discussion regarding education of NP (DNP) and PA compared to MD/DO

enoRN · Mar 15, 2009

I still dont understang why a nurse with a DNP cant be referred to as a DOCTOR, maybe everyother person too should not be referred to as doctors, maybe the title-DNP should be changed to something else. Why cant we just educate the public that there are other people too who went to "school" and can take care of them in some aspects and so deserve to bear the title they worked hard for if it so pleases them. The public have been learning a lot of other things, they can also learn how to call a nurse a doctor. :banghead:

Again, reread. . The MD and DNP degree are both clinical based doctorates.
So does that mean they are not worthy of using the title doctor, or is the title of doctor only reserved for physicians, or perhaps those who physicians indicate they may use the title doctor, such as dentists and podiatrists?
Good work on comparing apples to Buicks. It's not about what is better, what is harder, what is easier or what is more difficult. The basis of your argument against the utility of the title by DNP's, does nothing more than underscore the medical establishments rhetoric for increasing barriers for nurses and their professional development. Fortunately, the rhetoric is falling on deaf ears which is why the terminal degree for NP's for 2015 is the clinical doctorate.
With the DNP being the new terminal degree, you will soon discover that NP's will no longer be referred to as midlevel care providers. Not so much because they are no longer in between a basic nurse and a physician, which they never were in the first place, but because like the physician and unlike the PA, they have a clinical-based doctor in their own discipline and own profession.
Also, if you would prefer not to refer to DNP's as doctors in the clinical setting, I'd suggest booking tickets to hell now, while gas is still cheap. Your lack of respect for earned credentials by advanced practice nurses, however is appreciated.

wowza · Mar 15, 2009

I still dont understang why a nurse with a DNP cant be referred to as a DOCTOR, maybe everyother person too should not be referred to as doctors, maybe the title-DNP should be changed to something else. Why cant we just educate the public that there are other people too who went to "school" and can take care of them in some aspects and so deserve to bear the title they worked hard for if it so pleases them. The public have been learning a lot of other things, they can also learn how to call a nurse a doctor.

Putting egos aside, why should a DNP be called a doctor in a clinical setting? Do not have the same education as a physican. Do they have the same post-graduate training as a physician? No. They even don't have a completely different niche than a physician as say speech therapists or pharmacists do. Outside of feelings of entitlement, what rationale is there?

The title doctor assumes an equivalence where there really is not. Frankly you cannot even make a good argument why the DNP degree should not just be a masters. Just because it lasts 3 years does not mean it should be a doctorate. There are plenty of 3 year masters programs out there. This case should be no different.

Again, if the trainings become the same, as do the requirements for licensure, then I will feel DNPs are equivalent and therefore can definitely use the term doctor. Until then this push is only motivated by base ambition.

greygooseuria · Mar 15, 2009

Why should a PHYSICIAN be called a doctor? Physicians in Europe and most other countries aren't even CALLED doctor, they are called PHYSICIANS. Only people with a PhD get the title of "doctor". The medical establishment usurped this title, and they have no rightful claim to it. Sorry, but your argument doesn't hold water and even though you set your ego aside, it's very clear you didn't.

A doctor, plain and simple, is someone with a doctorate degree. If someone has a doctorate degree, regardless of discipline, they deserve the title of 'doctor'. I don't even call MDs and DOs doctors in the clinical setting; I refer to them by their name or say 'your physician'.

And when I get my DNP, I am going to be referred to as doctor. I don't care if it hurts some MD's ego.

wowza · Mar 15, 2009

Why should a PHYSICIAN be called a doctor? Physicians in Europe and most other countries aren't even CALLED doctor, they are called PHYSICIANS. Only people with a PhD get the title of "doctor". The medical establishment usurped this title, and they have no rightful claim to it. Sorry, but your argument doesn't hold water and even though you set your ego aside, it's very clear you didn't.
A doctor, plain and simple, is someone with a doctorate degree. If someone has a doctorate degree, regardless of discipline, they deserve the title of 'doctor'. I don't even call MDs and DOs doctors in the clinical setting; I refer to them by their name or say 'your physician'.
And when I get my DNP, I am going to be referred to as doctor. I don't care if it hurts some MD's ego.

In the US (and all other english speaking countries including the UK, australia, south aftrica, new zeland), it is custom to call physicians "doctors" clincally because the degree is the highest level attainable in the medical field. In the US, Physician and Doctor are synonymous. People more associate the term doctor with a physician in this country than a PhD. If you introduced yourself as Dr JBeau they would not think you got a PhD in whatever, they would think you were a physician. Because patients associate the word doctor with physician, only those who are physicians should use the term clinically. Call yourself doctor when you are everywhere else.

You did not answer my questions though:

If in a clinical setting, doctor means physician, why should a DNP call him or herself doctor when their training is not the same a physician? Outside of a feeling of entitlement, what rationale is there? (again outside of the hospital, couldnt care less)

Why should a 3 year degree, that is so similar to the previous masters defree even be called a doctorate?

greygooseuria · Mar 15, 2009

In the US (and all other english speaking countries including the UK, australia, south aftrica, new zeland), it is custom to call physicians "doctors" clincally because the degree is the highest level attainable in the medical field. In the US, Physician and Doctor are synonymous. People more associate the term doctor with a physician in this country than a PhD. If you introduced yourself as Dr JBeau they would not think you got a PhD in whatever, they would think you were a physician. Because patients associate the word doctor with physician, only those who are physicians should use the term clinically. Call yourself doctor when you are everywhere else.
You did not answer my questions though:
If in a clinical setting, doctor means physician, why should a DNP call him or herself doctor when their training is not the same a physician? Outside of a feeling of entitlement, what rationale is there? (again outside of the hospital, couldnt care less)
Why should a 3 year degree, that is so similar to the previous masters defree even be called a doctorate?

My point is that just because something is used colloquially now doesn't mean it HAS to stay. My point is that doctor DOES NOT and SHOULD NOT equal physician in a clinical setting. The rationale being that there are MANY DOCTORATES OUT THERE. WHAT is the problem with a physician walking into a room and stating, "Hi, I'm Dr. Wowza and I'm your physician" and an NP going in and saying "Hi, I'm Dr. JBeau and I'm your NP". The problem? There is none! It is ALL about ego on the medical establishment's part.

And per my friend from the UK, MDs are called physicians there, PhDs get the title of Doctor.

And also, your argument is ridiculous. Should we still be allowed to use the n-word, ******, etc. to describe minorities? I mean, it was correct and alright to do it at one point, so it must still be, right? Meanings of words change over time. Physicians, in the long run, will not win this battle.

wowza · Mar 15, 2009

WHAT is the problem with a physician walking into a room and stating, "Hi, I'm Dr. Wowza and I'm your physician" and an NP going in and saying "Hi, I'm Dr. JBeau and I'm your NP". The problem? There is none! It is ALL about ego on the medical establishment's part.
And per my friend from the UK, MDs are called physicians there, PhDs get the title of Doctor.
And also, your argument is ridiculous. Should we still be allowed to use the n-word, ******, etc. to describe minorities? I mean, it was correct and alright to do it at one point, so it must still be, right? Meanings of words change over time. Physicians, in the long run, will not win this battle.

No, something colloquial does not have to stay the same but what is the rational to change it outside of ego. If you want to change the status quo, you need a logical reason. You still have not answered my question.

The problem is that most people have no idea what an NP is. There is a distinction in education between NP and physician that would be blurred by everyone calling themselves doctor.

You did not answer my questions still:

If in a clinical setting, why should a DNP call him or herself doctor when their training is not the same a physician? Outside of a feeling of entitlement, what rationale is there?

Why should a 3 year degree, that is so similar to the previous masters degree even be called a doctorate?

greygooseuria · Mar 15, 2009

No, something colloquial does not have to stay the same but what is the rational to change it outside of ego. If you want to change the status quo, you need a logical reason. You still have not answered my question.
The problem is that most people have no idea what an NP is. There is a distinction in education between NP and physician that would be blurred by everyone calling themselves doctor.
You did not answer my questions still:
If in a clinical setting, why should a DNP call him or herself doctor when their training is not the same a physician? Outside of a feeling of entitlement, what rationale is there?
Why should a 3 year degree, that is so similar to the previous masters degree even be called a doctorate?

I really hope you are not an MD, because you lack basic reasoning and reading skills.

I answered your questions. They should have the privilege of calling themselves a doctor of a discipline because they earned a doctorate, just as every PhD, MD etc. has. NPs are not going to go around parading themselves as MDs; just because they say "I'm Dr. So and So" doesn't mean they won't make it explicit that they are an NP.

You say we shouldn't change it because of ego; the reverse is also true: why should we KEEP it due to ego?

Your argument that most people don't know what an NP is is absurd; many people DO know what an NP is, and if not, when they are at their PCPs office and seeing one, it can be explained. Just because people don't understand something is no reason to stop change; most people don't understand why gay people want equal treatment. By your definition, that means that they shouldn't have equal protection.

Most people don't know what an MSW is either; does that mean they shouldn't be allowed to do therapy?

Dr. Tammy, FNP/GNP-C · Mar 15, 2009

Perhaps I should clarify my point:
Nursing students have finished a bachelors degree. Medical students have also finished a bachelors degree but were selected to enter medical school out of the group of college educated people based on high grades (average of 3.6 nationally), scores and recommendations.
My comments would also fit for the average college student- non-medically related. Since medical students have been selected out of that pool of college students, it fits that they on average would be brighter than the average college student. Not everything said is meant to be a personal attack.

Very interesting clarification. So, if I understand your theory here, medical students are much brighter than other college students, which is why they are in medical school? So its not just nursing students and nurses who arn't so bright, its all college students who are not medical students. Is that right?

It kind of reminds me of when John Kerry said if you are smart enough to get good grades, you go to college and if you don't, you go to Iraq.

I suppose with this misinformed characterization and uninformed generalization your path must have been nursing or general college studies. Too bad. Better luck in the next lifetime.

Dr. Tammy, FNP/GNP-C · Mar 15, 2009

Putting egos aside, why should a DNP be called a doctor in a clinical setting?

Uh, because they have a clinical doctorate degree. Thanks for keeping the questions simple for us nurses otherwise, we would have trouble following along.

Do not have the same education as a physican. Do they have the same post-graduate training as a physician? No. They even don't have a completely different niche than a physician as say speech therapists or pharmacists do. Outside of feelings of entitlement, what rationale is there?

Either do dentists, optometrists or clinical psychologists, but they all are referred to as doctors.

The title doctor assumes an equivalence where there really is not.

Equivalence to what? To physician? Cite your authority.

Frankly you cannot even make a good argument why the DNP degree should not just be a masters. Just because it lasts 3 years does not mean it should be a doctorate. There are plenty of 3 year masters programs out there. This case should be no different.

Cite your authority of why medical school should be 4 years and not the former 2 year apprentice program.

Again, if the trainings become the same, as do the requirements for licensure, then I will feel DNPs are equivalent and therefore can definitely use the term doctor. Until then this push is only motivated by base ambition.

It is not nursing's duty to become accountable to you or explain why we, as a profession chose to advance ourselves--even in contravention to your and your professions economic interests. And yes, we as a profession are ambitious. In just under 40 years of advance practice nursing history, APN's have prescriptive privileges in all 50 states and operate independent of the much brighter and smarter medical student and physician in 23 states.

JDCitizen · Mar 15, 2009

Basic points?

- How does one introduce themselves and explain their position in providing care?

- How does the patient perceive/understand that introduction as well as knowing who is going to do what and who is going to be in charge? The patient probably wants to know who the captain of the ship is.

We agree?

I am your Nurse does not suffice.

I am your Doctor does not suffice..

I am your Nurse Practitioner does not suffice...

Maybe before we start worrying about titles we need to know how the lay people see us:

So if Merriam-Webster is correct we as NPs are "qualified through advanced training to assume some of the duties and responsibilities formerly assumed only by a physician"...

Merriam-Webster

Doctor

Main Entry:

1doc-tor

Pronunciation:

\däk-tər\

Function:

noun

Etymology:

Middle English doctour teacher, doctor, from Anglo-French & Medieval Latin; Anglo-French, from Medieval Latin doctor, from Latin, teacher, from docēre to teach-more at docile

Date:

14th century

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 man

3 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

Nurse

1nurse

Pronunciation:

\nərs\

Function:

noun

Etymology:

Middle English norice, norce, nurse, from Anglo-French nurice, from Late Latin nutricia, from Latin, feminine of nutricius nourishing-more at nutritious

Date:

13th century

1 a: a woman who suckles an infant not her own : wet nurse b: a woman who takes care of a young child : dry nurse

2: one that looks after, fosters, or advises

3: a person who cares for the sick or infirm ; specifically : a licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health-compare licensed practical nurse , registered nurse

4 a: a worker form of a social insect (as an ant or a bee) that cares for the young b: a female mammal used to suckle the young of another

Nurse Practitioner

Main Entry:

nurse-prac-ti-tion-er

Pronunciation:

\-prak-ˈti-sh(ə-)nər\

Function:

noun

Date:

1969

: a registered nurse who is qualified through advanced training to assume some of the duties and responsibilities formerly assumed only by a physician

Physician Assistant

Main Entry:

physician assistant

Function:

noun

Date:

1970

: a person certified to provide basic medical services usually under the supervision of a licensed physician --called also PA physician's assistant

Dr. Tammy, FNP/GNP-C · Mar 15, 2009

In the US, Physician and Doctor are synonymous.

I'm sure dentists, optometrists, orthodontists, psychologists would completely agree with you.

You did not answer my questions though:
If in a clinical setting, doctor means physician, why should a DNP call him or herself doctor when their training is not the same a physician? Outside of a feeling of entitlement, what rationale is there? (again outside of the hospital, couldnt care less)

I'll answer it -- because there is no documentation or support of the medical establishments ownership of the title "doctor". There is however, support to note how physicians have attempted to hijack the term doctor from the academic community.

Dr. Tammy, FNP/GNP-C · Mar 15, 2009

The problem is that most people have no idea what an NP is.?

Are you for real? I cant remember in the last 20 years or so anyone who was not familar with what an NP is or what they do.