Nurses Masquerading As Doctors (INSULTING)

[djaychris]

The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by "nurse specialists" and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as "doctor" in health care settings.

(link removed - the page is no longer available)

What do you guys think about this idiot, and the ignorant nonsense he is blabbering over on fox news? Kind of insulting to those of us who have spent years pursuing advanced degrees such as CNP, and often save lives and clean up messes made by arrogant, egotistical physicians...

[mama.RN]

I prefer to see the most competent professional, be it an MD, DO, NP or PA. I've seen good and bad of all of these. There are MDs that I would never see again, there are NPs that are tops and everything in between. Some people are just gifted practitioners and some are not. The letters after the name are not the most important thing. I think most of the learning comes during practice, after the schooling anyway.

[APRN., DNP, RN, APRN, NP]

I came across this posting while procrastinating instead of studying and had to reply even though the thread is a little dated.

I find it very curious that we can say that a DNP is not a Doctor, because after all the MD is really the "doctor".

Right?

I disagree.

We, as a society, have been forced to change our words to better reflect whatever the current thought police have come up with to call something or someone. Our patients are very much a part of that society out there whom are aware that they can no longer refer to a Flight Attendant as a Stewardess.

However, the MD is really a Physician and Physicians do not own the 'doctor' title. I think that the same patients that are now using updated titles such as "postal worker" instead of "postman", and "firefighter" instead of "fireman" and "police officer" instead of "policeman" can handle todays reality that a doctorate does not an MD make. (Meaning to say, that all MD are doctorates, but not all doctorates are MD's.)

As far as patients getting confused about who is the 'real' doctor, I would like to point out the multitudes of scrub bearing personnel who enter into a patients room throughout their hospital stay. Are we laying awake at night twisting in our sheet in angst over the fact that not all of those people have made it starkly clear that they are NOT nurses? NO. This is because the patients Know Who Their Nurse is. This is no different than when I was an LPN and I would introduce myself as a Nurse. Invariably, my patients would ask me; "Are you an RN, or are you an LPN?". ......Do you see where this is heading?

If you are an APRN and you are at the bedside in an acute care hospital and seeing a patient, you are going to practice within your scope. That makes all the difference in the world.

[BostonFNP, APRN]

..we did not go through the schooling doctors went through and we should recognize that fact.

That fact is recognized in the protected term "physician".

Even more importantly, just because someone went through more schooling doesn't mean they have better clinical outcomes.

[SmilingBluEyes]

It's an opinion and he's entitled to it. A person who does not feel threatened by such opinions won't make a big deal out of it. I have known of NO nurse who had a PhD or DNP try to "masquerade" as a physician. This doctor is the one with a big problem, from what I can see.

[MurseJJ]

Somewhat related to the topic: the VP of Cardiac Services for the health system my hospital is a part of is an NP with a DNP. Whenever she is mentioned in an email, they refer to her as "Ms." They would refer to her and a physician in the same sentence, with the physician referred to as Dr., and her as Ms. This has happened at least twice. Pet peeve.

[AOx1]

Doctoral titles were first used in academia, so yes, nurses can be doctors. As a professor, perhaps I should demand that he stop calling himself doctor, since academics held the title first. After all, I hold a research doctorate. I earned this over years and am entitled to use the honorific. Sarcasm aside, I actually have more education than he does (two master's level degrees, one completed doctorate and a second nearly completed), so I find this whole thing pitiful. If you are truly secure in your own intelligence, you don't worry about another profession usurping yours. He is so concerned about marking his territory that I wonder if he pees on the hospital when he arrives each day.

[kalevra, BSN, RN]

The article has some valid points.

I personally feel better when I go see my primary care provider. My MD has had more training, education and experience. I do not feel the same level of security when I have to see an NP. I have had to see both an NP and MD at one point in my life. The NP just did not give me the same level of comfort and security that the MD gave me.

If I had a Masters during my NP course but had a doctoral degree in American Literature can I still be called "Doctor" in a healthcare setting?

In any case, why would an RN want to be called "Doctor" any way? Isn't that kinda insulting the profession. I mean if you have a PhD, you can be technically called "Doctor", that is ok I suppose.

But what if you only have a masters degree? Would they still be called "Doctor" even if they are technically not one.

[AOx1]

In any case, why would an RN want to be called "Doctor" any way? Isn't that kinda insulting the profession. I mean if you have a PhD, you can be technically called "Doctor", that is ok I suppose.

But what if you only have a masters degree? Would they still be called "Doctor" even if they are technically not one.

I am called "Doctor" because that is the expected convention for one who holds a doctoral degree in an academic setting, just as an English professor, a math professor, or a science professor with a doctorate is called doctor. If I have a master's degree, and try to make people call me doctor, that is falsifying my title. A master's degree is not a doctorate. When I am in the classroom, I am referred to as "doctor" by the convention of my University. When I am in the clinic or the ICU, I am referred to by my first name, as are all other workers (nurses, dietary, secretaries, physicians, etc) unless we are introducing ourselves to a patient. The patient cares about your role, not the type of degree you have.

The point is to provide the needed information to the patient that is appropriate to the setting. I really don't care whether someone "supposes" I am allowed to be called Doctor in an academic setting or not. Someone else's opinion does not invalidate my accomplishment. This entire argument again presumes that all nurses work at the hospital bedside. I "suppose" those holding RN credentials might be a bit miffed if I told them they could no longer use the title nurse because it is also used by LPNs (rightfully) and sometimes MAs and CNAs (incorrectly). This would be a gross overreaction. It would be better to simply crack down on those who misuse unearned titles rather than insist that no nurse could possibly have earned the title doctor.

What is insulting to the profession is the underlying assumption that to be a real nurse, you must be at the hospital bedside. If you are an educator, administrator, or researcher, you are considered to be someone reaching too high or desperate for a title and not a "real nurse." This is frankly an embarrassment to the profession. It's well past the time to value the contribution of all nurses, including LPNs, ADNs, BSNs, NPs, DNPs, PHDs, those at the bedside, those in the community, etc. The site is called allnurses, but it isn't really. Our profession does not welcome those who want advanced degrees.

[kalevra, BSN, RN]

I am called "Doctor" because that is the expected convention for one who holds a doctoral degree in an academic setting, just as an English professor, a math professor, or a science professor with a doctorate is called doctor. If I have a master's degree, and try to make people call me doctor, that is falsifying my title. A master's degree is not a doctorate. When I am in the classroom, I am referred to as "doctor" by the convention of my University. When I am in the clinic or the ICU, I am referred to by my first name, as are all other workers (nurses, dietary, secretaries, physicians, etc) unless we are introducing ourselves to a patient. The patient cares about your role, not the type of degree you have.

I understand if you have a PhD, you are entitled to be called "Doctor".

The clarification I am looking for is if an NP with a masters degree worked in a clinical setting that allows NPs to be called doctor. The article had a line stating that NPs would be called "Doctor" in the healthcare setting. There are fewer Doctoral prepared NPs as compared to Masters degree NPs.

It would be more common to see the masters degree prepared NPs providing PCP care. Now since they are the PCP, would they also be called doctor even though technically they arent? If the facility allowed Masters degree prepared NPs to be called "Doctor" would that not also be a lie? If a PA or NP with no PhD are performing the role of a PCP, can they also be called "Doctor"?

These are the questions I am asking.

If you have a PhD in native American Culture, you are a "Doctor". That is a given convention of academia and society in general. I am interested in the PCPs without PhDs being called "Doctor" because of their PCP position.

[PMFB-RN, RN]

I understand if you have a PhD, you are entitled to be called "Doctor".

Does this statement indicate that you do not believe holders of other doctorate degree are entitled to be called doctor? A PhD is but one of a numbers of doctorates.

The clarification I am looking for is if an NP with a masters degree worked in a clinical setting that allows NPs to be called doctor.

Really hard to determine if this is an attempt at trolling or a serious question. I don't know what would be worse.

I will answer as if this is a real question. OF COURSE NOT! Don't be ridiculous. NOBODY has ever suggested that should happen. NP is a roll, a doctorate is a degree.

The article had a line stating that NPs would be called "Doctor" in the healthcare setting. There are fewer Doctoral prepared NPs as compared to Masters degree NPs.

We have already established that the author of the article (1) has an ax to grind and (2) is either lying through his teeth, or is spectacularly uninformed. Given that we already know that why would you give credit to what he says in his article?

I don't know what the numbers of MSN prepared NPs and DNP prepared NPs in in primary care, but there are many, many doctorate prepared NPs working right now.

It would be more common to see the masters degree prepared NPs providing PCP care. Now since they are the PCP, would they also be called doctor even though technically they arent

Of course not! Don't be silly.

If the facility allowed Masters degree prepared NPs to be called "Doctor" would that not also be a lie? If a PA or NP with no PhD are performing the role of a PCP, can they also be called "Doctor"?

Can you name an instance where that happened? The only people I know who are regularly called "doctor", who do not hold any doctorate degree, are the many physicians who are called "doctor" as a courtesy despite the fact that their highest degree is called a bachelors degree.

These are the questions I am asking.

Yes but my questions is are you trolling?

[toomuchbaloney]

In more than 3 decades of professional practice in several states and in a broad variety of settings I have NEVER encountered an NP or PA who was called DOCTOR in the clinical setting. In fact, the PhD FNP that I worked with was not called doctor in the clinic during delivery of care at his request so as not to confuse any patients who might overhear. That fellow, like the vast majority of health professionals understand that lay people often have a very limited understanding of these terms and their proper use.

[kalevra, BSN, RN]

I am not trolling, I am legitimately asking these questions, here is the reason why.

I recently volunteered to be part of a Community Outreach and Streamline Committee. Figured I could get some extra pay and a little glimpse on how business is conducted. I was present in a presentation in regards to the Hospitals Finances and where most of the expenditures and productivity are coming from. The biggest "waste" of resources (money) comes from the ER. The majority of pts we serve are in the lower end of the socioeconomic spectrum. Our state's reimbursement of procedures and services for these pts always ends up less than the actual cost, therefore for every pt that comes in with state coverage, we lose money. It is always a net loss, so now we are figuring out ways to mitigate hospital loss.

Now a few changes were implemented recently to decrease the amount of people using ER "resources". One of them was "Call ahead waiting", where the pt can reserve a spot in ER by calling ahead of time. Yes, I understand that if you can wait to be seated in ER then how sick are you really. Now the problem is many of our community use the ER as their primary care facility. So how do we "re-allocate" expenditures so as to increase productivity.

The Urgent Care Clinic we have can handle most of these pts. The problem is a lack of awareness and education coupled with long standing cultural belief. We do not have enough physicians to man the clinic and hospital. The reason behind this is that our hospital terminated a contract with a medical group covering the clinic mainly due to retainer fees and a few other things. Now we started staffing the clinic with NPs, most of them are masters prepared. I know them personally since they were coworkers in ICU that transitioned.

In theory the problem should have been solved. The problem now is that there has been an extreme decline of visits by these types of pts to the clinic. One reason is that the word has spread that the MDs servicing the clinic are gone. The pt population lost confidence in the kind of care they would receive and started going to the ER en-mass. The reason why they chose the ER is because they know there is always atleast 1 physician on duty.

So how do we fix this problem? One idea was re-branding. There is precedence for non-PhD staff to be called "Doctor". This precedence is set in Academia, where lecture instructors can have a MAsters Degree and still be referred to as "Doctor" due to their position. In short we apply a two prong approach.

The first proposal is The facility writes policy authorizing calling NPs?PAs with Masters Degrees "Doctor" in the Urgent Care setting or facility wide. The idea is word gets out that "Doctors" are now back in the urgent care clinic. Use of guerrilla marketing was mentioned at this point. Apparently if the people feel that the word came from witin their community they are more apt to believe the news. In theory pts would return back to the clinic instead of the ER. This is the short term fix.

The second proposal is to begin an aggressive community outreach education program to educate the targeted pt demographics in regards to what an NP can do. Educating the pt population in regards to their care not changing much now that NPs/PAs are the PCPs. This is the long term fix.

The reason why being called "Doctor" is important to the hospitals targeted pt demographics is a matter of culture. People grew up in the old country seeing a "Doctor", pts feel more comfortable with a "Doctor" in charge of their care. We sent out surveys in regards to pt satisfaction, and results were that people did not like having a "Nurse" in charge of their care. Compiled data from mail in surveys, in person polling and pt complaint records have shown a lack of confidence.

Now I log onto AN and see this article. I was wondering if anyone else has seen this implemented and how is it panning out. The proposed measures would also save the hospital money because instead of paying a medical group to cover services, you can now pay NPs instead. Since the NPs will be employees of the hospital, the hospital will also save money again by not having to pay retainer fees.

Every time the hospital can make or save money on something, they tend to try annd implement it even if on a trial basis.

Part of the plan feels like a lie, to change policy to call someone something they are not feels wrong to me. Re-Branding a title to make it sound more pleasing to target demographics, it makes me feel uneasy about it. It kind of makes me feel a little slimy.

But I guess this is how the Business of Healthcare is done. It has been an eye opening experience.