‘Doctor’ is a title and a credential

As a physician, I feel compelled to reply to a couple of the comments made by Carol Brewer in a News interview regarding the state of nursing.

She said: “ ‘Doctor’ is a role title, not a credential. Nurse practitioners are entitled to call themselves ‘doctor’ just as is a pharmacist, physical therapist or dentist when the title fits their educational credential.”

Doctor is a title and a credential, and every hospital credentialing committee would attest to this. Moreover, it is earned after significantly more training and education than a nursing doctorate. Physicians must spend a minimum of four years after a bachelor’s degree obtaining their M.D. Realistically, no doctor would be able to practice medicine without at least an internship (one additional year after medical school) and, in most cases, two to seven additional years of training depending on the specialty.

The idea that a nurse would be able to introduce him/herself to a patient as “doctor” is, in my opinion, problematic, and, in a clinical setting, misleading if not frankly deceitful. “Doctor” has always been presumed to be a physician. Patients seeking care from a medical professional should be absolutely clear on that person’s credential, and by extension, his/her training. Confusion is exactly what will happen if nurses introduced themselves as “doctor.” Other states have already enacted legislation aimed at the misrepresentation that would occur should nurses introduce themselves as such.

She goes on to say: “Laws designed to protect turf that do not improve quality are not useful. The real issue is money – loss of income for physicians who can bill for collaborating with nurse practitioners.”

The issue is not just about a physician who may not be able to bill for collaborating (which, by the way, exposes him/her to liability if the nurse practitioner is sued for malpractice), but also, probably just as much, if not more, about nurse practitioners spending more time and money to obtain an advanced degree, and hoping they will be able to bill more for their services.

Ana Natasha Cervantes, M.D.