Three NPs With Doctorates Sue to Use 'Doctor' Title; Ethicist Disagrees

Arthur L. Caplan, PhD


August 08, 2023

This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at the NYU Grossman School of Medicine. A lawsuit has been filed in California by three nurses. The nurses are arguing that because they have PhDs in clinically related fields of nursing and healthcare, they ought to be able to use the term "doctor" as a sign of respect for the work that they did to get a PhD.

That's no insignificant amount of work. I have a PhD in a different area, but I know the kind of labor that it takes to complete that kind of a degree. I have no doubt that there are many advanced skills associated with having a PhD in one of those nursing areas that benefit patients.

The nurses say that California law, which currently restricts the use of the term "doctor" to MDs or DOs, ought to be expanded to recognize their PhD work. I don't agree with this even though I certainly have nothing but respect for the work that nurses do, whether they have PhDs or not.

It seems to me that patients really come to hospitals, clinics, and healthcare settings distinguishing, if you will, between doctors (MDs and DOs) and nurses. They may have their ideas about what each of them do, and they may be wrong about what each of them do. I think the road to gaining respect for the work, the contributions, and even the importance of what nurses do is not to start to broaden the use of the term "doctor."

Part of the reason I worry about that is that it's a slippery slope. There may be others coming in who want to use that term. Some PhDs in bioethics may start to say, "Well, I've done a large amount of work in healthcare-related fields. Maybe I'd like to have that term used for me." People in some of the more life science–oriented fields may do the same.

I don't think heading down that road is the way to go. Instead, I would suggest that we try very hard to honor and recognize the work that all healthcare professionals do, including physical therapists, social workers, chaplains, doctors, nurses, lab technicians, and radiation technicians. When I have been in the hospital, I deeply respect all the work that those folks are trying to do to help me.

I don't use the term "doctor" so much as the only person who's worthy of respect or the only person who's in charge. I use it just to distinguish between the set of skills, responsibilities, data collection, recommendation of therapy, and so on that, in my own head, correspond to different roles that people are doing.

Do nurses deserve more respect when they complete the difficult path to a PhD? Absolutely. My argument is simple. Let's teach everyone who goes to the hospital. Let's teach our students to respect everybody's work, to respect the roles and professionalism that everybody tries to bring to the care of patients.

I don't think having a battle over who really gets to use the word "doctor" is the best path forward because it still may lead to confusion. I think the path forward is learning to respect what all parties contribute in the care of patients.

I'm Art Caplan at the Division of Medical Ethics at NYU's Grossman School of Medicine. Thanks for watching.

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