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FROM THE FIELD
Statement by the American College of Clinicians
Adopted (October 6, 2008).
"The Use of the Term Doctor in the Clinical Setting".
The word doctor has been associated with physicians for many years. Doctor is Latin for "to teach" but this literal meaning did not place the word into general public use. More likely, it was the fact that medical practitioners were among the first of several groups to attain a doctorate as the terminal degree. Unlike other doctoral professions, medical doctors began to interface with the general public in larger and larger numbers. Thus the use of the title Dr. became more commonplace.
Historically, the title doctor has never been exclusively used to describe medical doctors, as the degree awarded by many professions confers this title as well. We all know of "doctors" outside of health care (Juris Doctor, Doctor of Divinity, Doctor of Philosophy). Within the healthcare world the public generally has associated the term doctor with physicians or with those people who provide them with medical or health care advice and treatment. In the middle of the 20th century, many neighborhood pharmacists who commonly dispensed medication, medical advice and treatment were affectionately called "doc". And for almost as long medics and corpsmen in all branches of our armed services have been addressed as "doc".
Today, many healthcare professionals besides physicians possess a doctorate. A more varied group of clinical professionals will possess this degree in the future. For many years' psychologists, nurses, clinical social workers, pharmacists, physical therapists, podiatrists, optometrists, nurse practitioners and physician assistants have obtained the highest level of education possible in their field and have been granted doctorates.
Several professions have recently announced that the doctorate is to become the entry level degree for their professional practice. We predict that over the next decade most professions that prescribe diagnose or treat patients will likely require a doctorate to practice. These professions will have a significant number of clinicians practicing at the doctorate level.
Understandably, physicians are concerned about this shift and the confusion it brings. We understand their concern in regard to the use of the term doctor. The American Medical Association has considered adopting official positions that would restrict the use of the term doctor to physicians, dentists and podiatrists (and also restrict the terms "resident" and "residency"). We ask how this would be achieved as no profession can own an academic title? It is the belief of organized medicine that the use of the term doctor by other health care professions will create confusion. We agree with this assertion, as even positive change can be confusing. What we do not agree with is that this temporary period of confusion will result in any significant disruption or decrease in the quality of healthcare that is provided.
We also do not agree with the view that many physicians espouse; that other professionals want to earn a doctorate because they want to be somehow viewed as a physician. State laws protect titles such as physician and any undesignated person who uses the title physician is breaking those laws. The ACC agrees strongly that it is inappropriate to violate title protection in any form. However, the ACC also recognizes the critical difference between the word physician and the use of the title Dr.
The American College of Clinicians believes that the title doctor may be used by all clinicians who have earned a doctorate and who choose to do so. It is a right they have earned. We also believe no one profession owns an educational degree (be it clinical or non-clinical, degree or title) especially at the doctoral level The realities of the healthcare world of the 21st century need to reflect this fact.
The College also believes that to minimize confusion, all healthcare professionals should identify themselves and their profession when first meeting a patient. All professionals, should wear a name tag which is in full view of the patient at all times when practicing in the appropriate circumstances and in the appropriate dress. This policy of identification with an appropriate badge or name tag should also include physicians, as patients encounter a number of different practitioners. We recognize that many institutions require clear identification, and seek this practice to expand into more practice venues. Lastly, we urge all health care professionals to use the word physician when describing someone who has a medical degree. Too many health care professionals continue to substitute the word "doctor" when they mean physician, even though they realize that many health care professionals have clinical doctorates. This simple change in description will enable patients to more readily understand the complexities of our evolving health care system and recognize the contributions of all the members of the health care team.
We urge the same response of health care administrators, the pharmaceutical industry and others who can have a positive influence on this problem. It is our wish to begin an open dialogue about this issue which would hopefully lead to an increased understanding of the contribution of all professionals involved in patient care.
The American College of Clinicians is a national professional organization that represents nurse practitioners and physician assistants. www.amcollege.org
Robert M. Blumm, MA, PA-C, DFAAPA
Immediate Past President, American College of Clinicians
He that gives good advice builds with one hand; he that gives good counsel and example builds with both.
- Francis Bacon
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