Should Nurse Practitioners with a Doctorate of Nursing Practice be Called Doctors?

Thursday, May 27, 2010 10:43

Nurse Practitioners – Doctors?

[Original post is published on The Health Care Blog]

By Barbara Ficarra, RN, BSN, MPA

My recent post on The Health Care Blog, “Nurse Practitioners – Doctors?”  addresses the issues surrounding nurse practitioners obtaining a doctorate degree.

I’d like to thank all those readers of The Health Care Blog (THCB) for their comments.  Thank you to all the doctors for sharing their viewpoints and their voice.  While many comments were indeed honest, they certainly were strong opinions and the readers did not hold back their feelings.  While some comments were rather harsh, I commend those readers for commenting.

It was disconcerting that more nurses did not comment; however what’s more worrisome is the fact that a key nursing organization, American Association of Colleges of Nursing did not respond to my request as well as Yale University, which is one of the many universities offering a DNP program.

While some readers of THCB feel this issue is “stupid” it is indeed a real issue that nurse practitioners and doctors will be dealing with.

In fact, in the “Position Statement on the Practice Doctorate in Nursing” the decision called for moving the current level of preparation necessary for advanced nursing practice from the master’s degree to the doctorate-level by the year 2015, according to the American Association of Colleges of Nursing.

We would love to hear from health consumers too.  If you were a patient in a hospital, would you find it confusing that a nurse introduces herself or himself as a doctor of nursing practice?

Nurse Practitioners – Doctors?

(To view comments on THCB please click the link at the end of this post.)

In a recent post on TheHealthcareBlog, “Nurseanonics” by Maggie Mahar, she addresses the heated debate over the difference between a doctor and a nurse.

Mahar tackles the question that Legislators in twenty-eight states are dealing with.  Should a nurse practitioner (NP) with an advanced degree provide primary care, without an M.D. being in charge?

But another pressing question that needs to be addressed is:

Should nurse practitioners be called doctors (DNP)? (DNP is a Doctor of Nursing Practice.)

That is the question that I will address here.

I reached out to the medical community to get their reaction.

It’s not surprising that the immediate response of  some doctors when asked if nurse practitioners should be called doctors (DNP) is “No!” evidenced by Dr. Stangl’s comment.

“NO!  Nurse practitioners should NOT be called “doctors” because they are NOT!  While many NPs do an excellent job of handling certain types of problems in certain settings, they do not have near the depth or length of education that physicians do and should be credited for what they Do have, which is their nursing background and expertise.”  Susan Stangl, MD

Take a look at this comment that appears in Thehealthcareblog:

“An NP has mostly on the job training…they NEVER went to a formal hard-to-get into school like medical school,” wrote one doctor.

“I have worked with NPs before, and their basic knowledge of medical science is extremely weak. They only have experiential knowledge and very little of the underpinning principles. It would be like allowing flight attendants to land an airplane because pilots are too expensive. HEY NURSIE, IF YOU WANT TO WORK LIKE A DOCTOR…THEN GET YOUR BUTT INTO MEDICAL SCHOOL AND THEN DO RESIDENCY FOR ANOTHER 3-4 YEARS. NO ONE IS PREVENTING YOU IF YOU COULD HACK IT![his emphasis]”

It’s clear that for these doctors, the simple answer is No.

After all, why would doctors want additional prey in their territory?  Even with the shortage of primary care physicians, doctors aren’t looking at nurses to help fill the void.

The medical profession is quick to respond, and in some cases, with outlandish comments (evidenced in Mayer’s post) against a group of professionals who have earned an advanced degree.

I posed the question again to my (yes) colleagues in the medical community.

The question again:

Should nurse practitioners be called doctors (DNP)?

Doug Farrago, MD, explains:

“It is about the word DOCTOR. If you want to be a doctor, then by all means, I implore you to become one. We need you. The training is a bitch and; unfortunately, a gauntlet you have to get through. You don’t get that in NP school. You will be all the better for it, though. It really comes down to paying your dues. You just can’t call yourself one because you, well, just want to.

Nurse practitioners came about to strengthen the healthcare system by making them “physician extenders” not “physician competitors”. By going this new route the NP group has made this relationship uncomfortable at best. I will get “hate email” over this but I didn’t do anything. The NPs are blatantly changing their strategy, demanding to be called doctors and are in direct competition with us yet I know they will rip me for pointing this out. The bottom line is the you are not a doctor. You are an nurse practitioner. It is a fact and it is not demeaning to say it. It is just a term. Get over it. I call myself the KING of medicine but just because I call myself one doesn’t mean I am one. Or does it?”

OK, I believe this is where we need to dissect the question.

Although the question is simple and direct, it is being answered very quickly, without stepping outside the box.

Doctors have a tendency to stay within their own territory.

Yes, Dr. Farrago it is about the word “Doctors.”

So when the question, “Should nurse practitioners be called doctors (DNP)”? is asked, the immediate reaction from most doctors, adamantly is “no!”.

When you think about the question, the answer makes sense; a nurse is a nurse, so how can a nurse be called a doctor?  That is the black and white response, but like many questions and areas in life, there’s more than black and white, we need to look into the gray areas for a different approach.  We need to step outside the box.

Remember, the question is should nurse practitioners be called doctors (DNP)?

It does not ask if nurse practitioners should be called medical doctors.  (In that case, there’s a simple answer and that would be no, not unless they attended medical school and obtained the Doctor of Medicine Degree.)

Kevin Soden, MD, medical journalist has this to say,

“This is a fairly straightforward answer. A nurse practitioner should not be called doctor unless they have gone through a well-defined course of study showing mastering of a prescribed content like any other doctorate program. The danger that I can see for the lay public is the confusion that may arise if a person gets a doctorate degree in nursing and when they see patients, they or their staff refer to themselves as doctor. The average patient might think they are seeing a medical doctor with more advanced training in diagnosis and treatment. It’s important that the patient be educated in this regard.”

Here’s an interesting comment by Michael Blumenfield, MD –

“I see more downside to upside to calling NPs “doctor” in the hospital setting. It would suggest to patients that nurses who were not NPs were somehow not as important, responsible or critical to the patient’s care. In fact at times the opposite is true i.e. in trauma and critical care units etc as well as other places [take out psych] such as psych units etc where they have just as important roles and have had as much training as NP. I see this as even more important than the blurring of identification with physicians which might create some minor problems. Nurses deserve a great deal of respect which I believe that they have. I would hope that the hospital environment not become the place for working out political agendas.”

Time to scrutinize the question

Let’s look at the history.  What does doctor mean?

Doctor originates from the Latin word (gen.: doctoris) which means teacher,  it is abbreviated “Dr” or “Dr. and it’s used as a designation for a person who has obtained a doctorate-level degree.

Doctorate “is an academic degree or professional degree that in most countries represents the highest level of formal study or research in a provided field. In some countries it also refers to a class of degrees which qualify the holder to practice in a specific profession, such as law or medicine. Examples of the former are the Ph.D. (Doctor of Philosophy) and the S.J.D. (Doctor of Juridical Science), while examples of the latter include the U.S. degrees Doctor of Medicine, and the Dutch Professional Doctorate in Engineering.”

Doctorate dates back to the Middle Ages, the Medieval Era as a license to teach. [Source:  Wikipedia]

The first university, the University of Bologna, was founded as a school of law by four famous legal scholars in the 12th century, and the first academic degrees were all law degrees, and the first law degrees were doctorates as stated in Wikipedia.

Theology, law, and medicine were the earliest doctoral degrees.

“The term “doctor” refers to an individual who has earned a degree of Doctor of Philosophy, or Ph.D.  Beyond academia and in the classical professions, such as medicine and law, professional doctorates emerged such as the Doctor of Medicine M.D. (an abbreviation of the Latin Medicinæ Doctor), Doctor of Osteopathic Medicine D.O.’”

“While many US lawyers and physicians who pursue purely academic and research careers in law and medicine do so after having earned a J.D. or M.D., respectively, these degrees are considered professional doctorates because most who earn them pursue careers as working professionals. In more recent times, other professional doctorates have emerged such as the EdD (usually held by school administrators), the DBA and the DPA (nearly always earned by prior recipients of the M.B.A. and the M.P.A., who continue to pursue ongoing professional careers in business and public administration) and the Doctor of Physical Therapy (DPT.)”

“There are other health professions such as physical therapy, podiatry, dentistry, chiropractic medicine, optometry, and veterinary medicine, where the title “doctor” is used professionally.”

What is the issue?

First, it is true that some doctors can be territorial, but is this really the issue?  I had a long conversation with a good friend of mine who’s a medical doctor and not surprisingly, he’s not a proponent of nurse practitioners being called doctors.

He said, “The problem as I see it is that the academic term “Doctor” is distinctly different than the common understanding of “Doctor”.  Having Nurse Practitioners use the term “Doctor” just mixes up the two uses and is confusing for the majority of people. If somebody wants to be a common “Doctor” then they need to go to medicals school and residency.”  He adds, “…territorial is irrelevant. PATIENTS go to their DOCTOR.  That is just common vernacular that has developed over several centuries.”

While medical doctors aren’t the only doctors; does the issue become academic vs. institution.

Is it okay to call a nurse practitioner “Doctor” when he or she is in an academic setting and NOT in an institutional setting?  Shouldn’t it go both ways?

Heated Debate

This ostensibly will remain an intense heated debate.

Kevin Pho, MD, founder of KevinMD writes a blog addressing the role of nurse practitioners.

“Merely bringing up this idea brings out the worst in turf battles, with most discussions devolving into nurse versus doctor cat-fights,” writes Kevin Pho, MD.

Cat-fights we can do without – team is the best approach

KevinMD writes, “…doctors and nurses have to realize that it’s the patients who come first, and to care best for them, a team-based approach is needed.”

Will this debate lead to cat-fights between doctors and nurses?

As health care continues to change, perhaps it’s time we move out of the box and greet the DNP, the doctor, the teacher, the doctorate as a health care provider.

If DNP is a Doctor of Nursing Practice, that simply means that they are teachers of nursing practice; it does not mean they are medical doctors.

And yes, in regards to Dr. Soden’s comment, what simply needs to be done when the DNP sees a patient is to introduce her or himself and make it clear that she/he is a Doctor of Nursing Practice, not a medical doctor.

DNP will be an asset to patients, but it’s important to realize what Dr. Blumenfield points out.  There are many exceptional nurses who provide excellent care and they may not be an NP or DNP.

It’s important to note that there are health care professionals who believe that by obtaining the highest level of learning, that they should be called doctors.

“OF COURSE THEY SHOULD BE CALLED DOCTORS,” says Michael Butler, DC, MS, R NCS T says in an email.  He adds, “THEY PASSED CERTIFICATION OF HIGHER LEVEL OF LEARNING. THE PATIENTS THEY SERVE RECOGNIZE THEIR EXPERTISE.”

Bonnie Marting, DNP, ARNP replies:

“Regarding the question of whether NPs should be called doctors: Using the term “doctor” implies a higher education than the masters prepared nurse practitioner. It is an excellent opportunity to introduce the patient to the ever-evolving world of healthcare and the extent of the education this type of healthcare provider has. It does not confuse one with “physician”, simply clarifies.”

Bottom Line

We need to tread the waters very carefully here.  The last thing health care needs are fighting nurses and doctors.

Both groups are professionals with advanced degrees and we need to recognize that each entity in health care is unique and special.

While medical doctors aren’t the only doctors; does the issue become academic vs. institution.

Is it about titles and territory?  Or is it about the patient?   It’s vital that in the 21st century and with changing health care policies, that it’s time that both doctors and nurses work together as professionals for the good of the patient.  No matter the title and the number of degrees, it’s vital that communication with patients is transparent and that they know who you are and are not misled.

Questions to think about

  1. In a hospital setting, should medical doctors be the only doctors allowed to use the title doctor?
  2. Lawyers can technically be called doctors since they obtain a Juris Doctorate degree, but they do not use that title. Should the same go for nurse practitioners that obtain the Doctorate of Nursing Practice (DNP)?  Should they obtain the DNP but not be called doctor in a hospital setting to minimize any confusion to patients?
  3. Will patients be confused by a nurse practitioner calling themselves doctor?
  4. If nurse practitioners are very clear in introducing themselves as a doctor of nursing practice, will that alleviate the confusion?
  5. Should nurse practitioners be called doctor only in an academic setting and not in a hospital setting?
  6. Is it time to change the “common vernacular” of Doctor?  – Doctor in a hospital setting does not necessarily now mean medical doctor since the advent of the DNP.
  7. Should Colleges and Universities along with the American Association of Colleges of Nursing present an ad campaign to the general public to educate them on the new title of nurse practitioners?  After all patients should not be misled, and transparency is critical.

—–

Facts about The Doctor of Nursing Practice

By 2015 nurse practitioners will hold a doctorate or a DNP according to the American Association of Colleges of Nursing.

Doctor of Nursing Practice (DNP) Programs

A couple more…

Yale University School of Nursing

New York University College of Nursing

Your turn

What do you think?  Should nurse practitioners be called doctors (DNP)?

Barbara Ficarra, RN, BSN, MPA is the executive producer of the Health in 30® Radio Show and founder of Healthin30.com, a featured writer on Huffington Post, and an administrative head nurse at a teaching hospital.

To read comments from The Health Care Blog (THCB) readers, please click here.

[Updated April 3, 2012 – Presently there are 171 comments published on THCB]

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73 Responses to “Should Nurse Practitioners with a Doctorate of Nursing Practice be Called Doctors?”

  1. Laura Blanton says:

    March 2nd, 2013 at 11:11 am

    I was treated in a local hospital ER Thursday night.  A young man came in an introduced himself as Dr. Smith (Named changed.)  He never said Doctor of Nursing – just Doctor.  Despite his terrible bedside manner, refusal to listen, and the chip on his shoulder, he did prescribe properly and I am improving.  When we took my prescriptions to the pharmacy the next morning, the pharmacist asked the doctor’s name as you could not read the signature.  We told him and he says “there is not a doctor by that name in this ER.”  My medicine bottle has another doctor’s name on it.  This makes me very unhappy.  I do not have a problem with CRNP’s.  I think they are needed and a great idea.  However, they do not need to assume the title of Doctor.  If he had introduced himself properly things could have been entirely different.  We have a daughter who is a nurse and we are very proud of her.  We have encouraged her to at least get her master’s degree but she is busy and happy being a wife and mother of a two year old.  Rest assured if she ever gets her doctorate of nursing, she will still be a nurse.

  2. Samantha says:

    August 6th, 2013 at 11:22 am

    I do not understand how nurse practitioners can think that they are on the same level as a physician who went to medical school after attaining their bachelors. Yes you may have taken one semester of organic chemistry, anatomy, microbiology, etc but that’s just a fraction of what people majoring in a science field like biochemistry or even bio-sci for their bachelors take. Your 1 semester is just a scratch on the surface of what actual physicians have to take. Yes you may be qualified to do primary care practice but the lack of in depth knowledge puts you at a greater disadvantage for catching those not so ordinary conditions that may have a few every day symptoms. I respect the nursing practice and understand the role that nurses have in the health care system, but to call yourself Doctor in a hospital or clinical setting is misleading. You may not think so, but to just an ordinary patient it is. If you truly had an understanding of what every day patients perceive is the hierarchy in medicine then you would not call yourselves doctors without specifying that you are not an MD but a NURSE practitioner. Do not assume that your education is on par with an MD. I have a BS in microbiology and a PhD in biochemistry but even I don’t assume that my education is on par with that of a certified physician. If I wanted to be called Doctor in a medical setting, I would have gone to medical school. So for you nurse practioners that want to be called Doctor in a setting other than academia, go take the MCAT and go to medical school. 

  3. Jenny says:

    February 26th, 2014 at 9:49 am

    Anyone who holds formal education in a doctorate program has the right to be called “doctor”. Yes physician’s have held the term doctor but this is not the nurses fault. There are different doctorate programs and they should each be recognized for their formal education. PhD, EdD, DNP, etc. I see no problem as long as the NP introduces herself properly. “Hello, I am Dr. ________, your NP taking care of you today.” There is no confusion in that statement. Medical doctors have a medical doctorate degree there job title actually is physician or attending physician… When I see jobs available at the local hospitals they use the term physician, not doctor. This is just an issue because many doctors think nurses are inadequate and nurses think they must prove themselves to doctors because of this. As long as the patient is getting proper care why must we argue about the term “doctor”?

  4. Scott Mendelson, M.D., Ph.D says:

    June 2nd, 2014 at 12:26 pm

    Having both a Ph.D and an MD, I believe I am in a unique position to add to this discussion. There is an old saying among Ph.D.s that, “Ph.Ds learn more and more about less and less until they know practically everything about nothing.” Of course, one might extend this to say, “MDs learn less and less about more and more until they know practically nothing about everything.” However, given the consdierable amount of time preparing for medical school, 4 years in it, and 4 years or so as a resident, I think it more fair to say they know a helluva lot about a lot of things. Some DNPs, however, may have done their dissertation on studies of patient flow protocols in rural versus urban hospital settings, or in vaccination of school children among rural Amish. Thus, they may be an NP like any other who happens to know almost everything about nothing that has anything to do with caring for 99% of his or her patients. This individual should not be called “Dr.” in the hospital setting.

  5. Janice says:

    September 2nd, 2014 at 5:25 pm

    I agree with the Doctors is it very confusing for patients when the NP refers to herself as a Dr. I recently experienced this myself with an APRN not knowing what that meant she has me calling her Dr. and her last name. Finally I decided to ask my sister who was a critical care nurse for over 25 years, and she told me by no means should she be referring to herself as a Doctor that is might be a serious ego problem, and with her experience those in medicine that have done that tend not to ask the advice of a Medical Doctor when the NP doesn’t know she advised me to see a Medical Doctor. My question is when and ARPN writes you a prescription do they use the initials DR with there last name and not APRN? I believe it is very important for patients to understand that the NP or DNP or APRN can not do any kind of surgery if needed in an emergency, nor can they visit you as there patient in the hospital as your Medical Doctor could.

  6. Someone says:

    September 23rd, 2014 at 7:39 am

    @ EKK
    “A nurse is a nurse. A doctor is a doctor”

    A nurse is a nurse. A physician is a physician. It isn’t the nursing community’s fault that physicians have hijacked a title that anybody with doctorate-level training is entitled to use and has been entitled to use since the birth of formal academia. If you want to go into technicalities, a doctor is a teacher. How many newly minted physician “doctors” do you know of who are qualified to teach anything? 

  7. JC says:

    October 22nd, 2014 at 4:29 am

    Dear Barbara,
    I can see where all this confusion is coming from. If you go and ask the physicians, who are more profoundly abusing the title “Dr”, then of course you realise that you have stepped on the snakes tail, what other reaction are you expecting there?
    In fact a lot of non-doctor physicians are wrong using (or abusing, I should say) the title that they have never earned. Don’t go and ask them, if someone who has rightly earned the title can or should use it in whatever setting? Someone who has rightly earned the level of Doctorate, has earned the right to use the title in every setting & should do so without fear of being bullied by any group of people, of any profession.
    Come-on Barbara, you are not thinking of giving much notice to what the wrong group have to say – are you? In fact I do not even believe that this is a right question to ask – because whoever has earned the title has every right to use it – some people may or may not agree to that, but that has absolutely nothing to do with the person’s rightful use of his/her well earned title. Perhaps the right question to ask here would be – How come people who have not earned the title, misusing it, and getting away with it? i.e., why are medical graduates not being penalized for misusing the title “Dr”, when in fact they have not earned it? And NO, going through medical school, and completing residency does not give them the right to use the title, because at the end of it they are still basic medical graduates. Unless they complete their Doctorate, they should only use the title “Mr/Ms/Mrs”. They are by no means experts in their fields by graduation and residency. So, if they want it, they will have to earn it by acquiring the Doctorate in their field & proving their expertise that way.
    As to those who say – a doctor is a doctor, and a nurse is a nurse, to them I will say, what is right is right & what is wrong is wrong. Meaning whoever has earned it is entitled to use it, whoever hasn’t earned it has no right or entitlement to use it.

  8. Barbara Sartell says:

    November 12th, 2014 at 12:45 pm

    I am a professor in an NP program and DNP program. I have had an academic doctorate for years. I ONLY use the term in ACADEMIA where it belongs. It has NO place in the clinical setting where all it will do is confuse patients. There is not enough time in the world to explain the differences to patients and it is not fair to them or to medical doctors. Further, it is similar in nature to nurses being the only ‘profession’ that puts BSN, MSN etc after their names because they feel they must somehow tell everyone about it. No other profession does that. Its actually embarrassing to see that in print. MOST academic doctorates do NOT use the term outside of an ACADEMIC institution. That is simply how it is. To the nasty commenter out there, if we WANTED an MD we certainly could have done that. That is NOT what this is about. We ALL have important ROLES in this system. When Family Practice goes to the wayside in Med Schools because there is no money in it, the NPs will most likely fill that gap. THIS is about PATIENTS and what is best for them. And for THAT, I say using the term DOCTOR will only confuse and could actually cause problems. Be secure in yourself. If you went back to school as I did, and have a doctorate, Bravo. If you went just because you couldn’t wait for someone to call you a doctor, you have other problems.

  9. John says:

    November 24th, 2014 at 9:04 am

    This is a silly question that only an MD would ask – the answer is simple:  ANYONE who has a doctoral degree is, by definition, entitled to the title of DOCTOR (this title NOT exclusive to MDs and is awarded, as others have noted, to PhDs as well).

    Perhaps the AMA should come up with a different title for MDs that is exclusive to their profession if they are concerned about patients becoming confused when they speak with a PhD (ex. psychologist or pharmacist).  Why would an MD assume that “doctor,” which is NOT exclusive to medicine, only applies to them?

  10. Michael says:

    November 29th, 2014 at 11:51 pm

    As healthcare clinicians a huge part of our job is to educate our patients. With that said DNPs SHOULD be called Doctor.
    APRN: Hi my name is Dr. Jones, nurse anesthetist,  I will be taking care of your anesthesia today. Patient: you’re a doctor and a nurse? APRN: I’m a doctorate prepared nurse anesthetist. Patient: Ok, nice to meet you. 
    Bottom line:educate our patients! 

  11. Franklin says:

    March 8th, 2015 at 12:35 pm

    I am a Doctor of Nursing Practice with specialty certifications in psychiatric mental health and addictions. I served six years in the Army (active duty) with multiple deployments. I attended the University of Tennessee and graduated with a BSN. During that time I took a number of classes including anatomy and physiology 1 and 2, chemistry 1 and 2, organic chemistry, biochemistry, calculus, statistics, biology 1 and 2, microbiology, all before I started the 3 year nursing program. During that program I was trained in all sorts of healthcare environments (pharmacology, pathophysiology, surgery, critical care, acute and chronic etc…) I’m not talking about 1-2 weeks either, entire courses were dedicated to these subjects. While I was in school I worked in the ER as a tech (the civilian world does not recognize military medics) full time. I clocked thousands of hours during those four or five years. I went on to work full time in the ER until I decided to go back to school for a Masters degree. I attended the University of Memphis graduating with a Masters in Nursing and became an APRN. I immediately enrolled in the DNP program at the University of Tennessee and graduated with my Doctor of Nursing practice. Each one of those programs were intensive with a focus in practical application of medical science. I took advanced pathophysiology, advanced pharmacology, advanced psychopharmacology, advanced health assessments and diagnostics etc…. I clocked several thousands of hours in clinicals before my residency program. Granted our residencies were nothing like medical school residency (four months of 40 hr a week work under a licensed MD) I did learn a lot. In the 15 years I have been employed in the medical profession I have clocked over 51, 840 direct patient care hours. I have been taught by hundreds of Medical Doctor’s in real time on the job training. If you think I just handed out pills and wiped asses your an idiot. I know what presenting signs and symptoms are, what they look like, I know which diagnostics to run to rule out or rule in a diagnosis, I have a great understanding of pathophysiology and am capable of critical thinking. I have a great deal of education and experience in medicine, I know how medicines work chemically, physically, and more so how to use them safely. I have prevented tens of thousands of medication errors for patients from their medical doctor. I have titrated, calculated, formulated etc… tons of critical care medicines. I know the side effects because I have witnessed them, I know the antidotes because I have used them. I introduce myself as a Nurse Practitioner with a Doctorate in Nursing Practice. The Doctors (M.D.’s) I work with call me Dr. They recognize my value as a mid-level provider and are often grateful for my consultations (orders they have written by the way). Oh and for the idiot who thinks we have pseudo-doctorates how much money did you make last year? I grossed 162,000. Personally I don’t care if you like it or not, I am respected within my profession which in my opinion is the same damn profession MD’s are in. I am compensated for my hard work, 10 years of education, and career performance. I have more patients than I can schedule, many of which left their MD’s to come see me! I feel it is an honor and a privelege to care for them. So hate us if you want to just remember you can’t do a damn thing about it! They hate us cause they ain’t us (a patient taught me that)!

  12. Jen says:

    March 16th, 2015 at 8:44 pm

    Martin I could not have said it better if I tried. 
    Jen, DNP, AGACNP-C

  13. Jen says:

    March 16th, 2015 at 8:45 pm

    CORRECTION: That message was to Franklin. Its late. No idea where i came up with Martin….

  14. Renee says:

    April 28th, 2015 at 1:20 pm

    There are some superiority/inferiority issues, however the main theme is DNP and MD co- existence in same clinical setting. The MD feels that their doctorate degree is more valuable, and necessary than all other doctors. Let’s explore why…perhaps years of education, depth or matter of content, and traditional views. MDs in particular has a historically unique relationship to the nurse. This relationship entailed giving orders, instruction, and education to the nurse. The nurse often feared the medical doctor and this phenomenon was assume to continue for centuries. Now we see a paradigm shift as nursing developed into its own professional entity and science. There is a medical model and a nurse model of care, however the argument is that the nursing and advanced model is inequivalent. As the profession of nursing achieved its independence from medicine’s control and developed and scientific/empirical understanding of their professional then why must the nurse doctor be challenged and humiliated by their physician colleagues. Perhaps we are not considered colleagues? Perhaps we are regarded as beneath the doctor and our nursing expertise (not medical expertise) but at some point it does form a Y? There are several issues, however I personally believe that the drNP has earned the doctorate title per the accrediting body of the program that she/he has completed regardless of clinical/practice setting. Now it would be in the best interest of the patient, nurse, and respect to the MD to delineate the type of doctorate background or affiliation. Not applicable to do do in all settings however ” I’m Dr. Renee a nurse practitioner ” and a medical doctor can say the same. Whether the MD worker harder doesn’t suffice the request for eliminating the Dr. Prefix for a doctorate prepared NP. Every hospital has a different culture and may use their first names to address each other. However, nursing has been climbing the professional societal later and has a voice in health care. If that voice is doctorate prepared then that should be appreciated.
    Thanks to Jesus Christ the original Doctor.

  15. Renee says:

    April 28th, 2015 at 1:31 pm

    To Franklin , I wish md’s could read your post because I believe that you are a qualified expert in our field and has acquired the necessary educational or clinical didactic experience to substantiate it. Whether the Physician did more chemistry course work does necessarily apply as you have acquired a different route to academic leadership and clinical expertise.

  16. Uling Crosby says:

    June 30th, 2015 at 11:13 pm

    I must admit, I enjoyed reading every comments and I cannot help not to add in my 1-cent as a patient. If health care providers are able to explain the nature of the illness to their patients, how difficult is it to simply differentiate the roles of DPNs and MDs to their patients as part of the evolving health care system? Seize this as our teaching moment and surely, patients are smart enough to understand the semantics. It is time for the patient-community to be well informed, in five years time, it will not be an issue at all. We live in a rural area, my diabetic husband and I have been under the primary care of PAs and DNPs for many many years, we call them doctors and we recognize their independence and ability to provide us with the care we need within their means. They sometimes refer us to physician-specialists as needed and we have no problem with that. So far we are well and in the best of health. I think our current model of health care, though imperfect as it is, is heading to the right direction. Nurses are shifting paradigms. They are making waves, and it is a good thing. They are doing an immense work to meet the needs that are urgent and necessary in order to deliver care and alleviate the pain of suffering in an area where there is none or little heath care being provided. The shift of the invincible tower of omniscience should not terrify physicians, this is only a small shift but it will shift regardless, it’s just a matter of time and I expect MDs to know and act better than that. Instead, physicians must look at it in a positive way and work hand in hand with their DPN colleagues equally within a patient centered framework; after all, it is the patient that matters: a good daily reminder of their hippocratic oath. And yes, those with Doctorate of Nurse Practice are well entitled to gain the respect as any doctors do. Any argument against it is silly.

  17. Tracey L Bell Jr says:

    July 19th, 2015 at 9:45 pm

    I am a patient that prefers a NP or DNP as a primary care practitioner, rather than a MD. I say this becasue, although MDs go thru extensive schooling and pick a primary focus to practices and major in, they lack the experince of treaing a patient as a primary doctor. This in my opinion is becasue while they are in med school, nurses are pursuing are practicing and pursuing their NP and DNP at the same time.

    When needing speciality care then i pursue a MD for medical attention. This is becasue once again, MDs spend several years focusing on one particular area of medicine. IOnce they complete their learnings they are bascially experinemnt on patients to try and conclude their study; which can be good for the cancer patient or the neurology patient, but for primary care attention I am not going to a MD that has little real time knowledge on the common cold, when I can get care from a NP or DNP that has had extensive hands on experience with dealing with this matter.

    With this being said, In my opinon the NP or DNP are clinic doctors at primiary care medicnce, becasue they have mastered it with real time experinece vs the MD that has only the knowldge from schooling.

    THank You,

    Tracey L Bell Jr.

  18. Heather Surcouf DNP says:

    August 13th, 2015 at 2:18 pm

    I am a nurse practitioner with my doctorate (DNP). I have been an nurse practitioner for almost 15 years. It has taken many years to mainstream the idea that a nurse practitioner can assess, diagnose, and treat. This idea only took root through continued education of patients (mainly by nurse practitioners) and other healthcare providers. Nurse practitioners as a whole did not shy away from this education task. The same is true regarding DNPs. I introduce myself by saying I am Dr. Surcouf, nurse practitioner. I earned it, I am not going to bury it because some medical doctors are unhappy about it and some patients are confused. Rather, I do what NPs do best, educate other providers and patients. No misrepresentation, only the truth.

  19. Matt says:

    January 24th, 2016 at 11:42 am

    I see a nurse practitioner for psych and it is a different experience but I like it better.  She does the therapy and med component so I don’t have to defend myself against a therapist with countertransference issues who uses my doctor to abuse me by proxy.  I have had a couple good psychiatrists but I take controlled meds and it was nice when I met her that she continued what helped me for 10 years stay stable and calm.   Most psychiatrists have a more control freak approach and will switch meds even though you are fine and when it comes to ADHD meds, they rarely like to carry them over, documentation or not.  One of the two psychs was a neuropsych too so she had a different approach as well.  I almost became a substance abuse counselor but went the mediation route since it is legal based and more money.  So I used to get indignant with new doctors because I provided proof and have assured there was a conversation between them and asserted myself.  And I was treated kindly for once.  

  20. Jas says:

    May 20th, 2016 at 1:51 am

    My ex who was a NP (which I came to know after dating him for one year) always called himself as a doctor. Never accepted that he was Nurse. There is nothing wrong to be a Nurse, Practitioner, Doctor or anything as long as you are comfortable in your own skin and proud on yourself what you do. If you want to call yourself a Doctor then go to Medical School, spent day and nights on study then who can stop you to be or call a doctor, but if you chose to be a Nurse then be proud and tell people that you are NURSE not a DOCTOR.

  21. Heather says:

    October 1st, 2016 at 2:23 am

    I feel that we are all missing a vital point and ignoring the most important audience to this argument: the patient. Past the “I deserves” or the harsh rebuttles of “no you don’ts” this boils down to patient perspective, understanding and safety. DNPs are a relatively new concept to mainstream health consumers and introducing one’s self as “doctor” as a DNP may inadvertently confuse and mislead the patient under false pretenses. To protect the patient care ethic of autonomy, being very clear as to your role and purpose as a provider (i.e. title and what that means) is important to allow the patient to make informed decisions about their care and choice of provider. We must set aside our pride and self interests and uphold beneficence by acting in the best interest of the patient and not ourselves.

    As a side note, both MDs and DNPs work really hard to achieve their dream, are equally important to healthcare delivery, and should not be dividing themselves by comparing and measuring the value of their roles and worth against each other. We are suppose to be working as a team with patient-focused and collaborative care as our common ground, not working against one another for self praise and justification.

  22. Linda O, EdD says:

    January 21st, 2017 at 11:34 am

    Hello, I am a Teacher and I have a “doctorate.” That does not make me a medical doctor (MD). I do not expect people to call me Dr Olsen. I feel that is pretentious. I am a teacher. If asked, I’m proud and happy to tell people I have a “doctorate” in teaching. I believe a Nurse is a Nurse, is a Nurse, no matter what acronym you have earned by a graduate course (or courses). You are still a Nurse to any ill patient who needs a Nurse, and to any medical Board or court of law you may appear in front of, if accused of violating your medical code of ethics. Be proud of your academic accomplishments, and your increased knowledge of medicine. Be proud that as a Nurse, you are more highly trained to help patients heal. Put the academic acronym after your name, but tread very carefully in what you claim to be by profession. You are still a Nurse. Don’t be high and mighty and confuse patients, especially the elderly who expect an MD to manage their complicated care and medication. Just be who you are, and proud of it. In reality, the number and type of acronym after your name might get you more pay, and a better standing in the Nursing community, but to everyone else in the world, you are still a Nurse.

  23. Jessica says:

    March 14th, 2017 at 5:18 am

    As a nursing student who intends to become a Nurse Practitioner (here in NZ it always requires a Masters Degree/Doctorate) and a patient from time to time, I feel this argument is about colloquial titles more than anything else.

    Define a doctor (MD): health care provider that diagnoses and prescribes.
    Define a doctor (NP): health care provider that diagnoses and prescribes.

    Each of these health care providers can refer their patients to a specialist (more specifically experienced health care provider), and delegate care to an RN (day to day health care provider that cannot diagnose or prescribe).

    Colloquially, a nurse cares, and a doctor diagnoses and prescribes.

    A nurse practitioner does both. Therefore should be able to introduce themselves as a colloquial (and academic for that matter) doctor, and be proud of the NP that follows their name.

    Patients do not expect a nurse to prescribe to or diagnose them. Giving a nurse practitioner the colloquial title of doctor clarifies things for the patient: You are seeing the person who will diagnose and prescribe for you. Not the person who is going to perform your daily care.

    NP, MD – arriving at ‘doctor’ through different pathways does not change the role you fulfil when you get there. Each provides healthcare for their patient within their scope of practice, which includes those key points of diagnosis and prescribing. Which frankly is what the patient is there, seeing them for.

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