Should the "Doctor" title really be an issue? - page 3
by SycamoreGuy 9,588 Views | 49 Comments
The number one arguement against DNPs using the title Doctor, especially in the clinical setting, is that it might confuse patients. Ignoring the fact the most DNPs clarify that they are not medical doctors, should this even be... Read More
- 1Apr 14, '13 by elkparkQuote from BlueDevil,DNP(I gotta say, Blue, I don't think that, in the specific incident you describe, invoking your professional title was "stupid and egotistical" in any way. What's sauce for the goose is sauce for the gander, as the saying goes. The principal was the one who made titles an issue. You were being cordial and respectful; when she requested that you address her by her professional title, then I think it was perfectly appropriate and reasonable for you to request the same consideration. If we're going to use professional titles, then, by all means, let's all use professional titles.)I will admit that I did use the title in a very stupid and egotistical way one time, because I was irritated at someone.
- 0Apr 14, '13 by JoryQuote from Esme12I love this story as well and do not regret what you did for a second. The women wanted to start on an uneven playing ground and with one swoop, you leveled it.I have to tell you I LOVE that story!!!!
I would have paid money to see the expression on that persons face. Well played.
Well played Doc, well played.
- 2Apr 14, '13 by BlueDevil,DNPI feel as though I "stooped to her level," actually behaving just as insecurely as she. In any event, what's done is done. We aren't the types to check the "Dr" box on forms asking for a title when addressing mail and we don't use it making dinner reservations, lol (I've been waiting my turn and heard it though).
In clinic, my patients know who I am and what they came to see me about, using a title as some sort of power play to remind them which of us is the medical provider is unnecessary. If they want to use it, they can. It is accurate. :shrug: If they want to call me Blue, well, as I said, it was good enough for my Mom and Dad, so that's fine with me too. If it is their first visit, or they are new to the state and unfamiliar with either independently practicing NPs, DNP prepared NPs, or both, it is understandable that they may need some clarification on how their care is going to be handled so that they can make informed choices. On those occassions, patients usually have a few questions about who or what I am exactly, lol. I explain.
In 4 years, I have lost exactly one patient who said they thought they were making an appointment with a MD, and would prefer to see a MD for her care, so she switched over to one of the physician providers in the office. Was she misled? I don't think so. All of our names/professional titles are on the website, in the yellow pages ad, on the 30 foot high sign at the street, on the front of the building in 8 inch letters, and on the wall behind the front desk when you walk in announcing if we are in/out for the day and if we are on time or how far behind schedule. They all read:
Joe Brown, MD
Bill Red, MD
Frank White, MD
Blue Devil, DNP, FNP
Jane Pink, MSN, FNP
I am not sure how she mistook me for a MD. ??? She did act as though someone had tried to deceive her. I walked in the room, introduced myself as a NP, and she seemed fine. Didn't ask me anything about it. As far as I know she was literate and able to read any of the many signs/pieces of paper with my name and title clearly displayed, all of which were available to her for an untold number of weeks before her visit. She called back a day or two later to complain to the office manager that she had been told she was seeing a "doctor" and wanted her co-pay back for that visit (she didn't get it), and wanted to switch to a MD.
Then she subsequently switched to the other NP in the office, reportedly so she could have all of her care from the same person, citing the fact that she wanted a female provider. I think perhaps she just didn't like me or Dr White, and it may have had nothing to do with the fact that I am a NP. Who knows. In any event, I still completed her visit "to establish care," which all new patients at our clinic have to do anyway, which never includes a physical. It is the History and ROS (including getting the reports on every prescription, narcotic and non-narcotic, they have ever filled that someone somewhere else on the website was upset about last week, lol), ordering labs and screening diagnostics due, etc. Then they have to come back for the CPE. We never so much as touch a patient on the 1st visit, so she didn't actually get any "care" from the under-educated NP provider. I don't recall now if she addressed me as "Doctor" or not, lol.
I don't know exactly how the telephone conversation went when she called to make that initial appointment. I have overheard snippits often enough though. They always say something to the effect of "We have appointment available that morning with either Dr Brown, or Dr White, or with either of our Nurse Practitioners, Dr Devil or Ms Pink." I suppose if someone wasn't listening carefully, they might not get the distinction. However, then they get mailed a 'new patient packet,' again, with my name and credentials, NONE OF WHICH SAY MD, all over it. Since three of the other providers do have MD after their name, if knew you wanted an MD provider and felt strongly about this, wouldn't you call and start asking questions in advance of the appointment? Or perhaps mention it that day?
I realize that I am one person, in one office, and hardly representative of all NPs and my patients are not representative of all patients. But my patients aren't the sharpest crayons in the box across the board, and they get it. I don't buy the "patients are going to be confused" line. Sure, they would be confused if we refused to explain it to them. Once explained, they understand. They even understand that one of us is a DNP and one of us is not, once we tell them. The other NP tells me she gets a lot of questions about this actually, and I think it is a source of frustration for her. People kind of nag her about "How come that other NP has a doctorate and you don't?" She said one time one of her patients was irate and thought that everone called me "Dr" just because I am a male, and wanted to file some kind of women's rights/discrimination complaint someplace. ROTFLOL.
Physicians will catch on, they are fairly bright people. duh. They just need some time to get accustomed to the new paradigm. Patients will catch on. Not as bright a group on the whole by comparison, but they are capable of learning, and they can grasp nuance when given the bloody information and some reinforcement. It is just going to take more time. In one generation, I predict DNP will be the standard among NPs and as often as not they will be called "Dr" in the workplace, just like the other non MD doctorally prepared medical providers are in their offices. In two generations I predict all NPs will be DNP prepared and will always be referred to as "Doctor," and none of them would believe that we ever put up with this nonsense!
- 0Apr 14, '13 by JoryThat is why I said, when residents introduce themselves, I think they hardly clarify, "By the way, all I did was graduate from medical school, so while I have the title of Dr. Smith, the state won't allow me to practice independently on any level until I have completed a residency...I'm just one step up from a student."
I grew up in a medical family and never knew what a medical resident was until I actually started working in a hospital.
- 0May 19, '13 by CortisolQuote from JoryFirst and foremost, medical residents are required to do more than just "graduate from medical school" before earning the right to use their doctor title on the floor. They are required to pass a minimum of three US Medical Licensing Examinations (two written exams and a clinical exam) as well as hold a medical degree before they enter residency. Furthermore, most states allow residents with one or two years of residency training who are US medical school graduates apply for full licensure.That is why I said, when residents introduce themselves, I think they hardly clarify, "By the way, all I did was graduate from medical school, so while I have the title of Dr. Smith, the state won't allow me to practice independently on any level until I have completed a residency...I'm just one step up from a student."
I grew up in a medical family and never knew what a medical resident was until I actually started working in a hospital.
- 4May 19, '13 by wtbcrna GuideQuote from CortisolAnd still the most dangerous time to be admitted to a hospital is in the summer when the new residents start... So I guess all those exams really mean a lot.First and foremost, medical residents are required to do more than just "graduate from medical school" before earning the right to use their doctor title on the floor. They are required to pass a minimum of three US Medical Licensing Examinations (two written exams and a clinical exam) as well as hold a medical degree before they enter residency. Furthermore, most states allow residents with one or two years of residency training who are US medical school graduates apply for full licensure.
Residents should still introduce themselves as residents even though they have earned their doctorate. Physicians have done more to willfully deceive the public than any other medical profession ever has.Last edit by wtbcrna on May 20, '13
- 1Jun 1, '13 by SE_BSN_RNQuote from wtbcrnaExactly!!And why is there not as much uproar when you go to the clinic to see your physician and the MA's are "nurses"? So they don't confuse anyone? I know for a fact, my physician's office has NO nurses employed there!It is funny it only really becomes an issue when nurses call themselves Doctor. I don't hear an uproar from physicians when chiropractors, psychologists, and/or podiatrists call themselves doctors but the moment a nurse introduces themselves as Dr. X the nurse it is suddenly a crisis of patient confusion and safety. A doctorate is an academic degree, and there are numerous types of doctorates that a person can earn. Any person that earns a doctorate may have a reasonable expectation to be called by Dr. "X". Being a non-physician and being called a doctor does nothing, but harm a select few physician egos.
- 1Jun 1, '13 by SE_BSN_RNQuote from mudphudstudentThe term "nurse" is also legally protected. People can face serious charges by saying they are a nurse when they aren't.I'm a 3rd year medical student with a PhD in engineering (MD/PhD program). I NEVER introduce myself as Dr. ____ when I see patients because it would be confusing and dishonest since I am not a medical doctor. The ONLY people who should go by Dr. in a clinical setting have the following degrees: MD/DO, DDS/DMD, DPM, +/- OD. If you're at a vet hospital or clinic then a DVM can go by "doctor". There is a reason some states protect the use of the term "doctor" in a clinical setting: it's not to diminish the worth of degrees, it's to not confuse and mislead patients. For this reason, I've never heard a physical therapist or pharmacist go by "doctor" in a clinical setting (or in any setting) even though they have doctorates. DNPs shouldn't use the term "doctor" when introducing themselves to patients for the same reason I don't introduce myself as Dr. ____.
Technically, we are ALL doctors, because the term "doctor" in Latin means "teacher." Sooo....there's another one for ya....should we call teachers "doctor"?Last edit by SE_BSN_RN on Jun 1, '13
- 2Jun 1, '13 by nomadcrnaI introduce myself as Doctor xxx, a nurse anesthetist or Doctor xxxx, a nurse practitioner. I earned the title. I'm damn well going to use it.
AND, no the patients are not confused.
Quote from manuskoI don't understand the problem. If someone is going to see a pt and they announce themselves as doctor, then I see the problem. I introduce myself as a student registered nurse anesthetist to my PTs. My CRNAs introduce themselves as a nurse anesthetist. I have never heard them say nurse anesthetist with a MSN in anesthesia.
Yes, doctor is an earned title and it should be part of your title but I personally would not introduce myself as Dr to a pt.