Nurses that earn doctorate degrees deserve the title "doctor"

I was concerned and disappointed upon reading an article recently published in the New York Times, about a trivial but apparently important topic to physicians — the use of the word “doctor.”

Apparently, some physician groups are advocating for legislation to prevent nurses and other health-care professionals that have received doctoral level education from identifying with their earned credentials, unless an immediate explanation stating that they are not physicians follows. 

I find this obtrusive and offensive. I did not return to graduate school 18 years after I earned my masters degree to become a nurse practitioner, so I could trick my patients into believing that I am a physician. I am a nurse, an advanced practice nurse and a nurse practitioner.  I do not masquerade as a physician, nor do I wish to be one. 

I introduce myself to new patients as “Dr. Waldrop, your nurse practitioner, ” because I am proud both of my degree and my profession, and I want my patients to know that I function at the highest level possible in my profession. I do not need a law to tell me how to represent myself.

Patient confusion is one of the reasons stated in the article for the need to differentiate between physician and nurse doctors. I guess there might be some people who only associate the term doctor with physicians, but I am sure that many will appreciate knowing that their nurse is prepared to provide care to the best of his or her ability.

Another insinuation in the article is that nurses wish to earn doctoral degrees so that they can demand more money.  I like to believe that most health care providers chose their profession out of a desire to care for patients and that this ability can be improved by acquiring more knowledge about the profession, instead of limiting skills to direct patient care only. 

Nurse practitioners have consistently demonstrated that they can provide care equal or better in quality to care provided by physicians within their scope of practice. But in today's healthcare arena, advanced practice nurses must also know more than just research and evidence-based care guidelines.

Advanced practice nurses must understand the roles that organizations, politics, outcomes evaluation, quality improvement and patient safety play in the healthcare profession to be able to effect change at higher levels.

Another concern of physician groups is that state legislatures will become convinced that nurses that have earned a doctoral degree should be able to treat patients without physician supervision. In fact, this has already occurred in many states even before the American Association of Colleges of Nurses recommended that advance practice nurses be required to earn a doctoral degree.

Furthermore, removing scope of practice barriers to allow advanced practice nurses to practice to the full extent of their education and training is part of recent Institute of Medicine recommendations to reduce the costs and improve the quality of health care.

Perhaps demonstrating that a collaborative approach to health care is the best model and demonstrating respect for what each group brings to patients' health and wellness is the best route to follow in the future.

Julee B. Waldrop, DNP, FNP, PNP, is the Director of the MSN-DNP Program and an associate professor at the University of Central Florida. She provides health care to children at a local community health center.

Further reading:

Newhouse, R et al. “Advanced practice nurse outcomes 1990-2008: A systematic review.” Nursing Economic$. 2011;29(5):1-22.

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