Thursday, March 7, 2013

When is a Doctor not a Doctor?

When I graduated from law school with my J.D. (Juris Doctor) degree, I remember getting a call from one of my smart-aleck brothers. We had another brother with a doctorate in theology, so Mr. Smart Aleck said, “Now we have two doctors in the family and neither one of you is worth a damn.” That might be a debatable point when he needs a lawyer, but he was reflecting a commonly held belief, maybe a bit old-fashioned now, that the only REAL doctors are M.D.s. But these days a whole array of health care providers attain doctorate degrees – most of which (like my J.D.) are non-research professional doctorates. So, physical therapists, pharmacists, and dentists are all “doctors.” But, especially in the field of nursing, the question of who can call themselves doctors has become an even hotter topic.

In my home state of Florida – where you can always count on the most extreme ideas to come from our state legislature – bills have been introduced that would force health care providers with doctorate degrees to explain to patients and the public that they are "not medical doctors" or face felony charges. Yes, that’s right – felony charges!!

The AMA has had a “Truth in Advertising” campaign for several years now. They have data that indicates there is a lot of confusion among consumers of health care as to who the various practitioners are. We in allied health know that this is a problem – everyone who has direct contact with patients is perceived by most patients as either a doctor or a nurse.

So, the AMA’s “model legislation” calls for all health care practitioners who come in contact with patients to wear a name tag “that clearly identifies the type of license held…” This is certainly not a bad thing and it would help promote the visibility of professions like medical assisting. The AMA’s material notes that the model bill “does not provide for criminal penalties.” But it goes on to say, “although a state may wish to pursue that course.” Really? Do we really want to further clog up our criminal courts with felony charges against a nurse practitioner who fails to clearly identify him or herself as NOT a doctor?? Will prosecutors, who are ever sensitive to political concerns, be lobbied to throw these “not real doctors” in the slammer?

For more information on the AMA’s campaign, here is the document I have cited: The AMA says this is not a “turf battle” but others disagree. Here’s an interesting article from Bloomberg that offers another perspective: