Call me “Doctor”
Watching this process unravel, as a Ph.D. Prepared RN, with the California ruling of an existing law… and now we see nursing organizations with their letters to their membership, condemning the courts ruling! I never expected to be called Doctor in the clinical setting! I understood my degree was an academic degree. OK, I get it… Everyone wants to be called “Doctor”, but, I’m on the side of the courts on this one, but I understand and our physician colleagues need to understand, the word “Doctor” does NOT equal physician… AND it does not equal a Nurse Practitioner or Advanced Practice RN. Many DNP’s are not Nurse Practitioners/ providers! BUT, the consumer see’s the term “Doctor” as a physician in the clinical setting. If I am seeing a provider and they come in and say I’m Dr. Smith, as a consumer, I assume that individual is a Licensed physician. This is where the court ruling stands as well. In the clinical setting, where the courts have made their very specific stance and I understand the need to reduce confusion. I also don’t trust the system enough to ensure everyone is going to introduce themselves as Dr. Smith + their role. We can barely get our nurses to script their name and RN when they go into a patients room!
But, since we can’t change how every single person in the US thinks of the term in the clinical setting here is a little history and my two cents.
The word “doctor” began as a purely academic title. In medieval Europe, a “doctor” was a university scholar licensed to teach (Latin docere, “to teach”), and the earliest doctorates were conferred at Paris and Bologna in the 13th century. The honorific migrated from the academy to medicine over time, but its original meaning was scholar/teacher, not clinician.
Modern U.S. medicine was reshaped by the Flexner Report (1910), which standardized medical education, closed substandard schools, and rooted physician training in laboratory science and supervised clinical training. That transformation is why today’s M.D./D.O. pathway is long, structured, and tightly regulated, but the M.D. itself remains a doctoral degree in the original, academic sense.
Nursing followed its own pathway to a clinical doctorate. In 2004, the American Association of Colleges of Nursing (AACN) formally endorsed the Doctor of Nursing Practice (DNP) as the practice-focused terminal degree for advanced nursing, distinct from research doctorates like the PhD. DNP programs were designed to deepen clinical leadership, quality, and systems competencies, again, squarely within the academic tradition of awarding doctorates to masters prepared nurses in the field. For clarity the DNP is an academic degree that is not limited to Nurse Practitioners! It’s open the Nurses in administration, education, Informatics… It does not broaden the scope of a Nurse Practitioner. A purely academic degree for those primarily in clinical settings
So, historically and academically, both physicians (M.D./D.O.) and doctorally prepared nurses (DNP/PhD) have a legitimate claim to the doctoral title. The conflict arises not from the degrees but from clinical communication: patients often equate “Doctor” with “physician,” and state laws increasingly regulate title use to prevent confusion. California’s recent federal court decision upholding limits on non-physicians using “Dr.” in clinical settings illustrates this trend; professional groups also push “truth in advertising” rules to make roles unmistakable to patients.
Given that history and the patient-safety imperative for clear communication, a principled compromise would be this:
In academia, research, publications, and inter-professional forums, use doctoral titles as earned (Dr. Smith; Jane Smith, PhD/DNP/M.D., etc.). That honors the historical, scholarly meaning of “doctor.”
In clinical encounters with patients and the public, avoid the standalone “Doctor” honorific and use plain-language role clarity instead, for everyone. For example: “Alex Kim, Physician (M.D.)”; “Jordan Patel, Nurse Practitioner (DNP, APRN)”; “Taylor Lee, Clinical Psychologist (PhD).” This aligns with transparency initiatives shown to reduce role confusion and supports patient-safety standards emphasizing clear communication.
This approach concedes nothing about academic legitimacy, both groups hold doctorates, while removing an avoidable source of misunderstanding at the bedside. It also harmonizes with evolving legal constraints and with the profession-agnostic principle that the patient should instantly know who is caring for them and in what capacity.
My recommendation… Eliminate the term “Doctor” in the clinical setting!!! Use the term in professional settings where you’re addressed by your academic title if you so desire!!!
