Are physicians and surgeons the only professionals we can call “doctors”? Depending on the state you live in, that may be true. A recent lawsuit in California has roused attention and concern among nurses with doctorates in nursing. Despite any controversy associated with the topic, it does raise objectively interesting questions. Is a nurse practitioner a doctor? What is a doctor in nursing? How do you become a doctor of nursing practice? Nurse practitioner vs. doctor: What is the difference?
What Is a Nurse Practitioner?
A nurse practitioner (NP) is a registered nurse who has pursued a graduate degree in nursing. NPs provide quality, cost-effective, and patient-centered care and are vital to offset our nation’s growing primary care shortage. NPs earn either a master’s or doctoral degree, pass stringent national certification standards, and submit for periodic peer review. Of course, the learning doesn’t stop with certification and finding jobs. Continuing education and professional development are necessary throughout their careers.
Can a Nurse Be a Doctor?
Not all NPs earn a doctorate in nursing. However, since this question applies specifically to the word doctor, we can forgo explanations about master’s level nurse practitioners and zero in on the nursing paths that include the word doctor. There are two paths—as follows:
- Doctorate of Nursing Practice (DNP): This is the doctoral path that leads to clinical practice.
- Doctorate of Nursing (PhD in Nursing): This doctoral path is more esoteric, primarily leading to research and academic roles.
Both these degrees have the word doctor in the title and are incredibly rigorous educational paths. Nevertheless, for NPs, the use of the term doctor is disputed. Several states have legislation in place to regulate who can use the moniker “doctor” in signage, websites, social media, etc.
Ultimately, if you have a DNP or PhD in Nursing, you should be mindful of the laws of the state in which you practice and very careful in how you identify yourself. Perhaps the better question would be, “Can a nurse practitioner be called a doctor?” If the answer to that question is yes, then very important follow-up questions should be, “Where, how, and under what circ*mstances?”
Legislative Restrictions for Use of the Term “Doctor”
In California last year, an NP with a doctorate was prosecuted for allegedly using the word doctor to describe herself. In response, a few other California NPs with doctorates in nursing practice have filed a lawsuit aimed at preventing further enforcement of the state’s law that allows only physicians or surgeons to use the term. This May, Georgia passed into law a bill that restricts non-physicians from using the title. Florida also recently passed legislation that would prohibit DNPs from using the title doctor—although the bill was vetoed by the Governor. Other states have legislation in place as well.
In some states with such restrictions, the consequence is a felony; in others, it is a misdemeanor. In others, a DNP may introduce themselves to the patient using the term doctor, but with a clarifier. For example, “I am Dr. Smith, a pediatric nurse practitioner.”
Interestingly, while the debate seems to be largely between nursing and physician organizations, increased restrictions on the title “doctor” could impact other healthcare professions. Other healthcare professions that require doctoral degrees include the following:
- Physical therapists (Doctorate of Physical Therapy)
- Pharmacists (Doctorate of Pharmacy)
- Audiologists (Doctorate of Audiology)
- Veterinarians (Doctorate of Veterinary Medicine)
- Chiropractors (Doctorate of Chiropractic)
- Dentists (Doctorate of Dental Surgery or Doctorate of Dental Medicine)
- Optometrists (Doctorate of Optometry)
What's the Difference between a Nurse Practitioner and a Doctor?
NPs are often primary care clinicians serving some of the same functions as physicians, so what’s the difference? The short answer is threefold: duration of studies, salary, and scope of practice.
Nurse practitioners, ultimately, are experienced registered nurses (RNs) who have completed a graduate degree. In other words, prior to their graduate studies, they were working in the healthcare industry, and this experience provides them with perspective and practical knowledge to build upon during their graduate studies and training.
Alternatively, physicians complete a bachelor’s degree and then go directly into medical school, afterward turning their attention to a residency program. Both the paths of an NP and a physician include rigorous studies and training; however, that of the NP is typically shorter.
Another difference between the two clinician types is salary. It is well known that physicians earn significantly more, on average, than nurse practitioners.
Furthermore, the scope of practice for a nurse practitioner has more limits, mostly contingent on their practice authority. The practice authority for NPs varies from state to state, although the pandemic prompted several states to reconsider practice restrictions.
Read More about Nurse Practitioner Practice Authority
Patient Education
One of the main arguments against allowing DNPs to identify as doctors is that it creates confusion among patients. Patient education is a part of every nurse’s toolbox; identifying yourself and explaining your role should be a natural part of that. Regardless of how physician and nursing legislation are impacted by the controversy over the doctor title, the truth is that NPs are valuable and critical healthcare providers to communities across our nation. Their dedication to the tenets of nursing and determination to take nursing to a terminal degree are commendable and deserving of respect.
