Strike While the Iron is Hot: Defining Doctor

So, we’ve all seen the news story Families sound the alarm on medical transparency after deaths of their childrenI just wrote about it in my last blog “Sophia the Worst. Well, turns out, other news stations caught on and aired the headline as well. Referenced in Reddit is a story about this story from WPTV News Channel 5, West Palm Beach Florida Defining Doctor. It focuses on the two cases highlighted in the original story but also speaks to the topic of using the title “Doctor” in a clinical setting. This video also highlights the training difference between physicians and NPs in addition to speaking about a pending law in Florida to make it illegal to use the term doctor in a clinical setting for NPs. The video also highlights how “online diploma mills” have low admission criteria and can be completed in a short period of time. Of course, the story interviews those that feel entitled to be able to use the term “doctor” in a clinical setting. One says, “my degree title says doctor of nursing practice.” But what she fails to realize is that the same could be said about Ross from the Friends TV show who had a Ph.D. Doctor of Philosophy, but we all have seen the meme whereby Rachel hushes him and says for him to be quiet as that means something different in a hospital. What she also fails to realize is that the curriculum of the DNP is less than rigorous and lax for doctoral level work when compared to actual PhDs or MD/DO. The story also speaks to that patients often don’t know who is treating them especially if the patient only hears the word “doctor.” The story references Florida Senate Bill 612, which initially appeared in 2013 but will soon be up for debate again.

Sophia the Worst says in the video that “Doctor is an academic title.” She says, “doctor doesn’t mean physician.” She says, “the physician world doesn’t own the term doctor.” Which of course in an academic setting that is true. For example, on college campuses, professors often use the “Doctor” title. But in a heath care setting, the most common connotation is that doctor means physician. The story highlights this lack of transparency seen in healthcare today. It seems that everyone in healthcare wants to be seen as important, which is fine. Everyone does have a role from the CNA, to the unit secretary, to the lab tech, to the RN etc., and everybody is important. However, the character of heath care players is starting to wane such that everyone is now entitled to wear the white coat, park in physician parking, eat in the physician lounge etc. These are just a few of my pet peeves, but bigger than these small items, I think they represent a bigger systemic problem in health care today. This being the out-of-control expansion of scope of practice and encroachment on the physician scope of practice and nomenclature by those that call themselves Advance Practice Providers (APPs). Now, many have just skipped that and end up calling themselves and advertise themselves as “Doctors.” The story referenced the Alexis Ochoa case that the NP introduced herself as the “attending physician” to the patient’s mother. I mean come on, attending physician?? Advanced compared to what anyway? Being a former NP, this terminology irks me as well as. I will state emphatically that I was not more advanced than a physician in terms of medical education and training so what the heck is the word advanced all about if not to simply confuse the public? But I digress, back to the video, this video and topic seems to be catching on and the truth will come out. And speaking of truth………..

The AMA has a Truth in Advertising statement that reads: 

“The AMA Truth in Advertising Campaign is designed to ensure health care providers clearly and honestly state their level of training, education and licensing. Patients deserve to have this information when in face-to-face encounters as well as when they read health care providers’ advertising, marketing and other communications materials.

Patients are confused about the qualifications of different health care professionals. Many non-physicians earn advanced degrees, and many of those degree programs now confer the title “doctor.” As a result, patients often mistakenly believe they are meeting with physicians (medical doctors or doctors of osteopathic medicine) when they are not.”

The AAEM has a position statement titled Updated Position Statement on Non-Physician Practitioners:

Every practitioner in an ED has a moral duty to clearly inform the patient of his/her training and qualifications to provide emergency care. In the interest of transparency, NPPs must not be called “doctor” in the clinical setting.

I don’t know where the following quote comes from, but it’s almost proverb like in quality, and I’m too tired to search, but it goes something like this: “They’re going to try every way they know to put lipstick on this pig, but you know when you put lipstick on a pig, at the end of the day, it’s still a pig.” I just wish the lies and BS would stop.

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