Wednesday, November 09, 2005
  The "Doctor" Difference
I must admit that I've been reading the forums too much and my perceptions have probably been just a bit jaded by some of the things I've read there. I already know that I am quite cynical by nature... I think I was born that way :)

Bear with me, I'm coming to my point:

About every week, there is an argument about who should or should not be called "doctor." I'm sick and tired of it and I think the term doctor should be abandoned completely.

Once upon a time, doctor meant teacher and friend. Somehow, over time, it has come to mean something more (or less, depending on your point of view). A doctor was a family friend (every family's friend, actually) who would take care of anyone because they needed the care. He was given respect for what he did and his willingness to come out at anytime, day or night, whenever he was needed.

Progressively, however, doctor has come to mean less and less friend and more and more a demand for respect, whether it was earned or not. I've written about this before - see this link for the previous post.

Now, there is concern, given the fact that patients are confused by numerous health care providers and hospital workers (nurses, techs, physical therapists, nutritionists, pharmacists, social workers, housekeeping, dietary, NPs, PAs, and physicians) and begin to call all of them "doctor." Is there anything wrong with this? Yes and no. There is nothing wrong with it if the person corrects the patient and says "No, I'm not your doctor - I'm the nurse/dietitian/etc." What commonly happens, however, is the person does not correct the patient and merely goes about his/her job until finished and leaves the room. This creates confusion when the actual physician enters the room to evaluate the patient and the patient asks about something they told/asked that "other doctor" who was in fact housekeeping. See the problem?

The other complaint is what does one call a Ph.D? Ph.D is a doctorate degree and the person has the right to be called doctor, since they are a teacher, right? However, what happens if you have a RN, Ph.D? Is it then Doctor-nurse? While the nurse may have a doctorate degree in nursing, in the clinical setting he/she is not a clinical "doctor." More confusion for everyone, especially the poor patient. Consider all the other permutations - a Pharmacist who is a PharmD or a psychologist who has a PsyD, etc, etc. It only gets worse and worse with time.

My solution: noone is called "doctor" and everyone goes back to their proper titles. What was "doctor" is now "physician," PA is "physician assistant," NP is "nurse practitioner," etc. Ph.Ds will be called "professor," since Ph.D is a teaching or research degree and that is what college teachers are called. RN, Ph.Ds will be called "nurse" or "nurse practitioner" (depending on his/her training) in the clinical setting and "professor" in the research or teaching environment. Everyone will have the option of being called by his/her first and last name, however, so long as your job is clearly explained and displayed for the patient.

This will alleviate a lot of problems of confusion for everyone, and will stop some midlevel providers from trying to back-door their way into the title of "doctor" in an attempt to legitimize their plea for independent practice rights.
Ahhhhh.. 4th year. If the rumours are true, this will be a cake walk. Herein is my online account of my 4th year of medical school - follow with me to see if the hype is true or lie.

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