Doctor Patti McCarver meeting with a patient
With pain in her right ear, Sue Cassidy went to a clinic. The doctor, wearing a white lab coat with a stethoscope in one pocket, introduced herself.
“Hi. I’m Dr. Patti McCarver, and I’m your nurse,” she said. And with that, Dr. McCarver stuck a scope in Ms. Cassidy’s ear, noticed a buildup of fluid and prescribed an allergy medicine. It was something that will become increasingly routine for patients: a someone who is not a physician using the title of doctor.
Dr. McCarver calls herself a doctor because she returned to school to earn a doctorate last year, one of thousands of nurses doing the same recently. Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title “doctor,” but also the money, power and prestige that often comes with it.
As more nurses, pharmacists and physical therapists claim this honorific, physicians are fighting back.
An illegitimate characterization. “Fighting back” implies medical doctors are losing something. The quandary is over their ego-smitten self-worth. Standards for doctorates in most fields, medical or otherwise, allow the term “doctor” for anyone who reaches or surpasses those standards.
For nurses, getting doctorates can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients. But so far, the new degrees have not brought higher fees from insurers for seeing patients or greater authority from states to prescribe medicines.
Nursing leaders say that their push to have more nurses earn doctorates has nothing to do with their fight of several decades in state legislatures to give nurses more autonomy, money and prescriptive power.
But many physicians are suspicious and say that once tens of thousands of nurses have doctorates, they will invariably seek more prescribing authority and more money. Otherwise, they ask, what is the point..?
The point is knowledge, skill and understanding. For the nurses. Obviously the point for the doctors is money and status. And money.
Physicians and their allies are pushing legislative efforts to restrict who gets to use the title of doctor. A bill proposed in the New York State Senate would bar nurses from advertising themselves as doctors, no matter their degree. A law proposed in Congress would bar people from misrepresenting their education or license to practice. And laws already in effect in Arizona, Delaware and other states forbid nurses, pharmacists and others to use the title “doctor” unless they immediately identify their profession…
As demand for health care services has grown, physicians have stopped serving as the sole gatekeepers for their patients’ entry into the system. So physicians must increasingly share their patients — not only with one another but also with other professions. Teamwork is the new mantra of medicine, and nurse practitioners and physician assistants (sometimes known as midlevels or physician extenders) have become increasingly important care providers, particularly in rural areas.
Six-figure physicians who feel they should be seven-figure CEO’s are the characters with the problem. Nurses, like members of any other craft, who seek more knowledge, who acquire increased skills in the practice of medicine have to meet standards as exacting as anyone else. It has followed among the technologists in medicine. Among pharmacologists and physiatrists. Just as it has in fields of study as far afield as mathematics and industrial engineering.
RTFA. Wear rubber boots while you waddle through the rationale from these poor doctors who fear opening up membership in their exclusive club.