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]

Please tell the DNP students about the “lipstick”, walk in their shoes and see if they think the course work is “lipstick”. Graduate school and the scholarly activities associated with completion are not often considered lipstick. Do you consider the Pharm D a “lipstick” degree? Which “Dr” curriculum is the most rigorous ? DNP-DC-Pharm D-OD ? Based on your posts I suspect you feel the DNP is the least rigorous?

As a practicing NP, i can tell you that the DNP curriculum is total fluff BS. There is nothing that the DNP would add to my practice other than the additional research and theory courses. The DNP is by far the least rigorous! Its touted as a clinical based degree, but where's the beef?? No advanced sciences or patient management courses, just more theory, research, and the illustrious capstone project. The faculty that came up with this as the terminal degree for NPs should be fired. NPs NEED more patho, pharm, anatomy, etc, not more nursing theory, leadership, or capstone projects. NPs actually need an education exactly like PAs receive. It would do more than the DNP to further our ability to care for patients.

[prairienp]

please tell the dnp students about the "lipstick", walk in their shoes and see if they think the course work is "lipstick". graduate school and the scholarly activities associated with completion are not often considered lipstick. do you consider the pharm d a "lipstick" degree? which "dr" curriculum is the most rigorous ? dnp-dc-pharm d-od ? based on your posts i suspect you feel the dnp is the least rigorous?

as a practicing np, i can tell you that the dnp curriculum is total fluff bs. there is nothing that the dnp would add to my practice other than the additional research and theory courses. the dnp is by far the least rigorous! its touted as a clinical based degree, but where's the beef?? no advanced sciences or patient management courses, just more theory, research, and the illustrious capstone project. the faculty that came up with this as the terminal degree for nps should be fired. nps need more patho, pharm, anatomy, etc, not more nursing theory, leadership, or capstone projects. nps actually need an education exactly like pas receive. it would do more than the dnp to further our ability to care for patients.

i would encourage you to return to pa school for the desired additional education you seek. i think courses on policy, administration, transitional research all play a significant role in advanced practice. knowledge is good, understanding the advanced practice role is essential. don't you ever wonder why nurses have independent practice? do you think we were given these opportunities? leaders in nursing with these so called fluff courses understood the political/policy aspects of practice and have sought to improve our practice. if all these dnp courses are fluff, and one would have to think teaching fluff would be easy, why is there such a shortage of nursing faculty? geez, they get to be called dr and everything while teaching fluff and getting high dollars, oh wait, the salary for fnp faculty are generally lower than the np students who are graduating from the programs and going into practice. as i suggested, walk in their shoes, you are making significant assumptions based on limited subjective data. you may have known this if you had taken a few fluff dnp graduate courses.

[PICUPNP]

I also believe that knowledge is power, but the dnp curricula adds nothing to what I and most other NPs are already doing daily. The ONLY reason we have independent practice is a strong lobby, not the fact that we are excellent clinicians. You can continue to beat the dead horse but for a TERMINAL degree, I would expect additional sciences and classes in patient management. The dnp is just fluff and add nothing to patient management. Its just a watered down PhD. Explain how the dnp will aid you in diagnosing a complex patient??? It won't because its focus is theory and leadership, not patient care.

[dgenthusiast]

tell dr. allan greenspan who was on "meet the press" sunday he should have gone to medical school if he wants to be called a dr. how silly, the argument of who is or is not called a dr. is just plain dumb. i have been called a dr. in the office for 25+ years, i constantly tell patients i am a np not a dr. , but i am their dr. i gave up correcting my established patients years ago. reality is very very few of our np dnp or phd colleagues are going to refer to themselves as a "dr" in the clinical setting. the vast majority are not into the need to be recognized as a dr, they want to be known as great healthcare provider.

you're manipulating what others are saying. either you're doing it on purpose or you're doing it unwittingly. i'll give you the benefit of the doubt and assume you're doing it unwittingly. i don't think anyone has ever suggested that no one who hasn't gone through medical school can be a doctor. look back through all the posts. no one has. what people have been saying is that in a clinical setting, doctor is synonymous with physician in the patients' view (due to long standing tradition) and others, even those with phds, shouldn't call themselves a doctor in a clinical setting because it misleads patients into thinking that they've gone through the rigorous medical training that physicians go through. go crazy with the doctor title in an academic setting if you want; no one's holding you back. that's not too hard to understand, is it?

on the other hand, i would argue that the dnp doesn't really deserve a doctorate title, especially not a clinical one. reasons include being able to get one online, lack of rigor, lack of any clinically useful courses, abundance of clinically useless courses (such as business management, nursing theory/activism, etc), etc. when compared to other doctorates (phd, md, do, etc), the dnp appears very watered down and useless for what it's been touted to be (a clinical doctorate). someone mentioned that the dnp is a watered-down phd. i don't think it's even that. it's more like a glorified mph. go ahead and compare mph curricula with dnp curricula and you'll see a lot of similarities there.

[prairienp]

you're manipulating what others are saying. either you're doing it on purpose or you're doing it unwittingly. i'll give you the benefit of the doubt and assume you're doing it unwittingly. i don't think anyone has ever suggested that no one who hasn't gone through medical school can be a doctor. look back through all the posts. no one has. what people have been saying is that in a clinical setting, doctor is synonymous with physician in the patients' view (due to long standing tradition) and others, even those with phds, shouldn't call themselves a doctor in a clinical setting because it misleads patients into thinking that they've gone through the rigorous medical training that physicians go through. go crazy with the doctor title in an academic setting if you want; no one's holding you back. that's not too hard to understand, is it?

on the other hand, i would argue that the dnp doesn't really deserve a doctorate title, especially not a clinical one. reasons include being able to get one online, lack of rigor, lack of any clinically useful courses, abundance of clinically useless courses (such as business management, nursing theory/activism, etc), etc. when compared to other doctorates (phd, md, do, etc), the dnp appears very watered down and useless for what it's been touted to be (a clinical doctorate). someone mentioned that the dnp is a watered-down phd. i don't think it's even that. it's more like a glorified mph. go ahead and compare mph curricula with dnp curricula and you'll see a lot of similarities there.

thanks for the benefit of the doubt, but the example was with purpose (versus "on") to show how silly the whole argument is about who is called "dr". i am not sure of what environment you have been exposed, i have been in a variety and all the phd and psych d refer to themselves as "dr" in the clinic and hospital, and infrequently the pharm d using the dr term. who really cares? i know the nps i work with don't give a hoot.

i am unsure of why you are so hostile towards the dnp? you have made broad general statements about the dnp without any facts to support your postulates. subjectivity is common among those who do not understand or unwilling to seek measurable outcomes. from what i have seen proposed for the dnp, numerous guidelines for curriculum essentials have been established. now these essentials are not written in the elementary concrete stipulations you would find valuable. those darn phd np people use all those big words and complex sentences to communicate.

in reference to a glorified mph, i find the similarities valuable. i have always considered the mph a rigorous curriculum and valuable in the assessment and provision of healthcare. granted, no significant clinical, nothing but a bunch of theories, population assessment, and statistics courses. yet, i would welcome any np with a mph as a valuable member of the team. i may even call them "dr" !

[PICUPNP]

I'm and NP and am hostile towards the DNP degree! It's ridiculous! If it added anything to my practice that would be one thing, but it doesn't. It is full of theory, leadership, and other fluff. For a terminal degree as a NP, the DNP offers nothing to the management of patients. I have worked in a hospital my entire career and have never heard a PharmD or other PhD refer to themselves. This whole discussion is more of the proverbial baeting the dead horse. Any NP that refers to themselves as Dr or has others refer to them in that way are only making themselves look bad in the eyes of the medical community. Why is it SO important for a DNP to be addressed as Dr? DNPs aren't even close to a medical doctor. I know, I know, there are studies showing no difference in outcomes, but those are not the complex patients. If DNPs want to be called Dr, then they should go to medical school.

[wowza]

good luck with calling rns lower level, i for one have far too much respect for my roots to think of rns or nurses as lower level.

someone asked what midlevels were between... so i answered the question. people need to stop taking things so personally. the 3 main groups of health providers are nurses, pas/nps and do/mds. a nurse's education is below an np/pas which is below an md/do's. it has no implications for how they do their job, or what impact they have with the patients. just that the education is less and the jobs, to some extent, are different.

tell dr. allan greenspan who was on "meet the press" sunday he should have gone to medical school if he wants to be called a dr.

when allan greenspan comes to the hospital and tries to start treating patients i will tell him exactly that.

in reference to a glorified mph, i find the similarities valuable. i have always considered the mph a rigorous curriculum and valuable in the assessment and provision of healthcare. granted, no significant clinical, nothing but a bunch of theories, population assessment, and statistics courses. yet, i would welcome any np with a mph as a valuable member of the team. i may even call them "dr" !

an mph is not valuable in the clinical setting. stop bsing.

when it is supposed to be a clinical practice doctorate, and instead of adding clinical courses or advanced science courses you add statistics and leadership courses... well it is not a clinical doctorate at all... it is just a masters degree still. which is what the dnp is. a masters degree with lipstick.

[wowza]

In the end it comes down to this:the DNP is not rigorous enough, does not have the right classes, and does not have enough clinical experience to be called a doctorate.

In terms of rigor how about this for some proof: Mary Mundinger pushed the NBME (people who do the medical boards) to create a watered down version of USMLE step 3. This included taking out many of the more complex questions and lowering the score needed to pass. Despite this, only 50% passed.

Now, >95% of MDs who take the harder, real version of the exam pass on the first try. They also take it when they are interns, so they have no time to study for it, unlike Mundinger's cohort. And you have to bet, because of the implications, Mundinger did everything in her power to make sure these students did as well as they could.

[efy2178]

People in this thread keep saying that NPs are mid-level medical professionals and that nursing and medicine are completely different jobs. I'm working towards becoming an FNP in a traditional family practice where I will be a primary care provider. There will be no physician over me and I will be providing the same care, Rx prescriptions and advice that a doctor does. The education and function of an NP must be thorough and similar enough for this to be allowed and working well for patients. I think in the hospital setting, nurses and drs. serve very different functions and nurses are usually below drs., but there is an entire world of primary care outside of hospitals.

The formal introductions that everyone is offering seem to work well in the hospital setting where the patient is seeing many professionals in many departments, but I'm still iffy on what a nice intro would be when I'm meeting a new patient in private practice. If I'm a primary care provider for that patient, for all intents and purposes, I am that person's dr. It also seems easier to call me doc than 'nurse practitioner so-and-so' or 'nurse' which in this country, doesn't seem to offer the same designation of authority. The easiest thing to do might be what my grandma's NP says: 'Just call me Jill'.

By all means refer to your self as "DOCTOR" if you have your DNP. In my state it is legal to do so. However, I refer to myself by my first name and make it very clear to my patients that I am a nurse practitioner. I have quite happy and proud to call myself a nurse. It is a teaching moment to give patients the opportunity to ask the difference between a nurse practitioner and a physician and I explain that I am a nurse first and formost with exceptional training and education and am well qualified to be their primary care provider. I also tell them I will be happy to refer them to a physician if their needs are outside my scope of practice.

[wowza]

I have nothing against NPs or DNPs. The one's I have worked with are excellent at their jobs and a huge asset to the team. But let's get one thing straight, the education is not the same. MDs and DOs are perturbed by the fact that the nursing leadership continues to push for equal practice rights despite the gaping difference in education. I personally don't get it.

On boards like this, it often comes off as MDs/DOs or the MD/DO students anti- NPs. That is not the case. Most are pro-NP. However, we are completely against undertrained people overstepping their bounds.

[ANPFNPGNP]

Please tell the DNP students about the "lipstick", walk in their shoes and see if they think the course work is "lipstick". Graduate school and the scholarly activities associated with completion are not often considered lipstick. Do you consider the Pharm D a "lipstick" degree? Which "Dr" curriculum is the most rigorous ? DNP-DC-Pharm D-OD ? Based on your posts I suspect you feel the DNP is the least rigorous?

As a practicing NP, i can tell you that the DNP curriculum is total fluff BS. There is nothing that the DNP would add to my practice other than the additional research and theory courses. The DNP is by far the least rigorous! Its touted as a clinical based degree, but where's the beef?? No advanced sciences or patient management courses, just more theory, research, and the illustrious capstone project. The faculty that came up with this as the terminal degree for NPs should be fired. NPs NEED more patho, pharm, anatomy, etc, not more nursing theory, leadership, or capstone projects. NPs actually need an education exactly like PAs receive. It would do more than the DNP to further our ability to care for patients.

PICUNP - Are you really a NP or a PA?? I'm starting to have doubts about your credibility...

[efy2178]

I have nothing against NPs or DNPs. The one's I have worked with are excellent at their jobs and a huge asset to the team. But let's get one thing straight, the education is not the same. MDs and DOs are perturbed by the fact that the nursing leadership continues to push for equal practice rights despite the gaping difference in education. I personally don't get it.

On boards like this, it often comes off as MDs/DOs or the MD/DO students anti- NPs. That is not the case. Most are pro-NP. However, we are completely against undertrained people overstepping their bounds.

"WE"??? That was telling.

The education does not have to be the same. We are not the same. We are nurses. We care for patients in a different manner. NPs are trained to be primary care providers. Do you think they need 8 years of med school to diagnose an ear infection? A sprained ankle or pneumonia? I certainly don't I could have done this years ago before going to get my masters. NPs are not arguing they are as knowledgable as MDs with regard to medicine. They do think they can adequately provide primary care and research has shown they are as capable as physicians in this regard.

BTW --- DR stands for doctorate. Something physicians stole for themselves decades ago. In any other field, no one would question calling someone DR if they EARNED a doctorate. Yet somehow this is quite threatening to physicians. And while I am at it, there is nothing "mid-level' about an NP who has earned that title. It is another insulting title given to nurses by arrogant physicians.