 Provided by Clinician 1
There has been recent commentary from the AMA, which discusses how an NP can be your “doctor,” and USE the term, too, if he/she has the Doctorate of Nursing Practice degree. http://www.modernphysician.com/article/20111014/MODERNPHYSICIAN/310149961#ixzz1an2ttzq2
As expected, physician groups have rallied, saying this would “mislead” the public about our credentials...only PHYSICIANS should have the ability to call themselves, “Doctor.”
What has transpired is nothing short of a “turf war,” IMHO. Really. These are seasoned professionals who appear to be jockeying for the “right” to use the term, “doctor,” in practice. The amount of fighting and discourse that has occurred from “organized” medicine has been, sadly, predictable. What I did not predict was the amount of dissension from within our own ranks.
Perhaps the term, “fighting” is too strong. Maybe it should be more along the lines of, “spirited discourse.” That would be politically correct. But, hey, I’m NOT about being politically correct, now, am I? (smile)
I would certainly expect PHYSICIANS to be upset at doctorate-prepared Nurse Practitioners to balk at them calling themselves, “Dr. X, your Nurse Practitioner.” Which, BTW, is required by MANY states, including my own happy home of Pennsylvania. You MUST identify yourself by your title, no matter WHAT your terminal degree is, when dealing with patients. It even must be identified on your person (as in, a name tag).
What HAS surprised me is the amount of dissension in our own ranks. Both NPs and PAs have come out, speaking against DNP-prepared NPs from calling themselves “Doctor.” The usual argument is that it will “confuse the patient.” Some say, “only MD/DOs should introduce themselves as ‘doctors.’ Others with doctorate education don’t use the term, as it would be “misleading,” they say.
Really? Aren’t patients already confused at times, assuming that we are physicians, working in our advanced practice clinician (APC) role? Do we not already have to clarify that we are NOT physicians, even if we have Masters degrees and APC titles? I’ve been in my current Internal Medicine practice over three years, and I STILL tell patients at least weekly...I am NOT a physician. Yet, some persist in calling me, “Dr. Kim,” no matter what I say to the contrary. To them, it doesn’t matter what my title is...I’m taking care of their needs, filling their Rx’s, counseling them about their issues...just like...a PHYSICIAN.
Notice...I did NOT say, “doctor” there.
“Doctor” means, “to teach.” My youngest son’s elementary school principal must have recently completed his doctorate (in what, I have no idea), because now, he’s no longer called, “Mr. Moyer,” but “Dr. Moyer.” We give acknowledgment to those in academia...and physical/occupational therapy, podiatry, chiropractic areas, optometry, etc.
So...WHY NOT THOSE WITH DNP DEGREES?!
Is it because we are (gasp)...NURSES? Subject to the usual media fodder, lack of respect, etc.? I’d bet that at least one group would feel this way (http://www.truthaboutnursing.org)...a website designated to showing how nurses are misrepresented in the media and other venues. I don’t know. I think it’s multifactorial.
All I know is, when I address my son’s principal, I call him Dr. Moyer. Period. Same as I would a podiatrist...or my husband, who is an optometrist. They have ALL completed doctorate education. So...IMHO, it’s NO different to call an NP who is doctorately prepared...”Doctor” so-and-so. So long as he/she ALSO states that he/she is a Nurse Practitioner. Making sure that our role is identified is MORE important than the title ahead of it.
We have come too far in our history to NOT acknowledge the amazing things we do as NP and PA providers. Calling those who have made that “extra” step in procuring their DNP degree “doctor” should NOT divide us. We have enough “angst among our ranks” as it is...let’s not let this issue further widen the chasm between us advanced practice clinicians...and physicians...and our patients.
Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA. Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings. She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs. She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health. She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| Deborah (Melbourne, FL) |
on 09 Nov 2011 at 9:09 am |
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| Personally, all I can see this change to Doctor Nurse Practitioner will only increase the resentment many physicians have for NP's and even push some of those that were ambivalent away from supporting us. As it stands right now, as an NP, MSN in Florida, the MOST important issue is to get us prescriptive priviledges for controlled substances! |
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| Kim Spering (Emmaus, PA) |
on 02 Nov 2011 at 8:19 pm |
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Thank you all for your comments.
From my research, most current DNP programs are geared to the post-Masters student; they aim to broaden the NP or other Advanced Practice Nurses' perspective on what you mention: administration, policy development, advanced management, etc. These programs are NOT geared to the RN who is a BS/BSN-prepared candidate to become a Nurse Practitioner...although these programs ARE starting to come into existence, particularly as the goal is that ALL NP programs have the DNP by 2015.
The problem is, as I see it, once you incorporate all of this clinical information with the additional hours to get the DNP degree, these programs will be upwards of 7 yrs. long (if done part-time, as most students do). I foresee problems with having new NPs willing to spend the amt. of time and money involved to get this terminal degree without some kind of financial assistance.
My own alma mater has a 2-year, full-time DNP program (post-Masters)...for an additional $34,000 (at current tuition rates). I cannot possibly afford the time or money to get this at the present time...and, as others have said, we do what we do WELL with our current MSN degree.
Even if we get the DNP, how much will it help health care overall? What are the measurable outcomes of having a DNP-prepared NP care for patients vs. an MSN-prepared NP? Is anyone going to do that study...and risk alienating THOUSANDS of Masters-prepared NPs? Well...probably someone will. That's another blog. (smile)
@ Ron: I don't necessarily disagree that clinical competence is implied by the NP/DNP degree...NOR do I feel that it IS implied by every PA program, either. We all, I'm sure, know providers of EVERY type who are lacking in competence, no matter what their background.
Perhaps your programs you taught in or have experience in are not representative of all NP/DNP programs. I certainly have precepted NPs who were lacking (and I failed them clinically). I also have met PAs whose clinical competence was questioned. (Not to mention physicians that I have met in 20-plus years of practice.)
However, back to the original blog...If others with a doctorate degree have the "right" to use the title, then a doctorally-prepared nurse should be able to do so as well.
Our clinical excellence is proven in our every-day work...NOT by our "title." THAT should be the real story...and what really "counts." |
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| Ron (MO) |
on 02 Nov 2011 at 3:46 pm |
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| I have no problem with the DNP degree or use of the term "doctor" as long as it is followed by the profession name. My concern is the content of the DNP curriculum. In looking at two schools DNP curriculum, neither contained any clinical courses, clinical rotations, or internships. The emphasis in courses appears to be nursing administration, management, and politics. As a PA who has taught classes in both PA programs and NP programs, I see lack of rigorous broad based clinical experience as the weakness in the NP degree. Some NPs obtain this experience through their own dedication and hard work, but clincal competence is not implied by the NP degree nor the DNP degree. |
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| casey (alaska) |
on 02 Nov 2011 at 3:14 pm |
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| What I don't understand is why an Nurse Practitioner needs to feel they need to get a doctorate degree. Can you not do the same clinical practice with a master's degree as you can with a doctorate? I am just unsure with this. If that is the case that you can do the same clinical practice with a master's as with a doctorate, what would be the point? Pride? Just to be called a Doctor? I don't know. What else would be the difference? Maybe I am just not as informed about the difference of a doctorate NP. |
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| Isaac (SLC) |
on 02 Nov 2011 at 10:26 am |
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| NPs are providers of health care services. We are trainded professionals with advanced degrees. We derserve to be identified by the title we have EARNED!!!! There should be no infighting on this issue. There should be support for the advancement of our profession. |
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| David (Dfw) |
on 01 Nov 2011 at 11:17 am |
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| After giving this much thought, I agree with you Kim. Persons trained at a doctoral level are titled doctor, which means "to teach". Doctors exist in many professions and is not the domain of medicine alone. As a PA, being a member of the medical and not nursing profession, I do not think PA's could call themselves doctor, however, because the terminal degree for medicine is a doctorate. People could call us Master PA. Hahaha |
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