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Is Your Nurse a Doctor? (Or is the Person You Call Doctor Really a Nurse?)

By October 7, 2011

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Titles have always been important in healthcare. A title is supposed to address someone's capability of taking care of us. An MD has a certain level of expertise, a nurse has a certain level of expertise.... "Doctor John Brown" would presumably have more knowledge about diagnosing and treating than "Nurse Nancy Green" - and so forth....

Or... maybe not?

Why is it we call a doctor, "doctor" and we call a nurse by his or her first name? Why do we call a nurse practitioner who has been practicing for 20 years by her first name - vs - calling a new medical resident "doctor" because she has, by virtue of the fact that she has completed four years of medical school, earned the title?

And now a relatively new phenomenon, as the New York Times pointed out, what do we call the nurse who has earned a PhD, and has, according to the academic pecking order, therefore earned the title "doctor"? Is she Dr. Green? Or is she Nurse Nancy, or just plain Nancy?

As I read the NYT article, I had to think about it. What IS in a name? And who really cares?

It struck me that the people who care are the people concerned with that pecking order. I believe it's mostly the professionals themselves who are concerned with it - not us patients. Why is that so important to them?

If this fellow named Jeffrey Smith is a board certified neurologist, will I get better care from him because he is Dr. Smith as opposed to Jeffrey? If he just earned that board certification last week, will I get better care from him than from a nurse named Nancy Green, who is called Nancy, and who has been a neurology nurse practitioner for twenty years? If she earns a PhD, will I get better care from her just because I can call her Dr. Green?

What IS in a title? We may think a title by itself provides some knowledge about the capability of the person who holds the title. It may hold some, but just by the questions above, clearly it may not hold what we think it does.

Further, even within the titles we know and hear, there are many additional levels of expertise - doctors may also be attendings, residents and fellows. Nurses may also be nurse practitioners or PhD-type doctors. Assistants to physicians or medical assistants - or physician assistants?


Most of us patients are clueless about the differences among those titles. And the truth is - for myself, I don't care what you call the person, I just want to know that person can help me with the aspects of care I need help with.

If you believe that's true as well, then you may want to begin double checking on the capabilities of your providers and not rely just on their titles.

How? If it's someone you already have a satisfactory relationship with - then ask. What is their level of education? How do they describe their expertise? You may find out that the person you thought was a doctor is really a nurse Practitioner PhD - or not.

If you are in the process of choosing a new doctor, then make sure you are well aware of the important aspects of choosing the right doctor for you, including a review of his or her credentials and some detective work to uncover malpractice.

OK - time for a snack. Think I'll go find a Dr. Pepper. (With that more important name, it's bound to quench my thirst better than a coke, right?)

How to Find Dr. Right

How to Review a Doctor's Credentials

Learn more about Nurse Practitioners and Physician Assistants

Uncover a Doctor's Malpractice Record

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Agree? Disagree?
Share your experience or join the conversation!


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Photo iStockphoto.com

October 13, 2011 at 2:09 pm
(1) Doug Capra says:

Good points, Trisha.
What’s often not discussed is what I consider to be the deprofessionalization of bedside care. It used to be done mostly
by nurses. Now we have all kinds of titles for that job — nurse asst., cna (and various versions of cna), patient techs, medical assts. etc. Some of these caregivers are coming right out of high school, or only have a GED, spend maybe 8 weeks in training, and then begin the bedside care. In some states, they are permitted to do some very invasive procedures. Most doctor offices are now staffed by medical assistants, not nurses. And it’s my understanding that they are not licensed, but work under the doctor’s license — which means they may do procedures that even LPN’s and RN’s don’t do. As long as the doctor takes on the responsibility.
Now don’t misunderstand. I’m not saying that all these jobs don’t have a place in medicine. They do. But it seems to me that they’re often outside their scope of practice. Why? Well, you’ve said it many times before. Follow the money. They’re cheaper to train and cheaper to hire.
I consider this to be what I’ve called the deprofessionalization of patient care, especially bedside care.

October 17, 2011 at 4:41 am
(2) Julie Shrive says:

In UK NHS Direct is run by admin & health professionals who are not over seen or directed by a Doctor . This is happening with every doctor contracted in to LAs & hospital directed by accountants protecting their interest . Have been told GP surgeries are rationing & don’t have to use medical oath nowdays ? Surely this can’t be true . I have had so many tests with no specialist on site or follow up including taking off a 24 hr heart monitor at bowel hospital then having to drive on motorways getting lost an hour later cardiac arrest .two years prior Specialist findings and private tests ignored no referrals. I have tried to get so many to address this health & safety risk . Nobody wants to know especially since Government deregulated. Who is in charge ???

October 11, 2012 at 5:40 pm
(3) Bob James, M.D., J.D. says:

I hope I am not leaving this comment because I am protective of a “pecking order” but I think patients are confused in the cinical setting about who is taking care of them. Is it a physician, physician’s assistant, or a nurse practitioner? I do think patients want to know even though it may not affect the care they are receiving. Calling nurse practitioners who have earned a doctorate degree “Dr” in the clinical setting only further confuses patients. I’m not sure what the answer is, though, because they have earned the right to the title!

October 12, 2012 at 4:15 pm
(4) gemdiamondintherough says:

I agree that it may only be valued by the medical professionals. But we ourselves have been part of the problem. For instance, a PA was telling patients in the hospital that he was Dr. So and So! I always bristled at this, however did not correct him in front of the patient. In a later conversation, brought up ‘Dr. So and So, I would then say, Oh, you mean the PA , So and So!
Also at my own Dr”s office, they would refer to the my Dr.’s nurse. I was fairly certain they were not nurses. We should not give people misleading titles. Do I think that the letters behind your name make you a better care giver? They may or may not. THE MAJOR issue is RESPECT! It is NOT about, if those letters behind their name make them more or less able to take care of my health issue. I do not care what letters they have behind their name. WHAT I CARE ABOUT MOST, IS THAT THEY TREAT ME AS A HUMAN BEING AND THAT ENCOMPASSES ALL OF ME, PHYSICAL, MENTAL, EMOTIONAL AND SPIRITUAL. I do not care about being treated as a number or as cattle coming through the gate!!!!!!!!!!!
Sorry to be so blunt, but I am a medical professional and have been taught the ideal. I also accept the fact that ideal is not always possible and you have to deal with reality. HOWEVER, THAT DOES NOT EXCUSE THE WAY PATIENTS, MYSELF INCLUDED, ARE BEING TREATED IN THE MAJORITY OF PRACTICES! THERE ARE SOME GOOD ONES LEFT OUT THERE, BUT THEY ARE FAR AND FEW BETWEEN. LIKE ALREADY SAID, MONEY IS THE BOTTOM LINE.

If I am speaking with a CMA, I would not expect or ask the same type of question to that individual. So there is a reason why it may be valuable to know whom you are speaking with. ON THE other hand, do all those initials tell you, if you will get better care. NO
The main thing we should ALL focus on is getting and giving the BEST possible care!!!!!!!!!!!!

October 12, 2012 at 4:21 pm
(5) gemdiamondintherough says:

Another case in point is that Physical Therapists, many of those coming our of school are Doctors now, also!!!!!!!!!!!
I am ALL for education, but I think that somehow we are overdoing education in certain areas. Be that as it may, I am not certain how to solve the problem, but I do believe that it does matter that patients are given the proper information, regarding who is giving their care. And all this color coordination in hospitals. That helps the hospital employees know who is who. There is not a universal system for all hospitals, so the patient does not know the system??? Add to the fact that they are not feeling well and their cognition and brain retention are affected by their disease, and we expect people to know who is taking care of them, by the color they are wearing. REALLY!!!!!!!!!!!!!!!!!!!!!!!!

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