MDs dont own the physician title

Trauma Columnist · Jul 11, 2013

Hey there ladies and gentlemen: can we get back on track? Thanks much.

A&Ox6, MSN, RN · Jul 11, 2013

Interesting because here in Florida, diagnosing and treatment as a physician is limited to MD, DO, or DC title. DPS, DDS, etc. are limited in their field. I am referring to the whole body. Thanks.[/quote']
First of all, while there are definitely situations in which a chiropractor can help a patient, there are also cases in which it can be very detrimental. For example, I have chiari I malformations, and when I was diagnosed, I was experiencing horrible back/neck/shoulder/head pains. I asked my neurologist for a referral to a chiropracter because I have friends who go for every one of these issues. My doctor told me that because of the lack of actual MEDICAL training that DCs have, it is actually dangerous for a chiari patient to go to one. They have no way of testing ICP, and can actually cause further herniation of the cerebral tonsils as well as complications existing issues.
I was told to rather go to a DPT who has training in such issues.
I do want to point out that a DPM can prescribed medication and do surgery within their specialty just like a OB/GYN can do surgery (c-section) and prescribed meds in his/her field. You would not ask a OB/GYN to treat your essential HTN.
Every HCP has their specialty.
Oh, and a DDS or a DMD can also prescribed meds and do surgery if they've been trained.

PMFB-RN, RN · Jul 12, 2013

Oh, and a DDS or a DMD can also prescribed meds and do surgery if they've been trained.

*** I used to work with an SICU intensivist who was a DDS and oral and maxillofacial surgeon. He was really great but answering patient family's questions all the time got old.

"Yes Sir the doctor who just updated you about your wife's condition is a dentist".

He used to tell us we should be honored to work with him since we would never again know a dentist intensivist.

FP Doc · Jul 12, 2013

When this happens it will be even more confusing than it already is which is not all good. If ARNPs want to maintain their current niche as more caring, compassionate providers who take more time etc. then they should be proud of their different status, and not also try to pretend to be doctors. I am a physician, i.e. MD. There are lots of ARNPs who blog also, but if they assumed the name of physician, it would be a clear attempt to mislead readers. Same goes for care of patients. I would not hesitate to see an ARNP for what I percieved as straight forward care, but would definately see a physician, i.e. MD or DO, if I felt more detailed or difficult diagnostic or therapeutic decision making was needed. Individuals should make their own choices, and we should each be proud of our own credentials, not try to fool patients with confusing titles.

nomadcrna, DNP, CRNA, NP · Jul 12, 2013

Why on earth does a physician feel the need to come to a nursing forum, seriously. You guys have your own forums where you are able to bash NPs. You come to our house and lecture us about how we should not attempt to "fool patients". You accuse us of pretending to be doctors. Really? How arrogant.

You cast a huge blanket. I've seen pretty bad MDs and NPs. I've seen good MDs and NPs. I've found we all have areas we are good in.

Not a single NP here has made any reference to pretending to be a physician. BTW, I am a doctor. I would also bet I have my areas of expertise where I know more or able to do procedures better than you. I'm also sure the reverse is also true. You have areas of expertise as well.

Don't be so insecure.

When this happens it will be even more confusing than it already is which is not all good. If ARNPs want to maintain their current niche as more caring, compassionate providers who take more time etc. then they should be proud of their different status, and not also try to pretend to be doctors., and am a physician, i.e. MD. There are lots of ARNPs who blog also, but if they assumed the name of physician, it would be a clear attempt to mislead readers. Same goes for care of patients. I would not hesitate to see an ARNP for what I percieved as straight forward care, but would definately see a physician, i.e. MD or DO, if I felt more detailed or difficult diagnostic or therapeutic decision making was needed. Individuals should make their own choices, and we should each be proud of our own credentials, not try to fool patients with confusing titles.

allnurses Guide · Jul 12, 2013

I have never heard of nurse using the title of physician to refer to themselves. I am against nurses using the title physician to describe themselves, but to I have no problem with nurses using the title Doctor if they have earned their Doctorate.

Every health care professional should introduce themselves in a way that clearly identifies themselves i.e. Hi, I am Dr. X your Nurse Anesthetist or I am Dr. X your Cardiologist etc.

Patients often see multiple physicians in one day and the patients could not tell you if they were interns, residents, or what speciality the physician was.

Nurses are not the ones that have been confusing patients for decades. It is physicians that often confuse patients. Nurses are the ones left in the room to explain things to the patients after the physician leaves, because the physician did not fully explain themselves or even who they were. When is the last time physician has come into a room and clearly told the patient they were intern or resident, or how many times do physicians come into a room say I am Doctor so and so and never tell the patient what speciality they are.

CrunchRN, ADN, RN · Jul 12, 2013

When this happens it will be even more confusing than it already is which is not all good. If ARNPs want to maintain their current niche as more caring, compassionate providers who take more time etc. then they should be proud of their different status, and not also try to pretend to be doctors. I am a physician, i.e. MD. There are lots of ARNPs who blog also, but if they assumed the name of physician, it would be a clear attempt to mislead readers. Same goes for care of patients. I would not hesitate to see an ARNP for what I percieved as straight forward care, but would definately see a physician, i.e. MD or DO, if I felt more detailed or difficult diagnostic or therapeutic decision making was needed. Individuals should make their own choices, and we should each be proud of our own credentials, not try to fool patients with confusing titles.

I think it is cool to get others opinions also and I really agree. NP's have a special place and I don't see that the "physician" really applies or allows people to know of the benefits they may provide.

And it will muddy the waters even more. I work with great NP's and if they have a PhD they can choose to be addressed as "doctor", but none really do as it is confusing to the patients. We usually just go with "provider".

myelin · Jul 12, 2013

I really don't buy the "it's confusing for patients for a nurse to call themselves doctor" argument. Non-physicians who work closely with physicians and use doctor all the time. Like clinical psychologists, optometrists, podiatrists, etc., and patients are able to handle it. Frankly, I find that everyone should be doing a better job of explaining their role - I often see med students being referred to as doctor and no one correcting it, etc. No one explains to the patient if the person examining them is a student, intern, resident, attending, etc. This is especially true at teaching hospitals. I think as long as everyone says "I'm Dr. so-and-so and I'm your cardiologist/psychologist/psychiatrist/nurse practitioner/whatever" that it should be fine. This is presuming the doctorate the person holds is related to their clinical practice (so a nurse w/a DNP or PhD in nursing is appropriate in referring to themselves as doctor, but not if their PhD is in some unrelated field).

greygooseuria · Jul 19, 2013

I introduce myself as a nurse practitioner to every patient I encounter.

Number of patients that have called me nurse practitioner: 0

Number of patients that have called me doctor: all of them

They know what an NP is and they still call me doctor, even after I explain it to them. *sigh* It doesn't really boost my ego though. I'd rather they just call me by my first name.

secretagent2011 · Jul 21, 2013

I'm currently in NP school getting my DNP but as much as I'm sure I will be proud of my Doctorate at the end of the day I don't want to confuse my patients. My father is a physician and keeps saying you could technically be "Dr." But I say in my area of the country where education is limited about the difference between each type of provider I think my personal preference will be to say "Hi Im Chelsea Im a nurse practitioner." If questions arise there then ill gladly do education, but I myself don't feel comfortable saying Im Dr.soandso. I do think its a personal preference thing. But we are considered mid level providers

nomadcrna, DNP, CRNA, NP · Jul 21, 2013

OMG, get the mid level provider out of your vocabulary. WE ARE NOT CONSIDERED MID LEVEL PROVIDERS. Our PEERS are all practitioners in your specialty to include physicians, NPs and PAs.

If you are in NP school now, you should be aware of our organizations positions on derogatory terms such as mid level provider.

There is nothing confusing about using the term DOCTOR, which you have earned. Many of us use the term every day. It is your choice but NPs should support and further our profession. Take the opportunity to educated your patients.

http://www.ena.org/SiteCollectionDocuments/Position%20Statements/AANPNPConsensusStatement.pdf

http://www.aanp.org/images/documents/publications/useofterms.pdf

The American Association of Nurse Practitioners (AANP) opposes use of terms such as “mid-level provider” and “physician extender” in reference to nurse practitioners (NPs) individually or to an

aggregate inclusive of NPs. NPs are licensed, independent practitioners. AANP encourages employers,

policy-makers, health care professionals and other parties to refer to NPs by their title. When referring

to groups that include NPs, examples of appropriate terms include: independently licensed providers,

primary care providers, health care professionals and clinicians.

Terms such as “mid-level provider” and “physician extender” are inappropriate references to NPs. These

terms originated in bureaucracies and/or medical organizations; they are not interchangeable with

use of the NP title. They call into question the legitimacy of NPs to function as independently licensed

practitioners, according to their established scopes of practice. These terms further confuse the health

care consumers and the general public, as they are vague and are inaccurately used to refer to a wide

range of professions.

The term “mid-level provider” (mid-level provider, mid level provider, MLP) implies that the care

rendered by NPs is “less than” some other (unstated) higher standard. In fact, the standard of care for

patients treated by an NP is the same as that provided by a physician or other health care provider in

the same type of setting. NPs are independently licensed practitioners who provide high-quality and

cost-effective care equivalent to that of physicians.

1,2

The role was not developed and has not been

demonstrated to provide only “mid-level” care.

The term “physician extender” (physician-extender) originated in medicine and implies that the NP role

evolved to serve as an extension of physicians’ care. Instead, the NP role evolved in the mid-1960’s in

response to the recognition that nurses with advanced education and training were fully capable of

providing primary care and significantly enhancing access to high-quality and cost-effective health

care. While primary care remains the main focus of NP practice, the role has evolved over almost 45

years to include specialty and acute-care NP functions. NPs are independently licensed, and their scope

of practice is not designed to be dependent on or an extension of care rendered by a physician.

In addition to the terms cited above, other terms that should be avoided in reference to NPs include

“limited license providers,” “non-physician providers,” and “allied health providers.” These terms are

all vague and are not descriptive of NPs. The term “limited license provider” lacks meaning, in that all

independently licensed providers practice within the scope of practice defined by their regulatory

bodies. “Non-physician provider” is a term that lacks any specificity by aggregately including all health

care providers who are not licensed as an MD or DO; this term could refer to nursing assistants, physical

therapy aides, and any member of the health care team other than a physician. The term “allied health

provider” refers to a category that excludes both medicine and nursing and, therefore, is not relevant to

the NP role.

secretagent2011 · Jul 21, 2013

OMG, get the mid level provider out of your vocabulary. WE ARE NOT CONSIDERED MID LEVEL PROVIDERS. Our PEERS are all practitioners in your specialty to include physicians, NPs and PAs.
If you are in NP school now, you should be aware of our organizations positions on derogatory terms such as mid level provider.
There is nothing confusing about using the term DOCTOR, which you have earned. Many of us use the term every day. It is your choice but NPs should support and further our profession. Take the opportunity to educated your patients.
http://www.ena.org/SiteCollectionDocuments/Position%20Statements/AANPNPConsensusStatement.pdf
http://www.aanp.org/images/documents/publications/useofterms.pdf
The American Association of Nurse Practitioners (AANP) opposes use of terms such as “mid-level provider” and “physician extender” in reference to nurse practitioners (NPs) individually or to an
aggregate inclusive of NPs. NPs are licensed, independent practitioners. AANP encourages employers,
policy-makers, health care professionals and other parties to refer to NPs by their title. When referring
to groups that include NPs, examples of appropriate terms include: independently licensed providers,
primary care providers, health care professionals and clinicians.
Terms such as “mid-level provider” and “physician extender” are inappropriate references to NPs. These
terms originated in bureaucracies and/or medical organizations; they are not interchangeable with
use of the NP title. They call into question the legitimacy of NPs to function as independently licensed
practitioners, according to their established scopes of practice. These terms further confuse the health
care consumers and the general public, as they are vague and are inaccurately used to refer to a wide
range of professions.
The term “mid-level provider” (mid-level provider, mid level provider, MLP) implies that the care
rendered by NPs is “less than” some other (unstated) higher standard. In fact, the standard of care for
patients treated by an NP is the same as that provided by a physician or other health care provider in
the same type of setting. NPs are independently licensed practitioners who provide high-quality and
cost-effective care equivalent to that of physicians.
1,2
The role was not developed and has not been
demonstrated to provide only “mid-level” care.
The term “physician extender” (physician-extender) originated in medicine and implies that the NP role
evolved to serve as an extension of physicians’ care. Instead, the NP role evolved in the mid-1960’s in
response to the recognition that nurses with advanced education and training were fully capable of
providing primary care and significantly enhancing access to high-quality and cost-effective health
care. While primary care remains the main focus of NP practice, the role has evolved over almost 45
years to include specialty and acute-care NP functions. NPs are independently licensed, and their scope
of practice is not designed to be dependent on or an extension of care rendered by a physician.
In addition to the terms cited above, other terms that should be avoided in reference to NPs include
“limited license providers,” “non-physician providers,” and “allied health providers.” These terms are
all vague and are not descriptive of NPs. The term “limited license provider” lacks meaning, in that all
independently licensed providers practice within the scope of practice defined by their regulatory
bodies. “Non-physician provider” is a term that lacks any specificity by aggregately including all health
care providers who are not licensed as an MD or DO; this term could refer to nursing assistants, physical
therapy aides, and any member of the health care team other than a physician. The term “allied health
provider” refers to a category that excludes both medicine and nursing and, therefore, is not relevant to
the NP role.

Thanks for that info! I only used that term bc my current employer and all my clinicals have used it. I didn't realize it was derogatory. Very glad to know what the AANP stance is on it though.