Should Doctorally Prepared NPs Use the Title “Doctor” in Clinical Settings?

Article Outline

• Support for NPs Calling Themselves “Doctors”
• Rationale Against NPs Calling Themselves “Doctors”
• Copyright

Joy Elwell, DNP, FNP, BC, an FNP since 1994, received her DNP from Rush University in 2006. Her doctoral project was “Effecting Legislative Change: Eliminating Mandatory NP-MD Collaboration.” She is an assistant professor and director of college health services at Concordia College in New York. She maintains a private family practice and leads a parish wellness ministry. She also is the immediate past chair and governmental affairs chair of the New York NP Association (NYNPA) and received their NP of the Year Award in 2007. She served ACNP as Practice Consultant from 2004 to 2008.

Marsha Siegel, EdD, FNP, BC, received her undergraduate degree in nursing from Floyd College/University of Georgia and her master's (FNP) from the University of Wyoming, where she is adjunct faculty. She earned a doctorate in human services administration/health care from the University of Sarasota (Argosy). She was instrumental in getting regulatory independence and prescriptive authority for NPs in Wyoming in the early 1990s. A member of ACNP since the beginning, she has recently served as individual member representative and is the association's president-elect.

As advanced practice nursing continues to evolve, fear and misperception rapidly emerge from some of our physician colleagues. In 2008, the Illinois delegation of the American Medical Association (AMA) proposed Resolution 303 to the AMA House of Delegates, declaring that use of the title “doctor” should be limited only to physicians, dentists, and podiatrists. This was likely a reaction to recent inaccurate depictions of the doctorate of nursing practice (DNP) degree by the media as a “Dr. Nurse” role analogous to the physician role, rather than as a terminal academic degree. The rationale offered to support Resolution 303 was based on an unsubstantiated belief that use of the title “doctor” in the clinical setting by nurses with an earned doctorate would confuse patients and somehow harm them.

The American Nurses Association, the American Psychological Association, and the Nurse Practitioner Roundtable (a coalition of 7 national nurse practitioner [NP] associations, including ACNP) gave immediate protest, and Resolution 303 was not adopted. Although doctoral education for nurses is not a new idea, the evolution of advanced nursing practice to the doctoral level raises the question.

What do you think? Should doctorally prepared NPs use the title “doctor” in clinical settings? Go to www.npjournal.org to vote. Contact editor Janet Selway at janet.selway@gmail.com if you would like to comment on this matter.

Back to Article Outline

Support for NPs Calling Themselves “Doctors” 

Joy Elwell

The answer to this question is a resounding “yes.” The word “doctor” originated in the 14th century and comes from the Latin docere, which translates to English as “to teach” and is defined in Merriam-Webster's dictionary as (1) “a person who has earned one of the highest academic degrees conferred by a university,” and (2) “a person skilled or specializing in healing arts; especially one (as a physician, dentist, or veterinarian) who holds an advanced degree and is licensed to practice.” Note that the examples given (physician, dentist, and veterinarian) are not exclusive to those disciplines. The title “doctor,” correctly used, indicates a professional who has earned a terminal degree. “Doctor” identifies an academic credential, not a specific category of provider.

Organized medicine has worked hard through the 19th, 20th, and into the 21st centuries to claim the title “doctor” for physicians alone. In 2008, the AMA went to the point of entertaining a resolution from its Illinois delegation to call for the title “doctor” to be legally protected, so that it could only be used by physicians, dentists, and podiatrists (the resolution was not adopted). Some employers will not permit NPs to use the title “doctor” when treating patients, rationalizing that using the term “doctor” would confuse our clients, who would be misled into thinking they were being treated by physicians.

This argument implies that NPs do not have the integrity to correctly identify themselves and that health care consumers are not intelligent enough to understand who is taking care of them. Neither could be further from the truth. In my clinical practice, I introduce myself by saying, “Hi, I am Dr. Elwell, your nurse practitioner.” No surprise, it works just fine.

Back to Article Outline

Rationale Against NPs Calling Themselves “Doctors” 

Marsha Siegel

My argument against blanket use of the title “doctor” by doctorally prepared NPs in the clinical setting is a visceral argument rather than a cerebral one, for it should truly be a personal choice. Medicine does not own the title “doctor” and definitely should not have any say-so in me using my title appropriately.

To my patients, I am Marsha. They are very well aware of my credentials and the fact that I am an NP, as this information is posted on our office window, hanging on the wall, printed on my business cards, and monogrammed on my lab coat.

But I am Marsha. We have both physicians and NPs in our practice, but patients often specifically request the NPs because “doctors are too busy to listen” and they want to see “someone who will listen to me and figure out what is going on.” They see our medical skills as equal but seek the advantage our nursing skills bring to the exam room.

By being Marsha to my patients, they see me as their ally, their partner in care. By being Marsha, I establish an intimacy with my patients that implies to them that I am oriented to them as a person and not as a disease. They show me a genuine trust and respect based on our interactions rather than my title.

Medicine has done a wonderful job of using the title “doctor” to isolate itself from being perceived by most patients as a “person who cares about me as a person.” I am concerned that the negative perceptions of the title could carry over to us.

We must be careful what we wish for; by insisting on being called “doctor,” we could separate ourselves from the very thing that sets us apart.