Are there too many ‘Doctors’?

Higher Education

In our society significant emphasis is placed on higher education, specifically the number of levels of higher education.  At one point in time, having a high school diploma was sufficient for most professions, and a college degree made you stand out and put you in line for management of some sort.  Doctorate level education was reserved for professionals such as Physicians and Dentists, or career academics like college level professors. As more and more people went on to college and obtained degrees, the Bachelor’s degree replaced the High School diploma as the entry level of higher education and the Master’s degree was conferred upon those who sought more advanced training in specific fields and wished to further their careers.

              The current social climate leads one to believe that without at least a Bachelor’s degree, one cannot obtain any meaningful job that has the potential for advancement.  And a Master’s degree only indicates to potential employers that you are committed to a particular career path. Many now feel pressured to continue their education after this so that they may obtain a Doctorate in whichever field they are pursuing, even if they never have the intention of teaching at the collegiate level.  And it is this upward educational creep that is causing some confusion in healthcare today.

The Confusion

              Please allow me to explain.  In the health care setting, the phrase ‘Doctor’ has historically meant the Physician who is caring for the patient.  Other patient care areas had their own title, such as Nurse, Medic, Technician, Medical Assistant, and so on, but ‘Doctor’ only meant one person.  Now, it is not uncommon to have Ph.D. trained Occupational Therapists, Physical Therapists, Nurses, Nurse Practitioners, Dieticians, Case Managers, and even some administrators.  If all of these individuals introduce themselves to a patient as ‘Dr. Ron Smith’, how does the patient know who is their Physician?

              Now, I don’t want anyone to think that I am against furthering your education and expanding your intellectual sphere, quite the contrary!  I feel that the opportunities for higher education have never been greater than they are right now. Nearly everyone in this country, and many throughout the developed world, have unprecedented access to colleges and universities of all kinds.  If someone has the interest to take a college level course on a particular subject, it is available to them 24/7. This has the potential to expand the general knowledge of our society exponentially, which may lead to countless improvements in our quality of life.  But, do we all need Doctorate level educations in order to do our jobs? And, just because we have achieved that level of education do we need to address ourselves as ‘Doctor’?

              When I introduce myself to a patient, I am ‘Scott, The PA taking care of you’.  Some patients hear me and know what that means, and some do not. Some patients do not hear me, but catch my name so now I am ‘Dr. Scott’.  I always correct them and explain that I am not a doctor, but a PA. And if they have any further questions about what that means or about my training or qualifications I happily answer them.  And while the AAPA currently does not endorse Ph.D. level training for PAs, even if I had that level of education I would not introduce myself a ‘Doctor Scott’, even though I had the right. Because this will confuse the patient, especially when my attending comes by and introduces themselves as ‘Dr. John Doe’.  Then I am looked at as a ‘trainee’, and the trust my patient has in me and my decision-making ability has just dropped several notches. I am most certainly not a trainee, I finished that part of my education long ago.

However, for my colleagues who have obtained Ph.D. level training, you have every right to congratulate yourself and be proud of your accomplishments.  By all means, make sure your ID badge has your Ph.D credentials on it, as well as your lab coat. You have worked hard to earn that degree, and my hat goes off to you!  But please be careful as you introduce yourself to a patient or their family, because they could easily misconstrue your words to mean something entirely different than what your intension was.  Our patients place a great deal of trust in us as Healthcare Providers. As you may have noticed, whether your title is PA, ARNP, DO, or MD, we are all “Doctors” in their eyes no matter how many times we try to correct and educate them about the differences.  Obviously, if you are not a DO or MD, you should not introduce yourself or refer to yourself as “Doctor”, and you should make every effort to correct and educate the patient about the differences. Sometimes it works, sometimes it doesn’t, but you still need to make the effort.  Enjoy knowing that you have achieved one of the highest levels of education in your field, and proudly explain that to anyone who questions your training or ability. But at the same time, please be aware of the confusion you may be creating if you refer yourself as ‘Doctor’, because the patients don’t always recognize the difference between MD and Ph.D.

By Scott Biggs, PA-C