You know, back in the days when "Doctors of Osteopathy" were part chiropractor, part allopathic physician, part naturopathic physician, allopathic MDs didn't worry much about them. They were seen almost as chiropractors. They were low in numbers, the schools didn't compete with medical schools, and they tended to expect much less money and prestige. It was coincidence their markets overlapped, mostly. They typically did the rural health care few MDs wanted., though, and their schools cost them less.
Then things evolved, and now DOs can practice in any specialty an MD can, and sadly, many of them do NOTHING "osteopathic" once they leave school. Far fewer of them do rural care, and they expect the same money and power MDs have. While MDs sometimes look down on them as people who "couldn't get into medical school", frankly some insecure MDs say that about foreign grads, podiatrists, dentists, PAs, chiropractors, and of course NPs. In other words, just about everyone whose training and work overlap MDs to any extent.
But even back in those days, DOs were "Doctor", too, even when it might have been quite confusing. And all along, there have been Doctors of Optometry (OD), and as a diabetes educator I can vouch that few patients understand the difference between DO, OD, and MD. Yet we don't worry our patients will be confused. We have Doctors of Psychology, Podiatry, Dentistry, etc., and few complain that they shouldn't use the title doctor, even when there might be a dentist and medical doctor in the same clinic. Or psychiatrist and psychologist.
The modern APN is no longer single faceted. We are branching in many directions, so we are as as different as podiatrists and dentists. Just as in medicine, you have the teaching/research huge area, and then everything else. (There are PHD doctors of medicine who are not qualified to practice in the field.)
Primary Care NPs will be one area, and I believe many of these will take over the gap left by DOs, caring for under-served and rural populations, because we, too, have that same culture. We will continue to grow in complexity, and scope of practice just as DOs did. (I pray we don't dump the philosophy that makes us unique as some DOs do. Those ARE MD wanna-bes.)
I firmly believe that MOST Primary Care Practitioners will be NPs in 20 years, because doctors can't bear the time pressure, the control from the insurance plans, etc. The pay doesn't suit them, either, with med school costing as it does. These things must happen, too, because NP school is getting expensive, and if we need 8 or more years to enter practice, then we need a way to pay for school, too.
I for one think the goal in clarifying the NP role and title is to proudly wear and use the "Doctor" an eight-year education deserves, embrace the practice guidelines that demand a doctorate...and wear a NAME TAG that SPELLS OUT the entire title.
Patients will ask, pamphlets will be printed, discussions will ensue, TV commercials and movies can be used as they are now to educate the public.
Nursing is not and never will be "medical doctoring". Like the "real Osteopaths" once did, we have our own holistic approach, and caring for the body is and has been only a modest part of that, for decades now. We have the right to evolve and expand, and to have a unique style of practice that now, yes, very much includes some diagnosing and prescribing and treating as part of a new type of practice.
Making it clear that, yes, unfortunately for doctors we're competing for some of the same business market, but no, we have no interest or intention of "trying to be equal" "trying to be MDs", "usurping the MD role", etc. Suggesting that we are is a red herring, a tactic used to avoid territory encroachment.
That can't be helped...but the territory is patient care of populations, not medical care nor a particular role. Advanced practice NURSING care is a whole new profession, not demi-"doctoring". There's just a new type of practitioner in town, and giving us our independence is the only way to go for all concerned. And with that independence must come a burial of the phobic taboo written into State Practice Acts saying, "Under no circumstances does a nurse diagnose or prescribe..." meant to remind a nurse she is not a doctor.
And when I say new profession, I mean so only in the sense of "doctoral-degreed profession", which is the meaning it has when you fill out a form asking you if you have a "professional degree". I mention this because RNs are professional nurses, period, in the broader sense.
Yes. you do have a "professional degree", DNPs. It's a doctoral degree. You are "Dr. So-and-so, the Advanced-Practice Professional Nurse", a specialty the public really knows very little about. There's no excuse in practicing nurses not understanding and getting the word out. Hiding your name tag will only muddy the waters when some do and some don't!
If you have to go to school 8 years to be something that earns half the money--at the most--a doctor does for similar work, but you went that route anyway, a doctor is less likely to think you wanted his job that, but didn't want the 2 extra years of residency, nor to earn the extra 50% pay...So the DNP requirement may help settle that old confusion.