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ADVANCE Perspective: Nurses

What’s In a Name? Nurses as Doctors

Published October 7, 2011 8:15 PM by Rich Krisher
"Hi. I'm Dr. Patti McCarver, and I'm your nurse."

That's how an Oct. 1 New York Times article describes a nurse-patient interaction in a primary care setting. McCarver is a nurse practitioner who recently earned a doctorate.

The trend of nurses earning doctor of nursing practice degrees has spawned a backlash from some physicians, who claim use of the term "doctor" by anyone other than a medical doctor could lead to confusion on the part of healthcare consumers.

The article quotes American Academy of Family Physicians Board Chair Roland Goertz, MD, MBA, as stating "There is real concern that the use of the word ‘doctor' will not be clear to patients."

At issue is who will be the first to treat patients, and therefore gain access to healthcare dollars. NP prescribing laws that require MD supervision are part of the discussion.

In New York, a Senate bill (S02250) was proposed in January that defines who and who cannot use the term "doctor."

The bill "[r]estricts use of the title ‘doctor' in advertisements to medical doctors, dentists, chiropractors, veterinarians, podiatrists and optometrists who have received a degree in the appropriate profession and have met all professional requirements of the appropriate program registered by the New York state education department or accredited by an accrediting organization acceptable to such department or are otherwise licensed to practice in the state of New York," according to a summary on the state Assembly's website.

After many years' of discussion regarding the value of requiring a higher level of education to become a registered nurse, opposition to nurses calling themselves what they are according to the degree they have earned - doctor - is puzzling. With national healthcare reform promising to increase the number of patients requiring primary care, it seems a step backward to argue over terminology rather than focus on how that care can best be delivered. And nurses cannot be left out of that equation, no matter what they're called.

Is there a reason I'm missing why nurses with doctorate degrees shouldn't be known as doctors?

16 comments

I think you have been given a lot of terrific ideas.  Please do try to make any food you chosoe   if you chosoe that   a healthy selection.  It's hard if you're trying to keep fit   or get fit   to be tempted with sugary treats.Whatever you get, I agree it's really appreciated if you write a letter to the hospital administrators and perhaps send a letter to the editor of the local paper, praising the nurses.  That is meaningful for them in the long run.

Stephen Stephen, gHEpPMqoZrhWuC - wImfsQrsS, vkeAmQpsbsJJl January 18, 2013 5:08 AM
lMSjzfpsna AL

Everyone who has an earned doctorate degree, education, psychology, theology, etc, has been allowed to use the name Dr., so have podiatrists, optomotrists, chiropracter's, vets, dentists, Naturopaths, and the list goes on and on.  If someone earns the degree they earn the right to use the title.  Unless there is a change across the entire system of this educational level to eliminate the term "doctorate" in the degree then anyone who earns that degree has put the time, knowledge and money in to deserve that title and if MD's can't accept that then too bad.  They have never had a problem with it until it comes to Nurses Practitioners who are a huge threat to the economy of the physician.  Since the beginning of NP's the physician's have tried to find every reason possible to benign the expertise of the Nurse, they have tried to show that NP's are a treat to patients in so many ways and time after time, patients have reported great satisfaction with the NP.  I have patients tell me almost everyday how I explain things to them, listen to them and treat them with better results than MD's they have seen.  Usually people only complain about things when they feel threatened so guess MD's feel very threatened with this new title because now they can't subordinate NP's as easily.  

Jeane, CPNP - ARNP October 29, 2011 5:42 PM
Orlando FL

It is usual practice in other countries that only medical doctors use the term DR in the hospital setting. Others use "Hi I am Psychologist Jones, or Clinical Pharmacist Smith, or Advanced Nurse Wamah, or Nurse Anethetist Chin" to introduce themselves. This keeps it clear for the patient who is the one of concern in the care arena, not our egos. If you can get MDs to say they are Medical Doctor Bohoma, then we can use the title Doctor of Philosophy or whatever in the clinical setting. I doubt the docs will change a lifelong practice.

Cher October 29, 2011 5:18 PM

It is of interest that no other profession's right to identify themselves as Dr. is being called into question. In the area of out patient psychiatry there are a plethora of people identifying themselves as Dr. in the same setting, the psychologist, the social worker, Ed's, pharmacists, as well as the psychiatrist. It does not seem to generate confusion for the patients or the staff. I believe the underlying issue is not one of patient confusion but a desire to maintain the hegemony currently existing in healthcare.  Interestingly if these proposed measures succeed it will be the patient who suffers.

Basirah TaHa, Psychiatry - APN, UBHC October 28, 2011 8:54 AM
East Orange NJ

This debate has been going on since nurses have become proactive in education and raising the bar to excellence.

But, as with any other profession (psychologists, pharmacists,etc)  pursuing a doctorate, we have the right to use the credentials earned. The origin of the word doctor means to teach, which nurses have been doing for decades. So why shouldnt we use the term doctor.

If not does that mean other professions will also be barred from using "doctor"?

Linda Gable-Gaston, Behavioral Health - APN, CFG October 27, 2011 4:25 PM
Bloomfield NJ

What is wrong with introducing yourself as, "Hello.  My name is Jane Doe, Ph.D. in nursing"?  Let everyone draw their own conclusions.  If everyone connected with the medical field introduced themselves with their earned title instead of "group" title, there would be no confusion.  If someone needed an explanation as to what Ph.D., D.O., M.D., D.V.M., etc. meant, then that person could explain it to them at that point.  Too much time is spent wasn't on trival things such as titles.

Debbie, Nursing - R.N., Visiting Nurse Assoc. October 27, 2011 1:58 PM
Oklahoma City OK

I do think it is confusing to address yourself as Dr. so and so , then as a nurse to the patients in medical settings. Nurse anesthetists have been practicing anesthesia for more than 100 years, and I still have friends and patients that have no clue what a nurse anesthetist is ! I do believe it is partly the ego issue to be called Dr.. I feel confident and professional when I address myself as Nurse Anesthetist to my patients, even though my co-workers (nurses, surgeons, surgical techs etc) know I at times do a better job than some of my anesthesiologists.

It might offense some people,and some disagreement, but that's the reality I get. I really doubt the value of a DNP degree. I have spoken to people who graduated from DNP programs and who dropped out of the programs. Just looking at their curriculum, you just learn more how to write another papers. Being claimed as a clinical doctorate degree, it does not really increase or improve much the clinical skills. You do your papers well, you get a DNP degree. Agree or not, that's how I feel and believe.      

Tak, Anesthesia - CRNA October 27, 2011 12:17 PM
Philadelphia PA

Yes, there is a reason that a nurse who has earned a doctorate should not use the title Doctor when dealing with patients. it has been quite simply stated by multiple physician organizations - it confuses the patients. It is not a easy or simple matter of education and to suggest this confusion will be eliminated through education is to miss the special relationships that exist between patient and healthcare providers of all sorts. Nurses have legislation to prevent anyone else from identifying themselves as a nurse unless they have undergone specific training and passed specific licencing requirement, why shouldn't physicians enjoy the same privilege? A doctorate degree does not equal a Doctor degree in terms of training, nor licensing. If your Dr. is not a Doctor, what do you have? Do you really want to hear, 'When will the real Doctor be here?'

Many fields prepare doctorate trained practioners, however they do not try to pass themselves off as a Doctor within a healthcare setting where confusion of roles is the expected norm. Males in nursing are still confused by patients as Doctors even with educaiton and identification, and frequently I hear female physicians refered to as a Nurse by hhealthcare workers AND patients alike.

Heath Pears, critical care - CNS, University October 27, 2011 8:27 AM
Sommerville KS

A clinical doctorate in now the level of entry for physical and occupational therapist.  Gone are the days where the only Doctor in the hospital is the medical doctor.  With proper education from the individual healthcare providers the public will come to know and accept that fact.

Leslie, MSN, RN, CPNP October 27, 2011 7:56 AM
Washington DC

I think that any nurse who has earned his/her Doctorate of Nursing Practice (DNP) which is the advanced degree for a Nurse Practitioner should be allowed to introduce themselves as Dr Jane and I will be the nurse performing your exam & deciding your treatment. It is up

to us as Professional Nurses to educate the public that we are obtaining these advanced degrees and that we are also held to a higher standard of practice. Whenever a new physician joins a practice a letter is sent to the patients in the practice letting them

know that Dr's background & experience. Why can't we do the same for DNP's? I stand fully behind nurses who have obtained their DNP to be allowed to refer to themselves as Dr.

And Mr Alan,  as a nurse who has 10+ yrs in practice as a nurse In teaching facilities I have seen many medical & surgical residents/fellows collaborate with the nurses they work with to get more understanding and ideas regarding patient treatment. Many M.D's & D.O's do the same because it is the nurse who spends the majority of time with the patients. I can also tell you that the only patients I've had that stress the need for their nurse to call them "Dr" are not Dr's in the medical field at all!

Michele, Cardiology - RN,CCRN, CNOR October 27, 2011 6:30 AM
NY NY

I feel it can be confusing when a nurse uses the title "Doctor". Even though the nurse earned this title, the public doesn't always understand these titles and the education obtained to receive it. Recently I had a Rx from the NP and the pharmacist had no clue that it wasn't an MD or DO but a NP. It was confusing for him and he is a professional.

Deidra, Retired - RN October 27, 2011 4:05 AM
Hollywood FL

As Breanna states below, it might be a matter of a learning curve for all involved to become familiar with the concept of nurses who have earned the doctor of nursing practice degree, which is still relatively new. An updated DNP fact sheet from the American Association of Colleges of Nursing is here: http://www.aacn.nche.edu/Media/FactSheets/dnp.htm. While nursing doctorates such as the PhD and DNSc are focused on research, the DNP is intended to help nurses “fully implement the science developed by nurse researchers,” according to AACN.

In the primary care practice my family uses, there are doctors of medicine, doctors of osteopathic medicine and nurse practitioners. As advanced-practice nurses with doctorates join the practice, I’ll know they are among the most educated nurses in clinical practice. That seems to me only a good thing. It’s up to the first generation of DNPs and those who follow to educate healthcare consumers about this new and accomplished nursing role.

Rich Krisher, ADVANCE - Editor October 10, 2011 4:18 PM

A nurse with a PHD degree has the right to be called Dr so & so.

However, she/he needs to clarify this ahead with something like: " I am your nurse Maria.., I have a doctorate degree. so you can call me either Maria or  Dr So & So....

botaikongh roberts, medicine - prof, psych October 10, 2011 6:33 AM
New York NY

While I understand your perspective, I must disagree. As has been stated, part of the honor of receiving such a degree is being able to be called by that special title of Doctor; no matter what field of study. But what is to keep that person from introducing themselves that way, in the medical field or not? They have earned the title as well as the right to use it. In addition to this, I do not think it will confuse the public any more than they already are. For example, if ones primary care provider (PCP) is a nurse practitioner (NP) or even a physicians assistant (PA), they will often be referred to by the client as their "doctor." In this instance, doctor does not mean one who has obtained a doctorate degree, but one who is doing primary care. As nurses are expanding more and more into this role, it seems only right that those with actual doctorate degrees be referred to by their earned title.

Finally, how much more confusion and even possible mistrust comes when the DNP who is providing primary care says to the client "My name is Breanna, and I'm your nurse. Here, let me start to do an exam and perhaps even prescribe you medication." The client might wonder why this nurse is acting like a doctor, because they know nurses are not usually given furnishing rights. However, if the DNP introduces herself as "Dr. Jewell, and I'm your nurse" I may initially create confusion, but also makes way for conversation between the client and the nurse.

I am about to graduate with my BSN in two months. I plan on going on to masters work and eventually to go on for my DNP. I see no issue with introducing myself as Dr. Jewell at that point; in fact, I look forward to that day. But I think more importantly, nurses and physicians alike need to put the patient first and focus on delivering  the best care possible, regardless of the title.  

Breanna Jewell, SN October 9, 2011 11:14 AM
Riverside CA

Mr. Alan,

 I agree with your comments, however, the doctorate being referred to in this piece is the DNP (doctor of nursing practice), not a PhD.  It does not negate the debate but the intention of this new "practice" doctorate is to have credentialing parity with the PharmD, DDS, DPM, MD, DO, etc.  I am a nurse as well as a current nurse practitioner student at Duke University.  I plan on completing a DNP myself but in the professional setting I would have a hard time introducing myself as Dr. Alexander.

Nicholas Alexander, , RN, BSN Duke University October 8, 2011 12:12 PM
Durham NC

When I graduated from law school I was awarded a doctorate, a J.D., but it is considered gauche for lawyers to refer to themselves as doctors. An M.D. is a professional degree, one which is necessary to obtain in order to practice medicine. The doctorate which nurses obtain is a PhD, which is an academic degree. Within an academic setting, it would be perfectly appropriate to refer to one's self as "Doctor". However, within a medical environment a PhD has no meaning because it has no bearing upon the licensure of the person. Suppose an R.N. obtained a PhD in Sociology. Would this also entitle an RN to refer to themselves as "Doctor" to a medical patient?  Of course not. Yet whether a PhD is in Nursing or in Anthropology, neither one has any bearing within the a medical setting. In the hospital and in medical offices a "doctor" is an M.D. Period.

Bruce Alan, Law - Attorney October 7, 2011 9:49 PM
Shingle Springs CA

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