A Doctor By Any Other Name

What’s in a name?  If person says they are a “doctor” does that mean they actually have a medical degree or a just a PhD?  Context can’t always argue the right decision, and sometimes you have to actually ask, “Are you a ‘doctor’ doctor or just a ‘doctor of philosophy?'”

The confusion between real medical doctors and the pretend “medical doctor” PhDs is very real — I have a friend who refuses to call anyone with a PhD “doctor” unless they also have an “MD” after their name — and a recent story in the New York Times extrapolates why this sort of soft label confusion has a biting edge of big money and greed for nurse practitioners hoping for a larger money grab by getting a PhD and then saying they’re a “doctor” when they’re with patients:

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. 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. …

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?

This Rise of Credentialism is a perniscious pox on our nation as I wrote on September 1, 2005:

So what changed in five years where the terminal MFA degree becomes worthless and the PhD becomes the standard by which all candidates are judged as their first task of hoop jumping? The answer is credentialism. As more and more women and other minorities challenge the ivory tower power base with higher base degrees, the bar of perceived excellence must be set higher and higher in order to keep the self-proclaimed majority elite in power and that is accomplished by requiring more and more layers of bullsh*t to protect a process that is already overrun by pomposity and downward-nose-looking.

An MD psychiatrist friend of mine who worked at Rikers Island as a staff therapist for 30 years made this insightful connection 10 years ago: She claimed since the quality of student was getting worse, the innate power of the degree awarded was cheapened in the following manner: The BA became the high school diploma. The MA became a BA. The PhD became the MFA. She went on to argue once you hit the MD or PhD ceiling the forced credentialism didn’t stop there.

The system demands more to keep out those it wishes to not welcome. You have to get other certifications and join other groups and the new requirements are all created by those in power — usually older White men — who want to preserve their domain by guaranteeing only those like them will rise to their level where the credentialism requirements are invented.

Patients have the right to know their doctor is a traditionally trained medical doctor and not just a doctor in PhD name only.  Playing with the title of “doctor” on a university campus as an odious mode of false respect is one thing — but pretending to have medical school training on the MD level when you do not is not a pox that must not continue to be fevered along to unwitting, and trusting, patients who may not have the know how to know any better.