Doctors fight back against nurses with doctorates calling themselves 'Dr"

[Liberal_in_LA]

credential snobs are a hoot

NASHVILLE — With pain in her right ear, Sue Cassidy went to a clinic. The doctor, wearing a white lab coat with a stethoscope in one pocket, introduced herself.

“Hi. I’m Dr. Patti McCarver, and I’m your nurse,” she said. And with that, Dr. McCarver stuck a scope in Ms. Cassidy’s ear, noticed a buildup of fluid and prescribed an allergy medicine.

It was something that will become increasingly routine for patients: a someone who is not a physician using the title of doctor.

Dr. McCarver calls herself a doctor because she returned to school to earn a doctorate last year, one of thousands of nurses doing the same recently. Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title “doctor,” but also the money, power and prestige that often comes with it.

As more nurses, pharmacists and physical therapists claim this honorific, physicians are fighting back. For nurses, getting doctorates can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients. But so far, the new degrees have not brought higher fees from insurers for seeing patients or greater authority from states to prescribe medicines.

http://www.nytimes.com/2011/10/02/health/policy/02docs.html

further down in the article, bills are being pushed to prevent people from advertising as 'doctor' unless degree is clear.

[ixion]

1. Uh, well, technically people with Ph.d's ARE doctors

so they're have to come up with some other way to distinguish themselves, I guess.

[boston bean]

2. I really think they should. When I go to the hospital or urgent care, and someone says they are a

doctor, I assume they went to medical school. Most probably would.

[ixion]

4. I'm not saying it's not confusing, necessarily

but most professors have doctorates, and use the prefix Dr.

[petronius]

52. When I got my Ph.D., the first person to address me as "Doctor" was my physician

:)

But I generally prefer the title of "Professor", which is the real pinnacle of my profession..

[emilyg]

9. So do I. I'm a retired nurse.

[dana_b]

27. exactly. I realize that getting that phD is s LOT

of work but this nurse (this doctor of nursing) should know better than to do this. It's not about his/her credentials, it's about the patient's care, comfort and knowledge of exactly who they are talking to. I am a nurse and find this to be too much. One of my instructors in school was a doctor of nursing but she never introduced herself as such to any patients (or actually anyone that I know of) as a doctor.

[Skidmore]

110. Having worked in a hospital, I never make that assumption.

I've known many non-medical degreed doctors who worked in the helping professions and who were just as critical to patient care as any physician or surgeon on the team. If a person has put the work into getting the education, they have earned the title.

[gristy]

29. In this setting, however, it will only cause confusion

When within earshot of any patient, only physicians should be calling themselves doctors.

[ixion]

32. that isn't really fair to the people who have invested their time and money and effort

into getting a doctorate.

[gristy]

34. Fair or not, the interests of the patient takes precedence IMO.

[Seedersandleechers]

44. She told the patient

she was a nurse.

[Scuba]

102. How about chiros? Psychiatrists? Other non-medical doctor "doctors".

[Exilednight]

109. Psychiatrists, in the US, are required to go to med school. If you're going to a chiro, you

typically are aware that the person is not a doctor. Although, I do agree that no chiro should call themselves doctor without completing med school.

[mainer]

120. chiropractors can't prescribe medications

psychiatrists can, psychiatrists have MD's, and only MD's can prescribe controlled drugs.

[blueamy66]

140. Then how is my nurse practitioner allowed to prescribe a

controlled substance?

[ChiciB1]

142. My Daughter Will Be Finishing Her Degree In May... However, She Has Been

told, and she has told me that she WILL NOT be able to prescribe "controlled substances". She is presenting doing her clinicals and is able to diagnose, practice & prescribe meds with a Dr. present. So far, she has NOT had any problem with the Dr.'s, but perhaps she will in the future.

Yes, she will make more money than she would have as a critical care nurse, but probably not as much as a doctor. So many doctors today have become specialists so she felt there was a need to go back to school to pursue this career. AND, she now has about $50,000.00 in student loans between her son who goes to FSU and herself as she still attend UF.

That's about all I know presently, but I'm glad she's doing what she's doing. In my older age I may have to rely on her for my health care. Plus her husband is also a critical care nurse at an Emergency Room here. It seems it will be a plus for me, but who knows.

[blueamy66]

145. Sounds great! You're hooked up!

I'm assuming Xanax is a controlled substance and an NP can/has prescribed them. No doctor present.....well, there is a PhD's name on the office door, but I've never seen her.

Go Gators! That's where my stepson goes to school! He just wants to teach math in HS. :-) Smart kid though.

[ChiciB1]

149. Not To Make This A Athletic Contest & The Noles Started Off Well... BUT

GO 'NOLES! Hey, I gotta support my grandson! It is what it is. He's pursuing a business major, having switched from medicine. Decided his heart wasn't in medicine. Not sure how the business will work out for him, but I do need to add that he really wants to go to an Asian country to work.

What that says may mean a lot!

But I am happy about having medical people in my family, it will be very helpful!!!

[blueamy66]

178. Go both boys!

Good luck to them both!!!!

[ChiciB1]

153. So Sorry For The MISTAKE... Daughter At USF... Grandson At FSU...

I do it all the time & should KNOW by now!

[mainer]

146. Because she's under the supervision of an MD

You may not be aware of it, but she is. All it takes is an MD in the building, or under contract to look over the prescriptions.

[blueamy66]

179. Okay....I guess so....

but I've never seen the PhD....ever

[MedicalAdmin]

113. What you are describing doesn't seem to me to be an issue of the ...

... interests of the patient, but rather than one of prestige and billing rights for the physicians.

Don't get me wrong, I agree with title protection for many reasons, mostly having to do with patient protection, but in the case you describe it is easily solved by the use of the protected title of physician without denigrating the earned doctorate.

[FourScore]

72. From the patient's perspective, I think the problem is more complicated.

I constantly experience the front desk trying to convince me to take an appt with a nurse practitioner. I usually push to see the doctor, unless he/she is so booked up that it no longer makes sense -- then I am left with the NP. Although some of them are fine, I have also experienced quite a few mis-diagnoses by NP's whereby I have to return to the actual doctor to get the correct diagnosis. Just recently, I was sent to urgent care by an NP at my doctor's office for an urgent "heart" problem when it turned out not to be anything at all with my heart. I was left paying for the NP appt and the urgent care bill when a doctor should have been able to diagnose me correctly the first time around.

But what really peaves me is that I get billed the same whether I see an NP or an MD. So, the doctor's office encourages me to see someone who hasn't gone through so many years of medical training as a doctor, and is therefore less qualified, and yet I am getting billed the same!!! I hate that. I think it's a scam. I see it as a way for a doctor office to make more money without hiring doctors to relieve the workload. This Doctorate degree/title crap is just another element of the scam, IMO.

[SharonAnn]

79. And the M.D.'s are "fighting back". They're just "fighting". They're the agressors.

[mainer]

148. It's like a boat pilot boarding an aircraft and saying: "I'm a pilot"

It's technically true, but given the context it's confusing.

[Liberal_in_LA]

3. uh oh... I just got unrecced by someone with a doctorate

[w4rma]

5. PhDs & MDs are both Doctors. (nt)

[ThatPoetGuy]

10. But so are lawyers, aren't they?

It's a Jurisprudential Doctorate.

I can see several sides in this story.

[elleng]

23. Yes, Juris Doctor, JD.

Lots of sides to this story, but the MD 'guild' opposes it for financial reasons, simple as that, imo.

[Manifestor_of_Light]

37. M.D.s versus paper doctors (J.D.s, Ph.D.s etc.)

Hell, I never tell anyone I have a law degree. I don't even have my giant diploma on the wall. It's big and impressive and makes it look like I actually did something important & worthwhile.

:banghead:


DH has a BS and MS in math/physics.

We have three degrees each. We both also have an associate's degree which is 2-year vocational school separate and not counted towards the bachelor's degree.


So we know LOTS and LOTS of useless trivia!!!! :D

[kelly1mm]

61. Are you all the Trivial Pursuit ringers too? (I am - mainly useless degrees

in History and Poli-sci with a JD for an extra dollop of uselessness) but I am darn good at TR!

[Manifestor_of_Light]

158. Ooh yeah!! Trivial Pursuit is my purpose in life!!

I ace Science & Nature and Arts & Literature.

[Liberal_in_LA]

6. credential creep

more from the article:

Six to eight years of collegiate and graduate education generally earn pharmacists, physical therapists and nurses the right to call themselves “doctors,” compared with nearly twice that many years of training for most physicians. For decades, a bachelor’s degree was all that was required to become a pharmacist. That changed in 2004 when a doctorate replaced the bachelor’s degree as the minimum needed to practice. Physical therapists once needed only bachelor’s degrees, too, but the profession will require doctorates of all students by 2015 — the same year that nursing leaders intend to require doctorates of all those becoming nurse practitioners.

[Tuesday Afternoon]

7. good lord

:rofl:

[Nye Bevan]

8. I think its pretentious for people with PhD's to call themselves "Doctor"

unless they are either medical doctors or in academia.

I know many PhD's, and only the "real" doctors call themselves "doctor".

And to avoid confusion, in a hospital setting only real medical doctors should be allowed the "Doctor" title.

(I will of course allow an exception for Time Lords).

[RKP5637]

11. Yep, same here. I know in fact pretentious PhD's and most of them don't

even use "doctor".

[ChiciB1]

143. Yes, I Do Think That Is True... My Daughter Will Be Calling Herself At

Nurse Practitioner. That's what she tells me and she is getting her PhD degree right now.

[Lucky Luciano]

13. Still many PhDs use a ton of intellectual firepower - often more than the MDs. nt

[eridani]

16. A PhD holder does NOT want to be "doctor" on an airplane n/t

[izquierdista]

28. How about dentists? Podiatrists? Chiropractors?

"Real" doctors are people who have done advanced study and had that title conferred on them by an accredited university. MDs might like to think that they are the only educated people on the planet, but on that they are soundly mistaken.

[Liberal_in_LA]

33. I remember all the controversy over "Dr. Laura" - that she had a docctorate in physiology

yet used the term "dr" for her therapy related talk show.

[izquierdista]

42. A title only goes so far

Which is why there should be another earned title -- Quack. You'll never hear me referring to a "Dr. Laura" radio program (which is fortunately in the past tense), but I would refer to the "Quack Laura" talk show.

Although Representatives Broun and Paul and Senators Coburn and Frist have studied for an MD and earned the title of Dr., I believe their politics of trashing Hammurabi's code has earned them the title of Qck.

[kestrel91316]

46. Physicians typically refer to us veterinarians as "not REAL doctors"", when in fact

we do hold a doctorate, typically a 4-year postgraduate degree just like theirs. Ours just has that one extra letter in the acronym.

They can be real snooty about it, too. Especially considering how much harder it is to get into vet school.

[Horse with no Name]

63. I have a friend who went to vet school first

and then to medical school.

He said vet school was infinitely more difficult than medical school.

[kestrel91316]

87. It's so rare for a vet to turn to human medicine. One of my classmates did,

and became a pediatric neurosurgeon. Apparently he considered feline surgery a good prep for surgery on infants, which it is.

[MedicalAdmin]

114. A friend of ours holds a number of degrees.

He earned them in this order, DVM, MD, ND, L.Ac, Dr. of Oriental Medicine. He said the most difficult and vigorous degree was the ND (naturopathic doctorate).

His wife is a vet and they have a joint practice; people to the left and animals to the right.

[Jamastiene]

151. Back when I looked into going to vet school,

they were telling me I would have to go two years longer than for just medical.

I wish my cats' vet was my doctor. He's a damn good Doctor.

My doctor, on the other hand, was more like a mad man. I remember him dragging me back toward him while I was on my stomach on the table, to remove stitches from the back of my legs. My cats' vet would have been more gentle than that.

I'm glad I go to the P.A. -C in the office for all of my appointments now. He's better than my doctor was. He actually listens and has helped me successfully treat a few conditions my medical doctor would not even look into when I asked.

[SwampG8r]

74. they have it easy

their patients can tell them what is wrong
not so with a vet
a "dr"deals with one species
a vet must be knowledgable in many
vets are way more dr than mds are

[FarCenter]

75. But MDs are only qualified to treat one species.

Vet school is tougher to get into than medical school, as you say.

Daughter the vet uses "Doctor" at work.

Daughter the PhD biologist doesn't use Doctor except in professional circles.

Medical doctors are weird in that they are the only doctoral degree holders who seem to always use the title in social settings.

[Lydia Leftcoast]

35. In general, the lower the prestige of the college, the more likely the professors

are to call themselves "doctor."

[Gormy Cuss]

43. I think it's pretentious for MDs to think they have a lock on the title./

DOs practice medicine too and call themselves doctors, but I'm old enough to remember when MDs were having temper tantrums over that too.

The wider use of the honorific does knock down the MDs a peg or two but they have the option to refer to themselves as MDs, and there's little ambiguity there.

[Confusious]

58. It's not about them, completely

If you're in an emergency situation, do you want to have to dig through 10 people claiming to be a doctor to find the one who does medicine,

Its a drawback of the language, so we need some rules so everyone can understand.

Oh, and I doubt any other language is better, seeing as the nearest competitor for vocabulary falls short by some 500,000 words or so.

[Gormy Cuss]

68. The patient isn't the one who needs to dig through all those doctors looking for a physician.

We call optometrists "eye doctors" even though they're not MDs, we refer to dentists as Dr. X even though we know they aren't general medicine doctors, and as I noted above, we call osteopathic physicians "doctors" too. IOW, we already use the term on other medical professionals who aren't MDs.

Extending it to other highly qualified medical professionals is not that big a leap., especially since those medical professionals have a vested interest in explaining that they are NOT MDs for liability purposes if nothing else.

[MedicalAdmin]

116. Doctor is not a protected title as much as physician or surgeon.

I suggest that any MD's with their underoos in a knot over this use their protected title or physician or surgeon.

Voila! Problem solved.

[Confusious]

127. Why? are you Dr. medical admin?

The only people who should be able to call themselves doctors in a medical establishment are the ones who actually have a doctorate in medicine.

Not for the doctors, for the patients. To avoid confusion.

There are right ways to make change, there are wrong ways. Making confusion is a wrong way.

[MedicalAdmin]

129. My suggestion was a way to reduce confusion.

Whether you think that the only people who "should" be able to use the term Dr. is irrelevant. I "should" be able to win the lottery if there was any justice on the planet.... :-)

Dr. is not a completely protected title and more than MD's have earned the right by education, clinical training, and law to use that title. While I'm sorry that some don't know that, that is the fact.

However the titles physician and surgeon are reserved by title protection laws (part of licensing laws) primarily for those who are MD's.




It's reality. Sorry if that upsets your applecart. Honestly, I was trying to clarify the situation.





edit - no, I am not a Dr. I just defer to the wisdom of the Dr's I work with,, most of whom introduce themselves by their first names.

[Confusious]

130. Good luck with that

When people think doctor, they think of medical professionals with an MD.

So you want to go the hard way and change the colloquial rule for every English speaker on the planet earth, rather then a simple rule that the only person who can be called doctor in a medical establishment is an MD.

Really, clearing up confusion, or making more?

Whats next on the agenda, world peace?

The only reason I may be upset is because of obliviousness of some people to reality. It's frustrating sometimes.

[MedicalAdmin]

165. If I may suggest ...

...when YOU think doctor, YOU think MD. Other people do not necessarily think that. I know I don't. YOu are upset of an obliviousness to reality and that is understandable. Change is hard for some folks.

English is a living language and it changes. For example, a fool used to be an astute commentator of the political climate, and now it just means that you work for Fox. The times are changing and while you may not like it, it doesn't change that fact. There are MD's, DO's, ND's, DC's, DOM's, etc. The world is bigger and smaller than you want it to be and I feel that frustration, but it doesn't change the fact that things are changing.

What I am trying to do is clear up what will be growing confusion. If you need to see an MD, then request one. And one way to do that without changing laws in all 50 states is to refer to MD's as physicians or surgeons as those are already protected titles that other doctors are not allowed to use. What you are suggesting will require the changing of literally dozens of licensing laws in all 50 states and the revamping of every board and subboard of medical practice in all 50 states.

And yes, world peace is next on my agenda. What about you?

[Confusious]

175. colloquial, adjective

1. characteristic of or appropriate to ordinary or familiar conversation rather than formal speech or writing; informal.
2. involving or using conversation.

You didn't seem to know what the word meant, so I included the definition.

Which means, doctor is a colloquial usage, meaning an MD. I said nothing about changing laws, nor revamping boards.

It is a common usage of the word by the public, which, by your name, you are not.

"I have a doctors appointment." common meaning, "I'm going to see the MD"

"I have a dentists appointment" even though a dentist could be a doctor of dentistry, in common usage if you say "I have a doctors appointment" it isn't a dentist.

The only growing confusion is the people who feel the need to pad their egos by calling themselves a doctor in a doctors office.

The only problem I have with change is if it leads to a stupid outcome, in this case an outcome where everyone can feel all warm and fuzzy about themselves and have their egos stroked, even if it creates confusion.

[MedicalAdmin]

180. I think we will agree to disagree on this.

I get your point which is based on the current connotative usage of the word doctor as it is understood in your experience, an experience doubtlessly shared by many.

My point is based on the legal definition as culled from licensing and title protection. I think I may be ahead of the curve.


The bottom line that I suspect we both agree with is that medical professionals need to be clear and complete in their communication with patients. Would you agree with that?

[Confusious]

184. Your final point I can agree with. nt

[MedicalAdmin]

185. Bueno.

Now lets go get a beer and occupy some building somewhere Dr. Confusious.

:toast:

[Confusious]

186. Thats just Confusious

Not really interested in being a Dr. of anything. Have to deal with to many people. :)

And I'll take an Amber. :)

[Confusious]

128. I think it's pretentious for other people to call themselves Doctors

in a medical establishment.

You have a doctorate of physics? Fine, in your lab, or in school, I will call you doctor. The only doctors in a hospital are the ones with a medical doctorate.

[Gormy Cuss]

132. So it's not confusing for residents to be called doctors, right?

They're entitled to the title but they're not quite the same as physicians,as they're in an OJT phase, Frankly, that already dilutes the value of the term "doctor" in a hospital setting --an intern who started work today is called a doctor just the same as the attending physician.

[mainer]

133. Residents have MDs. They are doctors.

The only difference is in the licensing.

[Gormy Cuss]

154. That's a big differerence.

If it wasn't, there would be no need for three year OJT.

[alcibiades_mystery]

47. So do I

And I have a PhD

:-)

It's just confusing and silly. If I can't help somebody give birth on an airplane in flight, I don't ask people to call me "doctor." Students will address me that way from time to time, but I never request it, and I never use it as a title in written documents. To be honest, I don't even usually place "PhD" after my name on documents or anything else, as it smacks of cheap psychologists selling shitty books. Besides, Disco Stu doesn't advertise!


:-)

[mikeytherat]

86. Just the other day, "Disco Lady" is kicking it on internet radio,

and I hear my wife, in her best Disco Stu, singing, "Whoa, kids??? Back away! Not today, Disco Lady!"

mikey_the_rat

[Dreamer Tatum]

57. Actually, PhDs were called doctors first, and medical doctors coopted it.

in order to seem more prestigious.

It's true.

[EstimatedProphet]

81. No, I completely disagree

"Doctor" is a title which is conferred. MDs stole it trying to make it only about medicine in a campaign in the late 1800's as a way of bolstering their own credibility. The term "doctor" comes from the Italian "dottore" meaning one who can profess doctrine.

If I am in a professional setting such as giving a paper like I did last month, I refer to myself as Doctor. So do all of my colleagues. MDs are the only people as a whole that I have ever seen to take their title into personal life.

[LWolf]

134. I don't.

The PhD's that I've known personally invested a great deal of their lives earning the right to that title. They don't have to give it up because too many people have a limited understanding of their own language.

[white_wolf]

12. What I really want to know is this:

If you spent enough time in school to get a doctorate in nursing, then wouldn't you have been there long enough to just have gotten your MD? Maybe I'm wrong, but I would think the cost in both time and money would be very close if not the exact same.

[Liberal_in_LA]

14. no comparison - very, very difficult to get admitted to medical school, $250K in student loans

common when done. No comparison to getting a pHD. none.

[blueknight]

18. my wife

is a nurse practitioner and has a PHD in nursing. She is currently getting her PHD in education as she teaches nursing. She never ask to be called Dr, she prefers professor. But she, at one time worked in a hospital and will be the first to tell you most physicians are pompous ass pricks. And that is what this is probably REALLY about.

[MedicalAdmin]

118. +1. And yes, I am married and work for exceptions to that rule. n/t

[dflprincess]

Getting an advanced degree in nursing is not something a nurse does

because she or he did not go to medical school. Believe it or not, many nurses wanted to be nurses, not doctors, like being nurses and want to advance in that profession.

My friend just got her PhD in nursing and puts "Phd" after her name, not just to avoid confusion but because she never wanted to be an MD (and she had the grades for med school, had she wanted to go that route) and doesn't want any patient assuming she is one.

[dana_b]

30. no -they are different areas

of studies besides the actual anatomy/physiology and disease process. Nursing focuses more on direct patient care, nursing process and integrating the whole person. Doctors of medicine really specialize in health, disease and curing.

[MedicalAdmin]

119. I would edit that list down to just disease and the suppression thereof. n/t

[white_wolf]

36. Thanks for the responses everyone.

My mom is a nurse, so that's why I was asking. Oh, and based on the compliants of her days as a floor nurse in a hospital I can add to the statement that a lot of doctors are arrogant as all hell.

[Horse with no Name]

64. Not everyone wants to be an MD

I know very highly educated nurses and they enjoy THEIR profession and what they bring to their patients.

[titaniumsalute]

15. If I go to a medical doctor's office

and someone presents themselves as a "doctor" obviously it will be assumed that individual is a medical doctor. I would be beyond irrate with an individual if they presented themselves in a doctor's office as a "doctor" and thier philosophy of study was something besides medical school.

My wife has a doctorate in music. She refuses to call herself "doctor" and does not allow her students to call her "doctor." She is fine with first name, last name, professor first name, professor last name, etc.

[eridani]

17. Rachel Maddow is a doctor too

Just not THAT kind of doctor.

[AngkorWot]

19. I hold a doctorate.

I correct people every time someone calls me mister.

But I sure as wouldn't call myself doctor if I were, for some reason, treating a patient. That's just unethical.

[izquierdista]

20. Be careful what you wish for, Doc!

I'll put my PhD up against an MD in 'Medical Facts Jeopardy!' any day. I'll take 'Fungal Infections' for $200, Alex. Did I clean your clock in that category, Doc? How about 'Biochemical Pathways' then? What's that, you got a B- in that 25 years ago, that's not your specialty? How do we know that you've been keeping up with your continuing education then?

Rocket scientist, brain surgeon, nuclear physicist; these people get called "Doctor" because they are learned in their field, despite the wishes of the AMA to throw two of them out. And before you go saying a PhD is not a "real" doctor, may I remind you what you got on your last organic chemistry test, Doc?

[uppityperson]

40. In a medical, clinical or hospital setting, it is nice to be clear if someone is an MD though.

Seems even a liability issue. I worked for a clinic and caught a non-licensed person telling someone on the phone she was DrX's nurse. The clinic manager didn't have a problem with it until I mentioned liability since people assume that "nurse" in that setting should know nurse stuff and untrained unlicensed staff could get them in trouble.

Aside from legally claiming to be something they weren't. But that isn't the issue here I know.

However, in a health care setting, seems that a provider should be very upfront with their licensure if only for liability.

[countryjake]

50. Are you my sister? LOL! Make it a true daily double, Alex!

And I do agree with your assessment of this current whining rising up from the comfortable cushy realm of the AMA.

My sis has degrees up the ass, in Physiology, Endocrinology, Zoology; she has continually updated those original degrees to add even more letters behind her name and is a Professor in the School of Medicine of a prestigious university in this country, gets to decide who gets accepted and who passes or fails. For decades, if any member of our lowly bumpkin family ever forgets to introduce her as "Doctor"...oops, no final jeopardy for us!

[EstimatedProphet]

82. Hell yes!

This Doctor (parasitology) concurs!

[theoldman]

21. I have known nurses who knew more than most doctors.

I don't care what they call them self as long as they can diagnose my problem.

[krispos42]

22. How about physicians start calling themselves physicians instead?

We should shift culturally. It would make more sense.

[Liberal_in_LA]

25. good idea.

[Blue_Tires]

83. that's not a bad idea...

Why not refer to their area of expertise? (Neurologist, Internist, etc.)

[gkhouston]

107. ...in the way that other sorts of doctors do? It would make more sense. n/t

[LWolf]

136. +1

[undeterred]

24. When you are in a medical setting, you want the patient to know

what your credentials are. If you have time to explain that you are a PhD that is fine, but I think for claritys sake it is better to tell the patient you are their nurse. Its not about you, its about the patient.

[Warpy]

41. The case in point did both and that's appropriate

The prescribing pharmacists where I worked also did both. It's called "not confusing the patient."

It's not good enough for the MDs, who want their Major Deity status preserved.

Note that this is a segment of MDs. Some of the better ones are cool with it.

[Manifestor_of_Light]

26. I have a paper doctorate.

I have a Juris Doctor, or Doctor of Jurisprudence degree.

It's basically 90 semester hours of pure hell.

Took me five years going to night school. Did NOT ever get me a job.

But hey, you can call me Dr. if you like. :D

[msanthrope]

85. You could be my twin--I have the various assorted degrees you described above,

including the JD. You did night? I did half night, half day and nursed my kid in every class from Con Law to IP.

I rock on Trivial Pursuit and Jeopardy. (I KNOW the answers, Alex, I don't just read them off a card!!!)

I think it's about patient expectation--the average patient in a medical situation expects that a 'doctor' is in fact, an MD.

[Jamastiene]

150. Whassup, Doc?

:D

[rustydog]

31. Get over your hyper-inflated egos, please

OH my God, someone else can call themselves a doctor, horrors!

doctor, physicist, President, whatever, whoever you are, you will be born, live and die just like me. You are not better than me just because you have a higher education, make great income, live in a larger house in a gated community and drive luxury cars.

Only you think you are superior to Nurses, RT's Radiology techs, etc... You will die just like the lowly housekeeper, engineer and volunteer you look down your noses at every day.

[gristy]

38. Suggest you read the thread here.

Many good points are made.

[Warpy]

39. They've been tantrum throwing crybabies over every little thing

and they need to realize that they're not the only doctorate prepared people in the world.

I've worked with lots of doctors including prescribing pharmacists. The focuses were different and the care was coordinated by an MD, but the pharmy generally had the last word over things like pain control.

I think they especially despise those uppity doctorate prepared nurses because they're mostly women. Of all their caterwauling about having to share turf, the worst of it has always been directed at nurses and their expanding role in medicine.

[mainer]

101. most medical students today are women, too.

So it's not about men vs. women. It's about people who've gone to school way longer, weeded out by far tougher odds, wanting to be recognized for that achievement.

[Warpy]

106. Have you looked at how long it takes to get a PhD in nursing or pharmacology?

Please do. The odds are tough there, too, because doctorate programs are extremely limited and competition is fierce.

[gkhouston]

108. A long time and it's a buttload of work. One of the "moms" at

my daughter's school is a nurse who got her Ph.D. in nursing. It was quite a slog.

[mainer]

112. Before an MD can start practicing medicine...

4 years college
4 years medical school
3 years residency (for internal medicine)
(or 5 years for general surgery. We won't even talk about surgical subspecialties or medical subspecialties)

11 years total, just to practice as an internist. Which means the average doctor is about 28 or 29 before he can open a practice.
Neurosurgeons are about 32 or older when they hang their shingles.

Are nursing PhD's required to do a 3-year residency? I really don't know.

Really, if someone wants to practice medicine as a physician, why wouldn't he/she apply to medical school? Why choose a side-door route? It doesn't make sense to me.

[mainer]

115. Prerequisite for PhD program in nursing: 3.2 GPA

At least that's what it was at one college website. And a lot of the coursework is online.

I'm afraid that GPA would not get a student's foot in the door at a medical school. And medical school is definitely NOT online.

[DirkGently]

45. Nurses deserve more respect than they often get. But in a hospital setting, only MD's are "doctor."

For practical purposes, "Dr." PhD and "Doctor" meaning M.D. are different words. No one in a hospital should be introducing themselves as "Dr." to a patient if they're not an M.D.

My take on honorifics associated with advanced degrees is that they make sense in the context in which they apply. M.D.'s are "Doctor" in the hospital and in their other work as physicians. Practicing medicine. Writing papers. Giving presentations. Teaching class. PhDs are likewise "doctor" in their professional communications.

I never thought it made sense for anyone to introduce themselves socially with their degree-associated honorific. It's a degree. It's lovely, but it doesn't mean you've been promoted to some permanent higher social status. It's not a social title. We don't have those here. No one else does that, because it makes no sense. "Hi. I'm Associate of Arts Johnson." "B.S. Cavendish here, nice to meet you." Bit silly.

I remember a friend's father, while we were in 7th or 8th grade, introducing himself to me as "Dr." so-and-so. He was an engineer. He was an ass in general, and I will forever associate his overall inflated sense of self-importance with his referring to his PhD in introducing himself to a 13 year old.

[Liberal_in_LA]

104. There is another controversy about nurses and others wearing white coats. Doctors don't like it

[mainer]

117. A lot of doctors don't wear white coats anymore

or ties, for that matter. It seems to be the lab and x-ray techs who wear white coats nowadays.

[SwampG8r]

48. my wife while not a dr

ia an advanced nurse practitioner
she sees her own patients writes scrips whatever they need
she is a physician but she is not a dr
they are not the same
and anyone with a phd is a dr whether the prissy little mds like it or not

[GaYellowDawg]

49. I have a doctorate.

I have earned my Ph.D. and I have earned the right to be addressed as "Dr." in a classroom setting.

I wouldn't ever dream of calling myself "Dr." in a medical setting. In my opinion, it's only appropriate to address someone with an M.D. as "Dr." in that setting. I think it's misleading and risky otherwise.

It's funny - I'm in the business of teaching the basics to future medical personnel; part of my job is teaching human anatomy and physiology. I have made it crystal clear to students that I have a Ph.D. and not an M.D. and I am not medical personnel, nor am I any kind of diagnostician. That doesn't mean I haven't earned the title "Dr." in that setting. No one has any right or business telling me that I haven't, or that I'm pretentious or insecure or any of the other b.s. I've read in this thread. I ask my students to call me "Dr." but I don't correct them if they call me "Mr." - I don't need the title to be good at what I do... but no one had better tell me I can't or shouldn't use a title that I have earned.

[Lizzie Poppet]

73. Agreed: it depends on the setting.

PhD here, as well...and I also would never dream of calling myself "doctor" in a non-academic situation.

[Liberal_in_LA]

90. why do people with doctorates like to call others by their first name? We all have a title.

That's what gets me, when PHD or MD types refer to themselves as Dr. and call the rest of us, Jane or Bob.

[gkhouston]

111. The ones I know don't. In social settings, they introduce themselves

without their title. In educational settings, a fair few of them don't even use the title with their students. Some of the more formal ones do use the title with students, but often refer to the students as "Mr." or "Ms." in return.

[Trillo]

187. So you believe that customers who have paid you to teach them

also need to stroke your ego with a title?

I can certainly understand your argument if the folks you were teaching didn't pay you (or more precisely your employer, who in turn pays you). But to claim that people, who are customers, who are students, must pay you AND give you respect by addressing you with a title seems a bit 'over the top' (unreasonable).

[KT2000]

51. I am with the MD's on this

Insurance companies have been trying to reduce the power of doctors and have taken to calling them health care providers. When the power of the doctor is diminished, the power of the insurance company increases.
If the term doctor becomes a generic term, the insurance companies will be very happy about that - the medical doctors' power will be decreased further.
I want my doctor to have the power.

Calling a PhD, doctor is ridiculous. Why don't we call people Apprentice Jones or Journeyman Smith? Maybe returning vets should have a title as well because 4 years in Iraqi hell is much harder than getting a PhD.

[hunter]

53. Can't wait 'til the insurance companies start churning out their own "doctors..."

This is Dr. Scrooge. He'll be signing you out of the Intensive Care Unit today.

What, you say, where did he go to medical school? It's so hard to understand you.

Oh no, he's not that kind of doctor. but he does have a PhD in something or other.

Am I a nurse? Don't be silly. I'm an accountant.

This hospital laid off all the nurses years ago.

[KT2000]

55. Exactly

to them - everything must be meaningless, except their money.

[MedicalAdmin]

121. Not to get snarky but they don't have to do that...

... because in truth they already do. They are called Independent Medical Examiners and they are the parasitic, failed doctors who can't hold together a practice of their own who make a living taking way too much money writing "independent" reports saying no to the care your contract says you deserve.

So you see the insurance companies are already doing this using Minor Deities.

I know a few IME's who cause havok in this area and if I ever see one of them walking or jogging on the side of the road they are going to be a road pizza.

[Firebrand Gary]

54. I am also with the M.D.'s on this.

[McCamy Taylor]

56. It's a turf war. All about money. MDs are afraid that nurse practitioners will glut the market

and doctors will take a huge pay cut as they find salaried physician jobs going to lower paid nurse practitioners.

Remember, a family doctor can ask for (and receive) $150-200 K salary in private practice. (I make much, much less working at a public clinic). A nurse practitioner will make around $80k. If the clinic thinks the nurse can do what the MD can do, it will go with the nurse. Usually, there will be one MD or DO and several so called "physician extenders." Oh, and they hire medical assistants instead of nurses and call them "nurses." That keeps costs down and profits high. Or, in the case of a public clinic like the one I work at, there may not be enough physicians willing to accept the lower wages, in which case a nurse practitioner can help a lot, the demand for charity care being so high at the moment.

BTW, I am an MD, MPH so it isn't a case of sour grapes. I just know how doctors think.

Economically speaking, if we ever do get universal health care, we will have to train a bunch of physician extenders in order to meet demand, because there is already a severe primary care shortage. Either that, or import a bunch of doctors from overseas.

[renate]

78. Is that really all that NPs make?

I've seen in more than one place that dental hygienists make a median salary of $60K a year; sure, the job is kind of gross, and I'm in no way implying it's easy, but the training required is so much less in terms of both time and expense. I can't believe NPs make only $20K more. Very surprising.

[mainer]

92. Agree. Problem is, the NP's scoop up the easier patients

and the more complicated patients with multiple problems end up going to the M.D.'s, who must devote more time per patient because of their complexity.

This phenomenon means that doctors can appear less efficient because they spend so much more time per patient, their patients are sicker, and often those patients are more likely to succumb of their ailments.

When doctors and NP's go into direct competition, the doctors get the short end of the stick. NPs and MDs provide similar services If the patients involved have relatively straightforward problems (bronchitis, strep throat, etc.). But the NP's always turf their more complicated patients to M.D.'s, who soon acquire a practice of older, sicker patients. And it's not fair that M.D.'s get paid the same as NP's when the MD's have to deal with all the tough cases.

[Brother Buzz]

59. "Hi. I’m Dr. Patti McCarver, I'm not a licensed medical doctor, but I have a doctorate in medicine"

[TwilightGardener]

60. If you are in health care and refer to yourself as a doctor, you'd better have "MD" behind your name

Not a PhD in nursing, or anything else.

[Ron Green]

62. I'd rather be seen by an Osteopath

than by an M.D., in most cases.

[FarCenter]

76. Either MDs or DOs can be licensed to practice medicine, which is what you really want to know

The question is really whether the person treating you has been licensed to practice medicine.

[MedicalAdmin]

122. Why? Because you will be offended otherwise?

Wow. We need a constitutional amendment.

STAT!

[Horse with no Name]

65. I have no problem with this

She absolutely did not misrepresent herself.

She introduced her education level and then divulged her credentials.

She earned the right to be called Doctor by her dedication to her profession and her willingness to further her knowledge.

In one sentence she conveyed to her patient that she was a very well educated nurse that would be taking care of them.

I know several NP's and PA's whose patients call them "Doctor".

Psychologists call themselves "Doctor"--which is much more confusing because they can't prescribe medication.

Dentists call themselves "Doctor" although many have neither been to medical school nor have they earned a Doctorate.

[Liquorice]

66. When I go to see a doctor, I expect to see a medical doctor, and if someone

comes in the room and announces s/he is a doctor, that person KNOWS that I THINK s/he is a medical doctor. Therefore if that person is not really a medical doctor, s/he is intentionally misleading me, and I consider that a crime--impersonating a (medical) doctor. Credential snob, indeed.

I deserve to see a medical doctor when I make an appointment with a medical doctor and show up at that medical doctor's office. I don't want to be involved in some nurse's ego drama about his/her credentials either.

[Lionessa]

67. She said, "and I'm your NURSE." Do all Americans really have to be treated like imbecils?

She said she was a nurse, how complicated is that, not at all. And if she prescribed meds, I assume in her state they are meds a nurse can prescribe. The only thing I might like to have seen (and perhaps she did but it isn't noted), I would like the nurse to have asked if the patient wanted to see a physician or felt properly attended.

[MedicalAdmin]

123. " Do all Americans really have to be treated like imbeciles?"

Apparently the answer is yes. Seriously tho' where have you been since inauguration day, 1980?

White coat? Check.
Rubber tube thingy around neck? Check.
BMW in parking lot? Check.

OMG. She said she was a nurse and she identified herself as having an advanced degree. I would be fine with that.

[LWolf]

137. +1

[WinkyDink]

69. Academic Ph. D's are not confused with MD's because their paths do not cross. THIS one? IS VERY

MISLEADING TO PATIENTS.

FURTHERMORE, how exactly are "doctorates" just "popping up"? Are years fo study and the writing of dissertations involved?

[WinkyDink]

70. Do the defenders here like "Dr. Phil"'s use of "Dr."?

[w8liftinglady]

71. I'm studying to be a nurse practitioner.

That being said,I want the patients to know I am their nurse practitioner.That translates into more holistic,empathetic care.I will be "Beth" to my patients.I want that kind of open relationship.

[renate]

77. good for you!

From what you just wrote and what you've written in the past, I'm positive that you're going to be an excellent one!

I'm always extra impressed by a health professional's confidence when they use first names and DON'T need to stand on ceremony with degrees.

[Trillo]

80. Little people fighting with other little people!

It's amazing how easy it is for the PTB to "divide & conquer".

[ecstatic]

84. Interesting article. The thing that struck me was the increased requirements

for pharmacists, and now nurses and physical therapists over the years. I guess the powers that be feel that too many people are entering those fields and they want to raise the bar??

[Liberal_in_LA]

88. credential creep. Soon you'll need a degree to most full time jobs...ooops. already happened.

[Javaman]

89. I have two friends who have their doctorate...

neither refer to themselves as "doctor".

I think in a hospital situation, unless you are a medical doctor, can you use the title.

[TransitJohn]

91. I didn't spend 6 years in evil medical school

to be called mister!

[Avalux]

93. Well, I agree with physicians on this....

A medical degree (MD) is different than a PhD...no clinical experience. This difference is particularly important in a clinical setting where patients are being treated. It should be clear who has received an MD and has the knowledge that comes along with it (and treatment experience). Unless this nurse attended medical school/residency program, she should not be telling patients to call her Dr.

[Maine_Nurse]

105. Actually, there are nursing practice doctorates (DNP)

Remember that a bachelors in nursing starts with doing actual patient care in the freshman or sophomore year. MD's don't do any patient care until grad school. A DNP is solely about practice, not research or education. It is very different than a PhD. I do agree that there is a possible confusion problem and wouldn't refer to myself as doctor in a clinical situation, but don't say that only MDs have clinical experience when DNP's start their patient care far earlier than MDs do.

[Avalux]

141. Good point.

However it stacks up though; a DNP is still not equivalent to an MD.

[Carolina]

94. I am with the MDs on this

There is a reason for the years of school plus postgraduate specialty training plus board certification plus recertification!

The PhD in neurobiology is not the one who treats you for your headaches, seizures, potential stroke...

The PhD in neurobiology is not the one who operates on your aneurysm or brain tumor or Chiari malformation

The NP is not the one who does the Cesarean section when mother nature goes south during labor

Your fractured limbs, osteoarthritic knees and hips ... are not surgically repaired/replaced by the PhD anatomist

The list goes on and on, but the MDs pay the high liability insurance because when things go awry with the PAs, NPs and other "doctors," the MDs clean up the mess.

[Horse with no Name]

96. And then who cleans up when the MD's make the mess?

:eyes:

By their licensure, they can make a much bigger mess than ANY of the ones you mentioned...in fact, they can and do kill people.

You do know that every PA and every NP has an MD that is supervising them???

[mainer]

100. NPs are agitating to not have MDs supervise them

They want to be independent of physicians.

[MedicalAdmin]

124. Horsepucky.

Yes, PA's, NP's and other doctors have things go awry, but the reason that MD's have such high liability insurance is because MD also make a large number of mistakes.

And yes, I run a clinic and yes I price the malpractice and liability insurance. And yes, we see patients who got less than stellar advice from less credentialed and experienced practitioners who made mistakes, but truthfully we see more patients that we misdiagnosed and screwed up by MD's than any other professional degreed medical professional. EVERY licensed practitioner carries their own insurance.

Insurance is based on the profession, not on how many patients you pick up from other professions. Sheesh.

[mainer]

126. MD's get the more seriously ill and complicated patients

NPs and PAs get the straightforward patients with self-limited illnesses. They usually refer the really sick people to the MDs.

Unfair to compare MDs to NPs who get to turf their sickest patients to doctors.

[MedicalAdmin]

157. It is fair.

ANd it is fair only in the limited way that I was only trying to respond to the specious linking of insurance rates and complications of patient load. Malpractice rates are based primarily on the number and cost of mistakes. Granted there are more and higher cost mistakes made with the more serious cases, but to say that the only reason is the difficulty of the cases, unless they are also claiming that Doctors should have a diminished expectation of efficacy because of their increased knowledge and training.

Increased scope of practice carries with it an increased expectation of competency and professional acumen.

On of the main reasons for the high malpractice rates for some types of MD's has to do with the forced number of patients physicians are forced to see due to the costs associated with working with insurance companies. Many of them are forced to churn and burn daily just to make payroll. One wise solution to both malpractice costs and the overwork and mistakes inherent in private insurance in the US would be a single payer system.

I hope this info helps.

[mainer]

164. Neurosurgery and high-risk obstetrics have high malpractice rates

because those patients are far more likely to have bad outcomes. Not because doctors have to see more of them per hour.

If medical errors were simply a matter of doctors forced to churn through too many patients per hour, then primary care would be the ones with the highest rate of malpractice suits.

I agree that increased scope of practice carries with it an increased expectation of competency. So NPs, with restricted areas of competency, skim off the patients who are least likely to have poor outcomes. They turf the poor-outcome patients to the M.D.s. And this skews any malpractice statistics.

I'm not sure how single payer is going to change that.

[MedicalAdmin]

167. I can help with that.

The main cost of malpractice suits is the cost of ongoing care for the patient with a bad outcome. (BTW - good point about the high risk subspecialization - of course part of the reason for that high risk is that the therapies they have decided to use have a high percentage of bad outcomes and (at least when compared to international statistics) are not necessarily the best first choices. For example, the number of C-sections and induced births in the US is WAY above the international norms for those proceedures and the outcomes are correspondingly worse - all too often the procedures in these cases are put in place for the convenience of the physician)Of course exemptions abound. --- sorry about that rant - apparently I need to get back on that ADD med)

:)

Back to malpractice. By shifting the main cost of ongoing medical care onto a single payer system where everyone is covered no matter what, those costs are no longer a factor in the malpractice insurance costs. Lower costs = lower premiums.

I looked into costs in Canada a few years ago including Malpractice insurance and it is about 10% of what we pay here for better coverage.

[Carolina]

172. Medical administrators

are part of the problem for us all... patients and practitioners alike

[MedicalAdmin]

174. Some of the them are. I would daresay almost all of them.

In my case I own a chunk of the low cost clinic I help manage. And I haven't drawn a salary in years in order to make sure that my staff gets paid when times got tough. We didn't fire anyone and we work our asses off to make sure that EVERYONE who comes to us gets the treatment they deserve. We don't turn anyone away and we are a private clinic. We don't get a dime of public money unlike twinkle toes bachmann and associates who are there to pray the gay away.

I hope that meets with your stamp of approval, but if not then too darned bad.

I have fought this fight when I worked for BC/BS and I have fought this at our state legislature to make sure that the care that Minnesotans deserve and need is the care they get. And I'll keep fighting this fight for as long as can and need to.

Yes, corporate administrators and those private ones who are only in it for their next BMW are part of the problem, but please don't use an attack the messenger tactic when you should be debating the message. If my message lacks validity feel free to point it out.

[AngryAmish]

95. 1. Nurse practioners are a good thing and we need more of them

2. In a hosital/clinic setting folks who are not MDs should not use "doctor". It is confusing.

3. Interesting question if someone who is a neuropsychologist or the like should use doctor.

Before I graduated I was joking with a friend that they should call me doctor after I graduated (I was getting a JD not a MD). My friend who was studying for his MBA said "Sure, I'll call you doctor. But you have to call me master when I graduate."

[Liberal_in_LA]

103. Love nurse practitioners

[Lucian]

97. Calling themselves a Doctor when they aren't medical doctors is very misleading.

When I go to see a doctor, I want to see a medical doctor, not someone who got a Ph.D. in whatever and didn't go to med school or do the training.

They need a different title.

[COLGATE4]

98. You also have to add to that the fact that many (if not most) medical

consults are stressful for the patient. He/she may not hear things as clearly as we might suppose. If we add to that the practice many nurses have of wearing the long white lab coats (generally reserved for physicians) AND add the token introduction that "I'm Doctor Susie, your nurse", you're begging for the patient to be totally confused as to who's treating him/her. And, if you don't believe it, believe this - my daughter is an M.D. Her lab coat says "Dr. XXX XXXX, M.D. on it as does her billboard size hospital I.D. She always introduces herself to her patients as, "Hello, I'm Doctor XXX". Nonetheless, about 98 times out of 100 the patients think she's a nurse.

[Lucian]

99. Yeah, and one would think that hospitals and clinics would have something against this.

I mean, if someone gets diagnosed with something, (or if they got misdiagnosed) by someone who isn't a medical doctor, couldn't the hospital/clinic be held liable?

[MedicalAdmin]

125. Oh my freaking god.

Every license has a clearly defined scope of practice that outlines exactly what they can and cannot do.

IF it is in their license to diagnose then this is not an issue. The issue is about practice outside of ones scope of practice or, more often, not referring when one is out of ones depth. And that is a problem in many fields.

[Lucian]

131. You don't understand this at all.

I want to see a MEDICAL DOCTOR. Not a freaking NURSE with a Ph.D.

[LWolf]

138. And nurses having Ph.D.s stop you from doing this...how? nt

[Lucian]

147. Nurses with Ph.D.s are NOT the same as medical doctors.

Gah. Were you people dropped on your head as infants?

[KatyMan]

156. No shit. Nobody said they were.

And they don't claim to be.

[Lucian]

160. Uh, nurses going into a room and calling themselves "Dr. XXX" is misleading.

There is a huge difference between a medical doctor and a nurse with a PhD.

[KatyMan]

163. Sure there is. Nobody says there isn't.

And any nurse that's a PhD that introduces themselves as Doctor XXX says they're a nurse in the very same breath.
I'm kind of surprised at the way some are perpetuating the "Doctors are god" stereotype, and buying in to the whole misogynistic mess that is the medical world. If some folks on this thread actually knew any nurses, they'd be singing a whole different tune.

[LWolf]

177. Of course they're not.

I never remotely suggested that they were.

I simply pointed out that their existence wouldn't hinder your goal to be treated by an M.D..

[MedicalAdmin]

155. The answer is simple.

Request one when you set up your appointment. It really is that simple. Just ask a few questions and be clear about your expectations.




If you want to make assumptions when it comes to your care, then that is your issue, not the clinics. MD's do not own the doctor name anymore. That is reality. Adapt to it.


Honestly I understand your point. Just make sure you make it to the people booking your appointment or seeing you and it will be handled correctly. Or at least it will at my clinic.


Good luck.

[mainer]

135. Lest we forget what goes into being a practicing MD:

4 years of college.
4 years of medical school.
3 (minimum) years of residency training. (It's 5 years for general surgery, plus additional years if you go into a sub-specialty)
Total: 11 or more years.

And these are not "online courses" that I see featured in so many nursing PhD programs.

In addition, MDs MUST pass medical licensure exams, part 1 and 2. These are extensive exams. Part 1 covers anatomy, physiology, pharmacology,biochemistry, microbiology, etc. Part 2 covers clinical sciences.

Also must pass board exams for their specialty. Most hospitals will not give admitting privileges to doctors who have not passed their specialty boards.

It's untrue that NPs know as much as doctors. They don't. And if they want to prove this and earn the same pay as MDs, then I suggest NP's pass the medical licensure exams and board exams.

Otherwise, it's like saying that legal secretaries can practice law without ever having passed the bar.

[KatyMan]

139. Nurses are hardly secretaries

and a nurse with a PhD is a pretty freakin well educated person. Five years out of school, a nurse with a PhD has seen way more patients than an MD.
You don't think nurses have to pass rigorous state exams?
NPs don't claim to be medical doctors, and a PhD is not required. A nurse with a PhD would outrank most medical doctors in any given hospital; they are departments heads, etc.

[mainer]

144. If they want to practice medicine LIKE MDs, pass the MD exams

That's all I'm saying.

The problem is that NPs claim they can do everything a doctor can do, and that their education is equivalent.

It is not.

[w8liftinglady]

162. wrong.

Nurse practitioners provide advanced nursing care,including prescription priviledges.
For example, upon graduation, I plan to open a primary care clinic for uninsured people with chronic diseases(diabetes,hypertension,high cholestrol,COPD)...which will include all modalities- dietary,psychological,social,and medical.It will involve families in treatment plans.It will provide resources for follow-up care and counseling.

Just like the doctor's office?

I WILL be able to prescribe.I will also refer to medicine when needed.

[mainer]

166. No, that's not like an MD practice.

What you'll be doing is exactly what an NP is well-suited for, and that's management of uncomplicated chronic diseases and coordinating family and community support. But once that COPD patient's blood gas drops and he turns into a blue bloater or needs intubation and a ventilator, I would hope the NP will admit that, no, she is not an M.D. and that her training does not prepare her to do what MDs do.

[w8liftinglady]

168. do you honestly think that is what a nurse practitioner would do?

I was the head nurse of the respiratory ICU at a large dallas hospital for 5 years, so yes, I believe I'd have a glimmer of sense upon when to refer a patient to an emergency room.
Any idea why it took a second opinion and multiple ER visits to determine that
1.I needed a pacemaker... and
2. I needed brain surgery?
because doctors aren't God....and some listen to their nurses....and some don't.

[mainer]

169. I would hope not. But please don't say the degrees are equivalent.

I hear too many claiming that an NP's education is as good as an MD, so they should have the same rights to hang a shingle and prescribe meds. Or that nurses make fewer mistakes than doctors. Or that NPs should be paid the same as MDs because they perform the same work. Or that nurses are superior to MDs because MDs are arrogant. Arrogance does not = incompetence.

NPs have an important role in caring for patients. But if a nurse wants to do the work of an MD, I suggest going to medical school. Because a PhD is not the same thing.

[w8liftinglady]

170. so you don't think I'll be competant.Thanks a lot

[mainer]

171. Where did I say that?

[WolverineDG]

152. Just wait til lawyers start using "Dr."

:evilgrin: :rofl:

dg

[Manifestor_of_Light]

159. There was a crazy old judge in Houston who did that.

He was nuts.
He made the lawyers address each other as doctor, and had signs on each table saying "Plaintiff" and "Defendant".

The old bastard sued his OWN court reporter, filed criminal charges against her of some kind. Fortunately the old bastard is dead. His first name was Jerry, I don't remember his last name. This asshole had a Civil District Court.

[WolverineDG]

173. At least he didn't make attorneys talk to hand puppets

as one infamous judge in Hidalgo County did. :crazy:

dg

[PCIntern]

161. what about we dentists?

We're on Angie's list just like the plumbers - no one ever doesn't call us Dr. We prescribe...but make no mistake: we are never confused for MD's and make sure that people know. the last thing you want to be called on is credentialling: it's embarassing and stupid. If someone says to me, "I heard that man call you doctor." I reply, "Actually, I'm a dentist." I would never ever introduce myself to someone professionally outside of my office as "Dr." without modifying the implication. It's unethical and not right besides.

[Throd]

176. How do they feel about Dr. Dre?

[msanthrope]

181. They think he just frackin' release 'Detox' already....nt

[Liberal_in_LA]

182. or Dr. Love? Radio host in LA in the 90s. The Dr. of Looooove.

[tawadi]

183. Oh, for fuck's sake. Physicians need to get over themselves.

:eyes: