Wednesday, August 10, 2011

MD vs. Dr.

Has the term Doctor become too generic? Having worked in several health care facilities, I have noticed more doctors are identifying themselves as MD’s on their documentation and even how they are identified by the hospital or clinic.

Here is what I’m thinking. When I was a kid and went to the doctor, it meant sticking my tongue out and saying "Ahh". Followed by some booster shot or needle for whatever was going around. I did not think of the doctor as anything other than medical in nature. Now every time you turn on the news or some talk show there is a doctor of something.

True that anyone with a PhD can call himself or herself a doctor, and I do not take anything away from that accomplishment, because they worked damn hard to get it. However, I don’t associate the PhD doctors of botany, astrophysics, zoology and business with the term doctor I grew up with and recognize.

Yes, maybe Dr. Seuss confused me as a little kid, and I still don't know who he is, but it seems different in how the word doctor is used today. Besides those with a PhD being able to call themselves doctor, in 5 minutes I could think of Dr. Dre, Dr. Oz, Dr. Drew, Dr. Laura, Dr. Phil, Dr. Scholl’s, Dr. Pepper, Dr. Dolittle and the Rug Doctor. Isn’t Dr. Oz the only real medical doctor in this bunch?

Along with that Nurse Practitioners will have to have a PhD starting in 2015. I think I will be happy to just be an NP, even if I get a PhD.


Doctor Blondie said...

Over here there's a difference between 'doctor' and 'dokter', the latter being only a physician. Being 'only' an MD, I'm 'only' a 'dokter'.

And you forgot Doctor Who.

NP Odyssey said...

Dokter Blondie, I like that difference, but I also like the Netherlands health care system better too.

Amber said...

How about Dr Feelgood??

I agree with you. It's really confusing for patients, too. When I'm done with school, I will be a Doctor technically, but will be happy to have my patients call me Amber...the NP :)

NP Odyssey said...

Amber, Dr. Feelgood? I like the Motley Crue reference?

MamaDoodle said...

I have given this a great deal of thought because it is a personal pet peeve of mine that only phycians should be referred to as "Doctor."

"Doctor" is a recognition of educational achievement, not profession. I agree that it is confusing when nurses are "Doctors" and when I have completed my DNP, I will not refer to myself as "Doctor" in a clinical setting. However, I also don't refer to physicians as "Doctors." It's such a confusing term that I'd like to see it completely phased out except as a title relating to educational achievement. (Things would be so different in MamaDoodle World!)

Perhaps because I have worked in academics in the past the word "Doctor" doesn't immediately make me think "Physician." Nor should it. It feels to me like the exclusive use of the term to represent physicians adds to the physician worship that is so present in our culture. I agree that someone with the level of expertise required to become a physician has earned the title of "doctor." However, limiting the term to physicians ignores the accomplishments of others who have also reached this level of expertise in their chosen fields and should be accorded the respect that comes with the term.

Stepping down from my soap box now. (As an aside, I HATE when nurses represent themselves as physicians by calling themselves "doctor." I'm noticing a trend among some DNPs to bury the fact that they are nurses deep in the depths of their websites, instead only referring to themselves as "a doctor who provides primary care," etc. As far as I'm concerned, there should be primary care physicians and primary care NPs, no primary care "doctors.")

NP Odyssey said...

MamaDoodle, some good points. I like the primary care differences. I hope that there are no DNP's in the hospital passing themselves off as doctors (physicians) of medicine.
I agree anyone with a PhD is a skilled individual in whatever they do.
We know the difference, but working in a free clinic with many people who are not fluent in English or who health literate, they think a doctor is a medical doctor.

Danielle said...

Agree on all points, great post.

I am all for anyone with a doctorate degree being called doctor...but not in a clinical setting where patient understanding is at stake.

Patients should be wholly aware of who they are interacting with, which is precisely why I always correct attendings/residents who refer to me as "doctor" in front of a patient, tell patients to call me by my first name as I am not a physician and make sure it is obvious when I'm speaking with someone that I'm not representing myself as a medical doctor.

I personally find that the best NPs are the ones who are proud of their role as an NP. There is a special job to be served by this cohort of people and those who try to bury the fact that they worked hard to get an upper level degree in nursing by pretending it's in something else are not the representatives of their profession.

If they want to recognize that they have a PhD by calling themselves doctor outside of the clinical setting, fine - but when it comes to patient care they should absolutely not be referring to themselves as doctor.

Like you said - this is especially critical when non-English speaking patient's are being served, as there may not be a clear way to translate these differences.

Good for you for taking on this subject. Well stated.

NP Odyssey said...

Danielle, Then what do you think about DO's

Besides health care access, health literacy is a huge missing piece of the system now.

Anonymous said...

In the (very large) hospital where I worked as an ER tech we had a nurse in Peds who finished her online Ph.D in Nursing Science. She began to refer to herself as "Dr." on patient whiteboards and charts and pt notes, stuff I could see.

She was told (by HR) not to do this anymore and she puffed up and told the charge nurse to tell HR to stuff it, that she had earned the title.

She was gone, fired, within 20 minutes, Security came for her stuff. A rather nasty email from HR followed within the hour. Our HR rep told me that her boss was told never to hire another advanced degreed nurse or NP. They've stuck to it so far.

So go ahead. I suppose you're entitled to your opinion on the matter, but whether or not you like it or agree, in a clinical setting "Doctor" is a job title, and you are not one.

Do you refer to a lawyer as "Doctor"? Why not?

Anonymous said...

Being in academia, I tend to assume every 'Dr. ...' I see is a PhD, rather than a medical doctor. But oddly I pronounce them differently in my head. A person with a PhD is 'Dr. X' . Just another couple of letters to tack onto their name, along with whatever BSc, MA, DPhil, etc they have there. It's a mark of academic achievement, not a profession.

Now a medical doctor, that's 'Doctor X'. Doc. Medical profession. I guess my point is, I don't think 'Doctor' is generic. To me an MD or a PhD holder might have a title that's officially spelt the same, but the context is totally different.