Traditionally, in a medical setting, the title “Doctor” is someone who has a MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) degree.

I do have the MD degree, and as such I am a “Doctor”.

Nowadays however, NP (Nurse Practitioner) or PA (Physician Assistant) with PhD (Doctor of Philosophy)/ DNP (Doctorate in NP) degree’s, in the medical setting are introducing themselves to the patient as a “Doctor”. As PhD’s, yes they have earned the right to call themselves “Doctor”. But would you expect in a medical setting, a person with a PhD in Math or Music, or English, introduce themselves to a patient as being a “Doctor”? And even if someone with a PhD/DNP did introduce themselves as a doctor, isn’t it ethical for them to clarify that they are NP or PA, and are not MD/DO, especially in the medical setting?

Calling oneself a “Doctor” without clarifying their degree, in a medical setting to a patient, in my opinion is unethical. It misleads a patient to believe that one has the expertise equal to that of a MD/DO, which a PhD/DNP does not.

Let me elaborate on the training of a MD/DO.

Medical School: The admission rates to a US medical school is about 10% of the applicants applying to the school. In most parts of the world, the admission rate is even lower. What this means is, only the very best candidates get admission to a medical school (the Marine’s slogan “The Few, the Proud” comes to mind). The selection process does not end here. After admission, the Medical Student who hopes to practice medicine in the US, must pass three of the most difficult medical exams on the planet. These exams called USMLE (US Medical License Exam), are so difficult, that most student who went to a foreign medical school need years of additional learning, inspite of having gone to medical school in their native countries.

Residency/Fellowship: After graduating Medical School, the “Doctor” goes through an additional three to ten years of supervised training before they can practice independently! This training is not where the “Doctor” is just sitting around observing someone else practice medicine. These years are the one, where the resident/Fellow (Doctor) is taking care of the patient, with the supervising Physician making sure, that they are not doing anything to jeopardize patient care.

Board Certification: After going through this rigorous training, the physician has to take yet another exam  in their specialty to prove that they have adequate knowledge/expertise in the field they will be practicing to call themselves “Board certified”.

As a physician, I have had medical students, residents, fellows, and NP/PA students train under me. And without going into the details, suffice is to say, there is a world of difference in the training between a Physician and the “Doctors” who are NP/PA.