Curious...using the title "Doctor" for a DNP...

Specialties Doctoral

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For a friendly debate topic.....

I remembered reading an old post awhile ago where an NP (who got her DNP) was told by Human Resources that she couldn't use the title "Doctor" at the hospital, because it would mislead the patients.

I am wondering if anyone has seen or heard anything similar where they work (you personally or someone else).

If hospitals are "all about introductions", I see nothing wrong with telling a patient, "Hi, I'm Dr. Smith, I'm a Nurse Practioner"...I see no difference between that and saying, "Hi, I'm Dr. Jones and I'm your Cardiologist".

To me, that would be a HUGE slap in the fact to someone who has worked hard for that degree, because they are entitled to use that title.

What ya'll think?

Specializes in ER/OR.
unless you happen to live in oklahoma. our state physicians ramrodded through a law that prevents us from doing that. the only exceptions include chiropractor, dentist, optometrist and podiatrist...

in that case, luckily i don't. run, don't walk!! :wink2:

Specializes in Nursing Professional Development.

To Nephilim: I do appreciate that you were trying to be respectful etc. in your post -- but I agree with the others who have responded. The fact that you personally, have yet to develop sufficient self-confidence to wear the mantle of "doctor" comfortably should not prevent others with years of clinical experience and a doctoral education from using the academic title that they have earned.

I am not an NP, but I am nurse with a PhD and over 30 years of experience as a nurse. When I interact with patients, I usually just use my first and last name and explain what my role is in relation to their care -- but I do not hesitate to use "doctor" title when appropriate. I am not about to "defer" to a new medical school graduate still wet behind the ears. I am every bit as entitled to use the "doctor" title as he/she is. We are both bonafide doctors and should both respect each other's academic credentials. ... And we should both clarify our roles when we introduce ourselves to patients.

Specializes in ED, Cardiac-step down, tele, med surg.

I agree with the above posts regarding the term "doctor" to refer to a level of education attained. I referred to my professors as "doctor" out of respect for their knowledge and efforts to attain that knowledge. Unfortunately, as a patient, I have come across physicians ("doctors") who were unworthy of my trust and fortunately I had enough intellectual ability to do my own research instead of relying on their judgment. This has happened more than once. I know that this could happen with a DNP as well or any other "doctor" where for some reason the educational level and even experience was not enough to prevent incompetence. Everyone makes mistakes. Sometimes professionals don't keep up with all of the new research and allow their skills to become rusty. I would strongly encourage the public to do their own thinking, and rely on medical professionals as guides, not as the sole decision maker. The public must be taught to be better decision makers, not just sheep who know little about their health and put all of their trust in physicians or any other medical professional. I also appreciate the contribution of the physician who spoke up on this forum and I am inspired by their respect of the highest ideals of medicine and those who have practiced from their hearts. If I were to go on to become a physician, I would want to practice from that place.

Unless you happen to live in Oklahoma. Our state physicians ramrodded through a law that prevents us from doing that. The only exceptions include chiropractor, dentist, optometrist and podiatrist...

Which is sad for psychologists, college professors, PharmD's and the like.

Here is an excellent article on this very issue that is a short, informative and good read.....

http://www.medscape.com/viewarticle/563176

I think the fundamental difference is whether you value what words mean to people more or less than what the word means in a dictionary. That is not a question open to rational debate and, I think, is something that is just personal opinion. That being said, I can't help but debate it.

It is clear what the word means to the general population. Google "Doctor" and every link on the first page refers to physicians. Click images and you see only images of physicians. You see Mediaography with images of mock physicians before you see something resembling a non-physician. I think anyone who claims the word means to people outside academia something other than physician is being disingenuous. What does Webster say?

1doc-tor

1 a: an eminent theologian declared a sound expounder of doctrine by the Roman Catholic Church —called also doctor of the church b: a learned or authoritative teacher c: a person who has earned one of the highest academic degrees (as a PhD) conferred by a university d: a person awarded an honorary doctorate (as an LLD or Litt D) by a college or university 2 a: a person skilled or specializing in healing arts; especially : one (as a physician, dentist, or veterinarian) who holds an advanced degree and is licensed to practice b: medicine man3 a: material added (as to food) to produce a desired effect b: a blade (as of metal) for spreading a coating or scraping a surface4: a person who restores, repairs, or fine-tunes things

Physicians come after "sound expounders of church doctrine." Clearly the definition is not what the word means to people.

The point is made that what that implies is patient education. Maybe so, but personally it doesn't feel like the motivation is truly to be as clear as possible with patients, but to appropriate the common meaning of the word. It is *that* meaning that holds value to patients. Not the meaning of one who if learned in catholic doctrine or even one who has achieved the highest degree offered in a field. Certainly that is true in the hospital.

"I am not about to "defer" to a new medical school graduate still wet behind the ears. I am every bit as entitled to use the "doctor" title as he/she is. We are both bonafide doctors and should both respect each other's academic credentials."

I wonder what your PhD is in and what circumstance you find using the title appropriate.

Some posters readily admit what the word means to people yet defend using it because, paraphrasing "I've earned it and if people are confused about it then they need to be educated". I wont speak to that at the moment except to say it strikes me a self centered and I don't believe for a moment that these people are motivated by a deep respect for adherence the Webster dictionary definition.

Specializes in FNP.

Health care is changing in all sorts of ways, and patients are adapting. Dr. Nurse may be one way they will have to adapt, but we still don't have a clear outcome on this. Nephilim, you have no idea what it's like, day after day, introducing yourself as a NP. (At times patients look at you funny, and need education on the role.) At the end of the visit, you often hear "thank you doctor". In a patient's point of view, if you look like a doctor, talk like a doctor, and do the work of a doctor, they call you one. So I don't think patients are so confused after all. They see the term "doctor" as a role, not as a degree.

On an amusing aside: I've often heard something to the effect from patients like "I've never seen a doctor that has made so much sense!". And I have to tell them that they still haven't. :nurse:

Dana

Specializes in Nursing Professional Development.
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"I am not about to "defer" to a new medical school graduate still wet behind the ears. I am every bit as entitled to use the "doctor" title as he/she is. We are both bonafide doctors and should both respect each other's academic credentials."

I wonder what your PhD is in and what circumstance you find using the title appropriate.

Good question. My PhD is in nursing. I rarely use "Dr. llg" t with patients as I work in a culture where most people (including physicians) use their first names regularly. Most times, I will simply say something like, "Hi, I am llg, one of the nursing instructors .... " In such circumstances, my academic credentials are not very relevant, so, I go with the convention of my culture and simply use my first and last name.

Most of the times when I use my "doctor" title is when I am interacting with other professionals, not 1 on 1 with patients. For example, if people are introducting themselves as "I am Dr. So-and-So" ... "Good morning, I am Dr. Whats-his-name" ... etc. I will similarly use my title to establish my propoer position and relationship to the other members of the group. We are colleagues and peers and I smile and politely claim my appropriate place among the group of doctors present. My name tag has a very big "RN" on it to clearly identify me as a nurse, but if there is any reason for me to suspect someone might not know that, I can easily add something like, "I am in nursing education."

I've been working in a hospital (not for a school of nursing) for 11 years with my PhD and using this approach has never caused any problems or misunderstandings that I know of. Ocassionally, a person (patient or staff member) will say something like, "Oh ... you are a doctor of nursing? How interesting!" ... or ... "I didn't know we had a doctorally prepared nursing here at this hospital" and a pleasant conversation ensues during which I have the opportunity to educate them about my role in the hospital as a Staff Development Specialist and Nurse Researcher.

Three decades of research related to the needs of patients and their families shows that the number one concern is that they are receiving the best possible available care. Physicians and nurses are the backbone of that care. The best of these each thinks a little like the other. The best of these works in tandem with the other to provide synnergistic care that neither could provide alone. Research also shows that healthy work environments with mutual respect and open communication are essential to providing optimal patient care.

When I earn my DNP, I will introduce my self as doctor_____, nurse practitioner. I will present this in a manner consistent with the needs of patients and their families. The need to know that they are receiving the best possible care. I will hold my collegues in medicine accountable to their professional standards even as I uphold mine. I will work every day, even as I do now, to earn the trust that is placed in me simply because I am a healthcare provider and work in a big white building. No one places more trust in nurse than the physician he or she is working with. They are the ones most able to truly understand the complex nature of our bedside practice as it relates to patient outcomes. Ask any heart surgeon what his or her practice would look like without qualified ICU nurses. We each see the best and worst of one another's professions. I, like Nephilim, am terrified to start practicing at a higher level. The title comes with the decision-making ability and associated responsibility to effect patient's lives on a broader scale. However, it is one that I will be emotionally and intellectually prepared for and am willing to take on. We are in a battle against disease and human suffereing, not one another.

Specializes in ED, Cardiac-step down, tele, med surg.

I think the DNP debate has to do with the fact that nurses, especially those with advanced training and experience, want respect from other professionals (M.D.'s included) for their knowledge and expertise. M.D's have gotten respect for their years of training and dedication. Nurses, on the other hand have not been given the same respect, even though they may be putting the same dedication in, putting their hearts, minds, and greatest efforts in their work, and being ignored or even disrespected, like attitudes revealed on SDN (student doctor network) indicate. How many other health professionals actually try to learn about what nursing is? Do physicians ever decide to read a nursing journal? I know that nurses probably read medical research. There is a huge disparity in power here between the discourse of medicine and the discourse of nursing, and it is based in part on the historical repudiation of women. That must end, because medicine is also based on the most sacred of human actions, to heal the sick. Nursing is also based in those ideals. So I think it is time for the discourse of medicine to change, give respect when it is due, humble itself to others and knowing that there will always be more to know and master and that no one every truly becomes a master. And practice from your heart, not the ego! The public also needs to change so that they become in a sense their own healer, where they use medicine as a tool and medical professionals as guides.

1doc-tor

1 a: an eminent theologian declared a sound expounder of doctrine by the roman catholic church —called also doctor of the church b: a learned or authoritative teacher c: a person who has earned one of the highest academic degrees (as a phd) conferred by a university

notice here that a phd is an example...but not the only example

d: a person awarded an honorary doctorate (as an lld or litt d) by a college or university 2 a: a person skilled or specializing in healing arts; especially : one (as a physician, dentist, or veterinarian) who holds an advanced degree and is licensed to practice b: medicine man3 a: material added (as to food) to produce a desired effect b: a blade (as of metal) for spreading a coating or scraping a surface4: a person who restores, repairs, or fine-tunes things

physicians come after "sound expounders of church doctrine." clearly the definition is not what the word means to people.

yes, but you left out the huge point that an advanced degree came first.

the point is made that what that implies is patient education. maybe so, but personally it doesn't feel like the motivation is truly to be as clear as possible with patients, but to appropriate the common meaning of the word. it is *that* meaning that holds value to patients. not the meaning of one who if learned in catholic doctrine or even one who has achieved the highest degree offered in a field. certainly that is true in the hospital.

"i am not about to "defer" to a new medical school graduate still wet behind the ears. i am every bit as entitled to use the "doctor" title as he/she is. we are both bonafide doctors and should both respect each other's academic credentials."

i wonder what your phd is in and what circumstance you find using the title appropriate.

some posters readily admit what the word means to people yet defend using it because, paraphrasing "i've earned it and if people are confused about it then they need to be educated". i wont speak to that at the moment except to say it strikes me a self centered and i don't believe for a moment that these people are motivated by a deep respect for adherence the webster dictionary definition.

it appears that my interpretation of the word "doctor" matches webster dictionary exactly.

thank you so much for looking up that information and making my point.

ps: not that this is directed to you...but has anyone else noticed that there are alot of brand-new posters that are anti-doctor-salutation posting to this thread with fewer than 20 total posts?

i just see a pattern here.

It appears that my interpretation of the word "doctor" MATCHES Webster dictionary EXACTLY.

Thank you so much for looking up that information and making my point.

PS: Not that this is directed to you...but has anyone else noticed that there are alot of brand-new posters that are anti-doctor-salutation posting to this thread with fewer than 20 total posts?

I just see a pattern here.

The point of that Webster quote is to show how out of step its definition is with the meaning it has in peoples minds. What support can you draw from a resource that lists a holder of a very advanced degree ahead of physician when the same reference puts those learned in catholic doctorine ahead of *everyone*? Websters is not where you want to be getting your information on what the word means to people. Your point is that what it does means to people and what it should mean to people is different and it should be rectified. But I don't think you want to hang your hat on the supposed authority of Webster's.

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