Dr. Duck: Professional Appropriator

No, this is not about duck calling, Duck Dynasty, or referencing to professional appropriators as quacks, it’s about a particular posting floating around social media recently. I’m not pasting the internet link to the posting to respect the privacy of and to respect the man in reference. I think doxing is cowardly and wrong. This blog is about terminology used in the posting that seems by design to confuse the lay public:  

Dr. Duck is fellowship trained in orthopedic surgery which is an achievement that only 4% of physician assistants currently practicing in orthopedics accomplish.

&

His Master of Physician Assistant Studies and Bachelor of Science degrees were both completed at the University of Nebraska College of Medicine through the IPAP.

&

holds an additional certification in orthopedic surgery through NCCPA’s Certificate of Added Qualification (CAQ)

Hold the phone!

Here’s the problems:

First – using the title of “doctor” for other than a physician in a clinical setting. The posting then goes on reporting “Dr. Duck completed his Doctor of Medical Science degree from the University of Lynchburg.” Often, mid-level providers with doctorate degrees introduce themselves as “doctors” which confuses the public who often don’t know the difference on who is treating them.  Yes, Dr. Duck, you earned a doctorate degree and by rights in an academic setting can refer to yourself as ‘doctor,’ but in a clinical setting, it’s a different story. This is professional appropriation at its finest. Why is this bad? 

There is no equivalency between a physician and a nonphysician health professional. This does not mean that nonphysicians are not valued members of the health care team (they are), or that there isn’t a need for their services (there is), and I certainly am not attempting to diminish their skills and talents. However, it is a demonstrable fact that every physician, regardless of specialty, has successfully achieved significantly more hours of didactic and clinical education than every nonphysician provider. (https://www.aafp.org/news/blogs/inthetrenches/entry/20190903itt-differences.html)

ACEP strongly opposes the use of the term “doctor” by other professionals in the clinical setting, including by those with independent practice, where there is strong potential to mislead patients into perceiving they are being treated by a physician. https://www.acep.org/patient-care/policy-statements/use-of-the-title-doctor-in-the-clinical-setting/

Second – “fellowship trained” – this medical terminology is hijacked from the term ACGME accredited fellowship which after a residency indicates further specialty training in orthopedic surgery. The fact that there are programs being called ‘fellowships’ such as https://school.wakehealth.edu/Education-and-Training/Residencies-and-Fellowships/Orthopaedic-PA-Fellowship, goes to show the problem is not only at the individual level, it is at the level of professional organizations. Everyone wants to confuse the public to equate themselves to physicians, or worse that they. Why else would one appropriate medicine and physician terms? Can you imagine poor old little Mrs. Jones, 85 y/o and breaks her hip going to the clinic thinking she is seeing a physician, real orthopedic surgeon? She wouldn’t know the difference. I think this is by design. 

Third, “orthopedic surgery”?? Really? Can this get any more blatant? Orthopedic surgery or any surgery is a privilege for surgeons only, ACGME residency and fellowship trained. That there are professional certifications in ‘orthopedic surgery’ also goes to show that professional appropriation is at the systemic level.  https://www.nccpa.net/orthopaedicsurgery

Forth, “College of Medicine” – No, Dr. Duck! You did not go to medical school. You went to University of Nebraska, College of Allied Health Professions Interservice Physician Assistant Program (IPAP) (https://www.unmc.edu/alliedhealth/education/pa/ipap.html).

At this point, it’s fair to ask, what’s the point? What’s the point of referencing yourself with all the appropriated physician terminology? Everyone wants to promote themselves with the esteem of a being a physician or to confuse that they are physicians. Why else use all the medicine and ACGME terminology? This needs to stop!

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Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.

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7 Responses

  1. David Adcock says:

    Once upon a time in Georgia it was illegal (besides being unethical) for anyone with other than MD or DO after their name, and a Georgia license to practice medicine, to refer to themselves or allow themselves to be referred to as “doctor” in a health care setting. This includes one well known PA in north Georgia who had a PhD. He egregiously referred to himself as “doctor” and many patients actually thought he was an MD. Yes, the goal is to confuse, and gain the respect and trust given to doctors without going to the expense, commitment and effort to earn that respect and trust.

  2. Sir Lance-a-lot says:

    Not sure what state this is in, but most states have laws that explicitly ban using the title “Doctor” in medical settings if you’re not one.

    I’d send a note to that state’s medical board, PA board, and Attorney General and see what happens.

    • arf says:

      Tried that in my state. A nurse practitioner was calling herself “doctor” with some doctorate of nursing practice. Lots of language on cards and signage “psychiatric services”, “psychiatry”.

      So walk into building, follow signage to get to office, pick up business cards, all the way it’s “DOCTOR Smith”, “Psychiatry”, “Psychiatric Services”, and then you wonder why patients say they have seen a psychiatrist.

      YES, I complained to the medical board, with documentation of all that was said here, plus copies of public advertising.

      The gutless wonders at the Board. She’s not a doctor, so not our jurisdiction. Talk to the Nursing Board.

      THAT is what they said. So, by that logic, my brother the accountant could advertise as a neurosurgeon. I guess if some patient got trephined by a CPA, not that my brother would dream of doing such a thing, the Board would say talk to the Accounting Board.

      The Accounting Board in turn would say, brother is duly licensed as a CPA, and the Board would not be interested in any other credential my brother would claim to have. Same as a nurse I suppose.

      Now if I put up signage saying “Podiatry”, “Podiatric Services”, because I took off an ingrown toenail, what do you thing the Board would do to me if the Podiatry Board complained.

      Oh, and in my state, it IS illegal for anyone, including me, to hold out to the public as a “psychologist”, unless licensed as such. If that nurse practitioner had advertised as “psychology”, or “psychological services”, she would have been in trouble.

      But PSYCHIATRY is OK.

      • arf says:

        Oh, and nurse practitioner with “psychiatry” and “psychiatric services” signage and business cards, my patients saying they have seen a psychiatrist.

        The Nursing Board said it was not the nurse’s fault that the patient misunderstood.

  3. Debbie Fletcher says:

    Agreed! How can we stop it? They do not seem to think the ACEP policy statement is meaningful to them. Does this need to be accomplished by laws at the state level?

    • Natalie Newman, MD says:

      An umbrella organization is not a regulatory agency. I would suggest checking the BOM website of your state, put “doctor” or “physician” in the search engine and it should bring you to the business and professions code for physicians. Somewhere in that hodgepodge is information on who can use the title “doctor”, “M.D.”, “Dr.”, etc. It may not be specific as stating NPs/PAs cannot use it in a healthcare and/or clinical setting; however, if it states only those with a license that says one is a a “physician and surgeon” can use those titles, it is essentially excluding anyone else.

      If you find an ad in which a NPP is misrepresenting him or herself, screenshot and file a complaint with the BOM or the agency that oversees all licensing bodies for that state.

  4. Harrietta Christodoulos says:

    Wow, that is really shocking

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