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First Year NP

What's Up, Doc?

Published January 17, 2014 10:37 AM by Katrin Moskowitz

In our urgent care there are four full time providers: three physician assistants and myself. Our medical director, a physician, comes in one half shift per week. As we enter a patient's room, we always introduce ourselves by our title. "Hi, I'm Katrin and I am a nurse practitioner." There is never any bait or switch and patients are aware of who we are right from the beginning. Even so, I am referred to as a doctor on a daily basis. I always try and clarify my role, but for some patients t is just habit to call you doc.

For me, it is not anything that offends me. I understand that the role of the nurse practitioner may be a new concept for some. We are lucky, though, that the role is present more and more not only in the primary care offices but also in many specialty areas. Having nurse practitioners and physician assistants in these offices often allows patients to be seen in a timelier manner. Other nurse practitioners may take offense not being addressed by their true title.

I have taken it a little more to heart and have decided to apply to my graduate school's DNP program. I knew that at some point in my career I wanted to take the plunge, I just was not sure as to when. Because of the amount of days that I have off per week I feel like this is the best time to do so. So although I will not be an MD, I will one day be Dr. Moskowitz.

I am officially off of orientation at work and becoming accustomed to the increased work load. Two of us providers hold down the fort and we are seeing the winter illnesses such as influenza and sinusitis flow in. I have found that although I was not able to perform many procedures in the emergency room since I was an RN, I did pick up many tricks of the trades along the way.

This past weekend my coworker had a patient with a dislocated toe and she asked for my opinion and guidance. When she was unable to relocate the toe she asked if I would take a look and give it a try. I was able to relocate the toe and when asked how I knew what to do, I just smiled and thought of all the wonderful doctors in the ER who were willing to have a curious nurse in the room during procedures.

Every Tuesday morning I work in the director's primary care office covering his patients. This is a nice change to my week but comes with its own difficulties at times. While I can handle the sick visits without difficulties, I sometimes find it difficult to complete follow ups. I look forward to maybe one day being able to increase my hours in primary care and building up my own patient load and following my own patients from beginning to end.


So are you "proud" to be an NP, or do you want to be considered on par with the Dr. By title? How do you plan to introduce yourself to your patients after you receive your DNP? From my understanding the DNP is not a clinical degree and therefore it would be misleading and still inappropriate to introduce yourself as "Dr." to your patients in a clinical setting. I've never understood people wanting a shortcut to being a physician. There isn't one! Trust me, I would have taken it. Be proud of your field and your role as a mid level provider increasing access to the medically under served. If you would like to be or be treated like an MD go to medical school.

Medical Doctor March 19, 2014 1:57 PM

Paula- that is an interesting comment. I do introduce myself by first name and then state that I am an NP. I am not quite sure how I decided to do that but that is what I do. I do not feel disrespected but can see how that might "down play" our role a bit. Maybe because my last name is a mouthful in itself!

Mary I like how we can be respectful of each other and encompass all roles all in one without having to confuse the patients!

Katrin Moskowitz January 28, 2014 6:50 PM

When I was in active practice, I too corrected patients (and the public) that I was not a physician.  (sigh)  Now that I am involved in allied health education, I make it a point to refer to "healthcare provider as the generic term, not doctor. (because) All providers are not doctors." and to use "healthcare" as the generic, because it is not the "medical field".

mary January 27, 2014 3:08 PM

Am I the only one who sees the irony in Judith-from-Maryland's identifier at the end of her comment??

Thomas Williams, Geriatrics - Physician Assistant January 27, 2014 11:41 AM
Tampa FL

Pts and the nurses continue to address me by my first name even when I identify my self to pts as Mrs Block.  I am a professional and want the pts to be aware of me as a provider.  It is disrespectful of nurses and pts yet call the MD "doctor ...".  Maybe respect should come from the bottom to be instilled early on training.  My first name is for friends not professional encounters.

Paula Block, Anesthesia - CRNA January 27, 2014 6:44 AM
Louisville KY

I absolutely agree Judith! I work a few hours in primary care and I have had to ask the secretary to specify to PT's that they will be comming in to see the NP. I want patients to remain completely informed. I am proud to say that all of our discharge instructions have our correct titles on them. What a scary situation that you had to go through. I do believe I would have had some urinary incontinence in front of the board! And yes how funny that you are from "MD" :)

Katrin Moskowitz January 25, 2014 8:11 PM

Is it ironic? Because I put the state where I practiced as Maryland, my comment had its abbreviation below my name and title.

Another way that it looks like I was trying to pass as a doctor!


Judith, Retired nurse-midwife - CNM (ret.) January 25, 2014 11:58 AM

Except for a few years that my children were young, I worked as a nurse-midwife from 1972 through 2006. I always worked for a hospital, private physician practice or community health center and never attended home births. As a young 20 something nurse-midwife, I introduced myself as "Judy" last name nurse-midwife. Many times in the 70s, there was a little discussion about midwifery and questions about home birth, but everyone called me Judy, patients, coworkers, doctors, everybody. When I returned to work in - community health center in 1990, it was the culture at the site that all were to be called by title and last name. I still introduced myself as "I am 'Judy last name. I am the nurse-midwife at site's name." By then I was forty-something and they called me "doctor". If I corrected them respectfully, the response was, "Well, you're my doctor." Eventually, I gave up correcting them. Business cards and signage said nurse-midwife. I was not passing myself off as a doctor. It was the public's misconception. I tried.

In 1995, however, the husband of one of my patients called to complain about a bill for an HIV test he did not want his wife to have received. She gave her consent without him present. I had never met the husband. The lab bill had as the "doctor", my name. He asked why the bill said doctor if I was not a doctor. The appointment slip also said doctor. He complained about that. I referred him to the business office to correct the bill and so he could verbalized his complaint about the forms. Awhile later, I received a call from the medical board. The husband filed a complaint because he said I was passing myself as a doctor. The medical board rep was angry. He called my workplace asking for Doctor Last name and they forwarded his call to me without correcting him. He was upset about everyone continuing the myth that I was a doctor telling me I needed to straighten out my workplace. He transferred the complaint to the nursing board. I met before the nursing board and stated my case. It took over a year but it was resolved without anything on my record. I was found to have done no wrong. It is our culture.

Other than having everyone call non-physician providers by first name, how can we correct this?

We need to educate at large to use the term healthcare provider as the generic term, not doctor. All providers are not doctors.

Also,have your places of employment to use provider on all appointment slips, lab forms, consent forms and anything else that a non-physician provider's name may be on. And correct all coworkers to use the correct term as they gently remind others of your correct title.

Judith, Retired nurse-midwife - CNM(ret.) January 25, 2014 11:53 AM

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