what my credentials are, I will say: "My name is X, and I have a clinical doctorate in physical therapy and a masters/doctorate in nursing practice." It's honestly as simple as that. No doctor term used and clinically appropriate imo.
Administrator rev ronin Posted July 3, 2016 Administrator Calling an NP only "a nurse" -- while technically accurate -- is as misleading as calling a PA only "an assistant." To demonstrate: Not really. Well, actually, not at all. If someone calls an NP a nurse, they are correct, in that in every state which I'm aware, NPs must maintain their RN certification or license as well. Thus, "nurse" == RN, not 0.5 x "Nurse Practitioner". If you've got an RN, you're a nurse, even though you may ALSO be a nurse midwife, nurse anesthetist, nurse practitioner, hospital administrator, etc. "Nurse" never stops being a correct title, even if it's far from the most applicable or highest level title. "Assistant" is not a whole title in the context of medicine, never has been. If someone wanted to, they could call me an EMT Basic, because I still maintain that certification, it would certainly be at least as correct. However, they couldn't call every PA an EMT, because not every PA is.
db_pavnp Posted July 3, 2016 The point was that it is misleading. It is misleading due to the convention of addressing people professionally according to their highest degree earned or according to the role they are playing / paid for. It would be misleading if I introduced you to your patients as an EMT while you functioned as a PA. It would be strange to introduce you as a PA in the field while you were doing a few hours to maintain an EMT cert. I don't agree with non-physicians using the term doctor in a clinical setting, but still - addressing people according to their highest title is polite convention. Physicians are not polite and neither is healthcare so this gets kinda gets a free pass.
Moderator EMEDPA Posted July 3, 2016 Moderator if you use the doctorate you need to qualify it I think: I'm Dr Jones, one of the ER physicians I'm Dr Jones, an NP here in the ER I'm Dr Jones a PA here in the ER all technically correct, however most pts would assume even after these intros that all 3 were physicians due to standard convention that all doctors are physicians in hospitals. I have PA, DHSc on everything, but introduce myself as a PA and let it go at that.
Moderator ventana Posted July 3, 2016 Moderator The point was that it is misleading. It is misleading due to the convention of addressing people professionally according to their highest degree earned or according to the role they are playing / paid for. It would be misleading if I introduced you to your patients as an EMT while you functioned as a PA. It would be strange to introduce you as a PA in the field while you were doing a few hours to maintain an EMT cert. I don't agree with non-physicians using the term doctor in a clinical setting, but still - addressing people according to their highest title is polite convention. Physicians are not polite and neither is healthcare so this gets kinda gets a free pass. What about a dentist, psychologist or chiro that introduces them self as Doctor? Should they be banned from doing so as they did not pass USMLE exams? What about the weather man, or political commentator who is Dr. SoAndSo? Do they get banned from using the term Doc? Why would we not be Doctor if we have a terminal professional medical degree at the doctorate level? Did the PT introduce him/herself as doctor over the phone or in person with you? You guys must be running into some vain physical therapists. I don't know any of my colleagues (in hospitals, outpatient clinics, etc.) who address themselves as doctors. In my opinion: -The terminology should fit the context: you do not address yourself as Dr. Smith (degree in communications) when seeing your physician in the office. -Calling a pharmacist "doctor" in the pharmacy is just as appropriate as calling someone doctor in the dental or psych clinic (for a dentist or psychologist). It fits the bill. -For someone who is personally obtaining board certification as a nurse practitioner, if someone asks me what my credentials are, I will say: "My name is X, and I have a clinical doctorate in physical therapy and a masters/doctorate in nursing practice." It's honestly as simple as that. No doctor term used and clinically appropriate imo. She was a new grad, was employed by local hospital system.... only had it happen once...... Why are we excluding ourselves from forcing the ongoing paradigm shift for PHYSICIAN to mean I Graduated from Medical College, did a residency, and passed Boards and let doctor be exactly what it is, an education degree.... Just to be clear - I am playing devils advocate here, I introduce myself as a PA (never say the A word anymore). As I have aged, and approaching 50, or due to my presentation, or where I work, I no longer get questioned on my role, my title, or what I do..... Thinning gray hair has some benefits I guess....
Boatswain2PA Posted July 3, 2016 Calling an NP only "a nurse" -- while technically accurate -- is as misleading as calling a PA only "an assistant." To demonstrate: "Assistant Smith has a master's in medicine, but she is an assistant and not a medical doctor. She has not been through four years of medical school, nor has she been through 3-7 years of residency like medical doctors do. I just want to make sure you and your family are clear on everyone's roles as we take care of you.'" Who said "only" a nurse? Nurses have an incredibly important role in healthcare. Yes, if a PA introduced themselves to one of my patients as a "Doctor" I would call them out on it as well. But I don't know of any Doctorate PAs who even cosnider doing that (fortunately).
Administrator rev ronin Posted July 3, 2016 Administrator Yes, if a PA introduced themselves to one of my patients as a "Doctor" I would call them out on it as well. But I don't know of any Doctorate PAs who even cosnider doing that (fortunately). PrimaDonna22274 might... :-)
2234leej Posted July 3, 2016 if you use the doctorate you need to qualify it I think: I'm Dr Jones, one of the ER physicians I'm Dr Jones, an NP here in the ER I'm Dr Jones a PA here in the ER all technically correct, however most pts would assume even after these intros that all 3 were physicians due to standard convention that all doctors are physicians in hospitals. I have PA, DHSc on everything, but introduce myself as a PA and let it go at that. See, for those last two, in a hospital setting, I don't think that's good. Those statements clarify what their profession is, but the word Doctor is what a lot of patients hear in that sentence. Again, this is specifically for a hospital. I think in other settings it is appropriate. And I do agree that physicians try to make Doctor their own title in any capacity under any circumstances. That I don't agree with.
db_pavnp Posted July 3, 2016 What about a dentist, psychologist or chiro that introduces them self as Doctor? Should they be banned from doing so as they did not pass USMLE exams? What about the weather man, or political commentator who is Dr. SoAndSo? Do they get banned from using the term Doc? Why would we not be Doctor if we have a terminal professional medical degree at the doctorate level? I see you quoted me here, but I generally feel that individuals with doctorates should be addressed as doctor. The convention of addressing people professionally / politely by their highest earned degree stands. Because the clinical doctorate is growing relatively more common, it also only makes sense to be clear about what your doctorate is in to avoid confusion.
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