NPs practicing as DRs

Specialties NP

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  1. Is the current DNP a "Clinical Doctorate"

    • 53
      Yes
    • 72
      No

99 members have participated

This has been a heated discussion between some of my friends and I, so I thought I would bring it to the forum.

Should people who are going through a DNP programs and taking the SAME test we all took for our MSN - NP for national certification think their education 'doctorate" is a clinical doctorate?

Until there is a national standard and an elevation of the test (think along the USMLE) then I think anyone who thinks their DNP is a clinical doctorate is a joke.

your thoughts. . . . .?

I do know that I will be getting a degree as an advanced practitioner. I know I eventually want to get my PhD and teach other nurses, but I don't think I'll get my "DNP." If I did, due to very serious confusion and liability issues, I would never refer to myself as doctor in a clinical setting with a patient. However, if I went through enough school to obtain a doctorate, I would surely be calling myself a doctor outside of the clinical setting. Around here (somewhere in the Pacific Northwest), if you've got a dotorate, people call you doctor; it doesn't matter whether you have a doctorate in biology, medicine, or something stupid, you are called doctor.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
@Esme12 - though i just graduated 14 months ago, I do see going the full MD route, unless a shorter bridge program is out there using my NP experience.

There are no accelerated NP/MD programs. Good Luck on your schooling!

Some schools still refer to their DNP program as a "clinical doctorate". The trend was started by Columbia which was a pioneer in this movement. Their DNP curriculum is clinically focused and is only open to nurses in APN roles. Faculty (Mundinger et al) from this school are founding members of the American Board of Comprehensive Care, a national certification board that offers the DCC exam. This board that administers the DCC certification was met with much controversy when they announced that their certification exam is patterned after USMLE Step 3. They no longer state that claim in their current website. The test is only open to all NP's who have a DNP degree. Despite being introduced around 2007, DCC certification is not widely accepted in all nursing camps and has raised eyebrows in the medical community.

I wanted to point this out as well. Columbia had originally conceived of the DNP as being very specifically a *clinical* doctorate, not a more general practice doctorate focusing on nursing management, for example. The purpose of creating the Diplomate of Comprehensive Care exam has been to allow those who have completed a clinically-focused DNP to indicate as much by passing the exam.

(As a side note: the exam has only been offered for three years, I believe, and not many people have taken it - of those that have, I believe there has been about a 50% pass rate. I think part of the reason for this is that it *is* similar in nature to the USMLE Step 3, which MDs would normally take after their first year of residency. Most of the people taking the DCC have been practicing as NPs for many years - how many MDs who have been practicing for years as psychiatrists or neurosurgeons do you think could pass the USMLE Step 3 if they had to take it today? Not many, I'd bet. Anyway...)

You can read more about the exam here: Columbia University School of Nursing-Led American Board of Comprehensive Care Receives National Accreditation | Columbia University Medical Center Newsroom.

Specializes in Occ. Hlth, Education, ICU, Med-Surg.

Anyone that has earned a doctorate in a given specialty has the title of "Doctor" conferred upon them...this has been the norm for hundreds of years. Those that receive a medical doctorate are more properly referred to as "Physician". The title of "Doctor" was adopted by the medical community for ease of use among patrons in the early 19th century or thereabouts .

MDs don't have a "clinical" "doctorate". So.... don't understand your poll.

I don't get the controversy. If a person has earned a doctorate, then they are referred to as "doctor" within their field. I don't get why it is confusing for patients if the person introduces themselves correctly. For example: "Hi I'm Dr. Smith, your surgeon. Hi I'm Dr. Smith, your psychologist. Hi, I'm Dr. Smith, your nurse practitioner." As long as the person clarifies their role and their training background, I see no problem whatsoever with someone referring to themselves as doctor when they have earned a doctorate.

Do we think that pharmacists, physical therapists, psychologists, dentists, optometrists, (etc.) are all afraid to refer to themselves as doctor? I've not seen this at all. Why is it suddenly so controversial when it happens in nursing?

Specifically in reference to the DNP, I hesitate to earn one. At this point it doesn't seem like the degree is standardized and what kind of advantages regarding employment, salary, etc. it may confer appear to be up in the air. I think I'll sit and wait it out. If, 5 or 10 years down the line, it appears that this degree is necessary or may provide me more opportunities, then I might go back to school and earn it then. I guess what I'm saying is I don't want to be the guinea pig, hehe. Right now I'm just pleased to be in the position to earn an MSN.

I don't get the controversy. If a person has earned a doctorate, then they are referred to as "doctor" within their field. I don't get why it is confusing for patients if the person introduces themselves correctly. For example: "Hi I'm Dr. Smith, your surgeon. Hi I'm Dr. Smith, your psychologist. Hi, I'm Dr. Smith, your nurse practitioner." As long as the person clarifies their role and their training background, I see no problem whatsoever with someone referring to themselves as doctor when they have earned a doctorate.

Do we think that pharmacists, physical therapists, psychologists, dentists, optometrists, (etc.) are all afraid to refer to themselves as doctor? I've not seen this at all. Why is it suddenly so controversial when it happens in nursing?

Specifically in reference to the DNP, I hesitate to earn one. At this point it doesn't seem like the degree is standardized and what kind of advantages regarding employment, salary, etc. it may confer appear to be up in the air. I think I'll sit and wait it out. If, 5 or 10 years down the line, it appears that this degree is necessary or may provide me more opportunities, then I might go back to school and earn it then. I guess what I'm saying is I don't want to be the guinea pig, hehe. Right now I'm just pleased to be in the position to earn an MSN.

I think it's mostly because of the often acrimonious relationship between physicians as a profession and nurses as a profession. Basically, a lot of physicians want to have the market cornered on the title "doctor" in healthcare because of how hard they had to work in medical school and residency. Many nurses are justifiably proud of providing care that is totally unlike that of physicians, so not every nurse even wants to go by the title "doctor". The field of nursing has changed so much in the past couple of decades that it is pretty galling to a lot of physicians that nurses could go by the title doctor - and members of the public are also unaware of the changes that nursing has undergone and how expert nurse practitioners are now (thanks, Grey's Anatomy et al...).

And then there's the whole crowd crying "patient confusion!!@@$!" - which personally I don't think is a very big deal, and is mostly used as a smoke screen for the real issue of who gets to be known by the worshipful title of "doctor". Like you said - your name tag would read Dr. Myelin, MD; or Dr. Myelin, DNP; or Dr. Myelin, DDM...and I don't see what's so confusing about that.

Specializes in Critical Care.

i like the idea of the DCC, but the only way all DNP educated NP's would be able to take it is if all DNP programs included a beefed up FNP curriculum with a lot of clinical hours, then finished up the degree with specialty courses and rotations, then you would take the DCC and your specialty certification test. I think it would be very good for NP's if such a test that was taken across the board to show some consistency. That way, every NP would have a solid foundation, then could specialize if they wish.

(It would be nice if all NP's would take this, then EVERYONE can have just NP-C after their name. Specialties could be extra certifications, maybe they can leave them off, MD's dont have MDFPP, MDPSY, MDINT, MDNEUR, etc just NP-C. stupid alphabet soup...)

i like the idea of the DCC, but the only way all DNP educated NP's would be able to take it is if all DNP programs included a beefed up FNP curriculum with a lot of clinical hours, then finished up the degree with specialty courses and rotations, then you would take the DCC and your specialty certification test. I think it would be very good for NP's if such a test that was taken across the board to show some consistency. That way, every NP would have a solid foundation, then could specialize if they wish.

(It would be nice if all NP's would take this, then EVERYONE can have just NP-C after their name. Specialties could be extra certifications, maybe they can leave them off, MD's dont have MDFPP, MDPSY, MDINT, MDNEUR, etc just NP-C. stupid alphabet soup...)

True - and if advanced practice nursing moves fully in the DNP direction, you would likely have many more people completing the DNP early in their careers such that the foundations in all areas of care would be fresher in their minds. I do think the key question is whether or not nurses specialize too early in their educations, such that it would effectively disqualify many from taking the exam (although I do know of an ANP who took and passed the exam simply by doing a heavy review of pediatrics beforehand).

Specializes in Anesthesia, Pain, Emergency Medicine.

I introduce myself as DR. ****, a nurse practitioner. THere is absolutely nothing wrong with it and many times it opens the door to public education about INDEPENDENT nurse practitioners. My medical care is the same as PHYSICIANS and my care is judged against my peers (physicians and NPs).

Stand up for your profession,

Nothing wrong with people with their doctorate to practice as "Doctors." They just can't practice as PHYSICIANS.

Specializes in Neuro ICU/Trauma/Emergency.

Anyone who has accomplished the prolonged education process for obtaining their Doctorates should be referred to as Dr. There is a difference between an MD & a DNP, and I think that distinction should be made clear prior to seeing patients. But, if you have placed in the hard work and effort to accomplish a Doctorates degree in nursing, you are in fact a PhD Doctor!

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