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

[justme1972]

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?

[PICUPNP]

WHy is it so important for you all with doctorates to be addressed as Dr so-and-so? It seems as though all of this wasted energy could be put towards something more important. Instead, you all want to sit around and bash the AMA for standing up for what is right. There is NO reason that a nurse, np, or dnp should be addressed as Dr or present themselves as Dr to their patients. How ridiculous that this conversation continues! Go to Med school!!

[JDCitizen]

WHy is it so important for you all with doctorates to be addressed as Dr so-and-so? It seems as though all of this wasted energy could be put towards something more important. Instead, you all want to sit around and bash the AMA for standing up for what is right. There is NO reason that a nurse, np, or dnp should be addressed as Dr or present themselves as Dr to their patients. How ridiculous that this conversation continues! Go to Med school!!

:-)

Actually the same conversation can be heard in academia... My father never got upset about the being addressed as Mister Citizen even after his degree but plenty of his fellows sure did...

Its a degree and a title: To some the title in more important than it is to others.

[Dr. Tammy, FNP/GNP-C]

When I get my DNP, I only expect those who it really bothers to address me as doctor. After medical students who have no clue as of yet what primary care means or what it really means to build nursing-based active care partnerships, and ego-centric physicians who have a vested interest in the failed medical model that is responsible for our current health care crisis, the list should be pretty short.

[Guinea]

How about this as a compromise? Everyone else can call themselves doctors, and those with MDs can call themselves medical doctors. Your relevant terminal clinical degree is printed with big letters (MD, DPN, DPT, PharmD) next to your ID badge so patients can easily identify what your doctorate is. No obfuscation, no BS. Good?

[mudphudstudent]

I'm a student in a MD/PhD program. When I start my third year med school clinical rotations I will already have earned my PhD in biomedical engineering. It would be, however, highly improper for anyone to refer to me as "Dr. MudPhuDStudent" in a clinical setting; I should only be referred to as "MudPhuDStudent, a third year medical student". The term "doctor" has a very specific meaning in a clinical setting. In a dentist's office, a physician (or history professor) shouldn't use the term "doctor." In an ICU, a dentist (or physicist) shouldn't use the term "doctor" when referring to him or herself. It would be technically true for me to refer to myself as a doctor on third year rotations, but in the clinic it would do nothing more than confuse the patients. This isn't about ego, it's about the patients. So in a clinical setting, I would (personally) be uncomfortable with someone with a PhD in nursing (or a DNP) referring to themselves as a doctor, just as I would be uncomfortable with someone calling me a doctor. I'm not ant-DNP (I don't have enough information to about the degree), but I am anti-confusing patients.

[llg, PhD, RN]

I'm not ant-DNP (I don't have enough information to about the degree), but I am anti-confusing patients.

When you think about the history and politics of the various health professions, it's the physicians who have confused the patients -- by trying to confiscate the title of "doctor" from the PhD's, who held that title long before physicians and surgeons were educated at even the Bachelor's level. It is the physicians' efforts to "own" that title by taking it away from other disciplines that is the root of the confusion.

If people were raised with the correct notion that medicine is simply one academic discipline (like many others) and that all disciplines use the title of "doctor" to refer to it's members educated at the doctoral level ... there would be no confusion in the first place. Physicians would introduce themselve as "physicians" or "medical doctors" and the other disiplines would similarly introduce themselves by signifying their discipline as well, as in "Good morning. I am Dr. llg, your nurse for the day."

Proper introductions would be easy and not confusing to anybody. Perhaps when you have more patient care experience, you will realize how easy it is to introduce yourself to your patients in a way that makes your role in their care clear. (ie. med students and residents who don't distinguish their roles from that of the attendings.)

If only the physicians hadn't gotten greedy and tried to trample on all the other disciplines in the first place....

[littleneoRN]

LLG, although what you say is true, what is is. I guarantee that telling someone you are Dr. LLG, their nurse for the day will be clear to some and clear as mud to others. I have clinical experience and am comfortable explaining the various roles. Most people get it after I explain, but the general public does not have a very good understanding of the various roles without obfuscating the titles. Most people don't know the difference between a medical assistant and a physician's assistant, even though the difference is huge. People often don't the difference between a CNA vs. LPN vs. RN vs. NP. Is it necessary to make it more confusing for them? I agree that MDs have contorted a title to make it their own; however, this term is rooted in popular use, and you have a long uphill battle to change that association. Aren't there issues in healthcare that would provide greater benefit to people with the energy we might put toward this battle over words?

[mudphudstudent]

When you think about the history and politics of the various health professions, it's the physicians who have confused the patients -- by trying to confiscate the title of "doctor" from the PhD's, who held that title long before physicians and surgeons were educated at even the Bachelor's level. It is the physicians' efforts to "own" that title by taking it away from other disciplines that is the root of the confusion.

My point is that this doesn't matter. You're probably right: physicians took that title when, perhaps, they should not have. But what is done, is done. From the patient's perspective, "doctor"=physician or dentist or podiatrist (in the clinical setting). You're talking about politics and I'm talking about not confusing patients. DPNs should feel free to refer to themselves as "Dr. _" in any non-clinical setting (lectures to other clinicians, etc.) and I would not begrudge them that. In front of patients, however, they should introduce themselves as "_, your nurse practitioner" to a avoid confusion, just as I should not refer to myself as "Dr. MuDPhuDStudent, your medical student".

A reason that some people seem to be uncomfortable with the DPN is that the degree seems to be more about politics than about good nursing: I've interacted with some good NPs who have masters degrees (at a family medicine office I worked at during the first two years of med school). Their training seemed sufficient to their scope of practice. Is the reason the DPN exists so that NPs will be better trained or is it so they can claim the title of "doctor" in the clinical setting? If it is the former, then I think it's great (everyone in all professions can be better trained). If it's the latter, then it seems to me that those who created the DNP programs have put their own egos/politics above actually better caring for patients. Like I said, I don't know enough about the DNP to judge, but from my naive view those are the two possible reasons the programs exist. I'm plenty comfortable with MSN NPs since I have interacted with some of them, but I have yet to meet any DNPs (or see any data on whether their clinical effectiveness, on average, is improved over that of MSN NPs).

[kindaquazie]

One of the driving forces behind the DNP is NOT politics but research translation. The application of all those wonderful RCTs in the real world is challenging and often fails to produce the results found in the original studies. The presence of practitioners, either nurses or physicians, at the bedside who are doctorally prepared to conduct TR is essential. The fact that only about 60% of patients receive care that is consistent with published guidelines backed by excellent research is appauling. Unless we are able to conduct the research, create guidelines, disseminate the information, and translate it into practice, patients will continue to receive sub-standard treatments by caring practitioners with good intentions.

I will introduce myself to patients as a nurse practitioner. In the course of our relationship, should it come up, I will certainly explain my academic credentials. I believe in nursing and its value. An excellent nurse is not an asset to the health care team, but an essential member without whom quality health care cannot be delivered. I do not need to compete with physicians nor do I require them to share the emoluments of their work. I require from them what I require from every member of the team, excellence and collaboration.

[llg, PhD, RN]

My point is that this doesn't matter. You're probably right: physicians took that title when, perhaps, they should not have. But what is done, is done. From the patient's perspective, "doctor"=physician or dentist or podiatrist (in the clinical setting). ).

Thank you for that acknowledgment. It's an "piece of politics" that needs to be acknowledged by physicians if we are going to get anywhere on this issue. Really, that acknowledgment means a lot.

I earned my PhD in nursing 10 twelve years ago and I have worked in hospital setting since then. Patients are not confused when I introduce myself. I simply tell them I have a PhD in nursing. Sometimes, it leads to a little more conversation as they have a question or make a comment, but "confusion" has not been a problem. They quickly grasp that I am a nurse with a lot of education -- and not a physician.

Actually, I don't usually introduce myself as "Dr. llg." I almost always just say that I am "llg" and "I am here to ..." My badge says "PhD, RN" and I don't make a big deal about titles. But when it does come up for some reason, the patients have no trouble understanding the concept of a nurse with PhD. It takes only a few seconds to explain it and avoid confusion.

All health care workers should introduce themselves to the patient in a way that communicates their role in the patient's care. Med students should say they are med students: residents should say they are residents, etc. Patients are confused every day by the parade of people they meet who do not introduce themselves properly. They can't tell the med student from the senior attending from the housekeeper sometimes! We should ALL include a phrase or two that clues them in as to our roles in their care. If we all did that appropriately, the "doctor title issue" would not exist.

[PICUPNP]

So kindaquazie, you are telling us that out of all of the master's prepared NPs, only 60% of their patients recieve care based on EBM because they are not doctorally prepared? That's a very bold statement to all of your colleagues who are out there actually practicing. Throughout all of the post regarding the DNP it has been promoted as a way to equalize NPs and MDs, which is ridiculous in itself. I more than agree with mudphud, with regard to this thread , in that the title use is more confusing than anything else. We can continue to beat the dead horse, but in the end only MD/DO should be referred to as "Dr" in the clinical setting.

[acubed]

All health care workers should introduce themselves to the patient in a way that communicates their role in the patient's care. Med students should say they are med students: residents should say they are residents, etc. Patients are confused every day by the parade of people they meet who do not introduce themselves properly. They can't tell the med student from the senior attending from the housekeeper sometimes! We should ALL include a phrase or two that clues them in as to our roles in their care.

ABSOLUTELY!!! I really really don't like when residents come in without stating that they are residents--it DOES make a difference to me. Most of the time, I don't know who is the CNA, LPN, or RN (I'm pre-nursing and recently realized there's a difference!). I say, state your role in the patient's care!!! Or if you're stuck on a title, use the title HR labels you with