Power Struggle or Patient-Centered? New Georgia Law Prohibits APRNs and Other Doctorate-Prepared Healthcare Providers from Calling Themselves Doctor

On May 2, 2023, Georgia Governor Brian Kemp signed into law a bill part of a larger act called the Health Care Practitioners Truth and Transparency Act. This bill, SB197, though notably missing from the 5/2/2023 press release highlighting recently signed legislation designed to improve access to healthcare in Georgia, has added fuel to an ongoing debate in the healthcare community as it prohibits non-physicians from using specialty titles. The bill summary reads as follows: “…relating to general provisions relative to professions and businesses, so as to prohibit deceptive or misleading terms or false representations by health care practitioners in advertisements and representations; to prohibit the misappropriation of medical or medical specialty titles by health care practitioners in advertisements and representations; to provide for definitions; to provide for related matters; to provide for a short title; to repeal conflicting laws; and for other purposes.” The actual bill can be read here.

Related: Georgia law prohibits DNPs from using the term "doctor"

Effective July 1, 2023, advanced practice registered nurses (APRNs) and physician assistants (PAs) who possess doctoral degrees can no longer introduce themselves as "doctor.” During patient encounters, APRNs and PAs must also advise patients that they are not medical doctors or physicians. Violations of this law place the offending APRN or PA in jeopardy of legal action or other injunctions to be taken by their respective professional licensing boards.

While transparency in healthcare should be at the forefront of patient-centered care, and patients should be educated on the differences in providers' scopes of practice, it's important to do so in a way that does not diminish the valuable contributions of other professions. Coincidentally, there are many similarities to be recognized between Nurse Practitioners (NP), Physician Assistants (PA), and Medical Doctors (MD). To name a few, all are trained to diagnose and treat illness, and all can prescribe similarly. They each bring a unique skill set to the interdisciplinary care team, however. NPs, for example, have full practice authority in some states, which means they can practice completely independently without physician oversight. PAs cannot but do have more formal medical education in their coursework than NPs. NPs can also be first assists in surgeries like PAs and tend to specialize, while PAs tend to work with a larger general population. Typically, even though their duties intersect, NPs, PAs, and MDs do distinctly identify themselves and their credentials with identifying badges. Many doctorate-prepared NPs also introduce themselves to patients as such—saying something like, "Hi, I'm Dr. X, the Nurse Practitioner.” Though healthcare providers strive to provide clear patient education, there is some degree of accountability that should be shifted onto the patient in understanding the members of their healthcare teams.

In a time when there is a critical shortage of all healthcare providers and workers, unity amongst the profession is vital. This law, whilst pitched as a patient advocacy law protecting patients, has inadvertently worsened the already deep divide between healthcare providers. Other states are taking note of this new Georgia law and may be enacting their own similar legislation.

Curiously enough, Georgia is one of only 11 states in the United States in which NPs have restricted practice authority. Will a law like SB197 combined with already restrictive practice authority cause APRNs to no longer pursue the DNP or stop practicing in Georgia altogether? In the United States, Doctor of Nursing Practice (DNP) program enrollment is on the rise nationwide, as it was decided by the American Association of Colleges of Nursing (AACN) back in 2004 to change the requirements of APRN practice from the master's degree to the doctorate level. And in a time where many professions, especially APRNs, are pursuing terminal degrees, should "doctor" be redefined? Only time will tell.

References/Resources

Gov. Kemp Signs Legislation Strengthening Healthcare Access, Supporting Healthcare Heroes, and Expanding Assistance to Expectant Mothers

Georgia blocks nonphysicians from using specialty titles

The linguistic controversies of clinical titles

Senate Bill 197 By: Senators Hufstetler of the 52nd, Watson of the 1st, Butler of the 55th, Kirkpatrick of the 32nd, Kennedy of the 18th and others; SB 197 "Health Care Practitioners Truth and Transparency Act"; enact

AACN Fact Sheet - DNP

23 SB 197/AP S. B. 197 - 1 - Senate Bill 197 By: Senators Hufstetler of the 52nd, Watson of the 1st, Butler of the 55th, Kirkpatrick of the 32nd, Kennedy of the 18th and others

Use of Terms Such as Mid-level Provider and Physician Extender

State Practice Environment: AANP

A Public Health Crisis: Staffing Shortages in Health Care: Master of Public Health (MPH) Online: The University of Southern California