Nursing Practitioners Are Not Doctors in Clinical Settings
Nursing practitioners should not be referred to as doctors in clinical settings, even if they hold doctoral degrees, as this may confuse patients who associate the term "doctor" with physicians. 1
Professional Distinctions Between NPs and Physicians
Nursing practitioners (NPs) are advanced practice registered nurses who have distinct training, skills, knowledge bases, and competencies that differ from physicians:
- NPs cannot substitute for or replace the skills and expertise of physicians, though they provide complementary approaches and additional skills 1
- Physicians have more years of training, and the range of care appropriately provided by each discipline is not equal 1
- The American College of Physicians explicitly states that because patients view the term "doctor" as synonymous with "physician" in healthcare settings, it is incumbent on all healthcare professionals with doctoral degrees other than MD or DO to clarify they are not physicians when using the term "doctor" in patient care settings 1
Patient Rights and Transparency
Patients have specific rights regarding understanding who is providing their care:
- Patients have the right to be informed of the discipline, educational background, and competencies of all clinical care team members 1
- Clinical care teams should provide patients with information about the training of all health professionals and the meaning of professional designations (MD, DO, NP, DNP, PA, PhD, etc.) 1
- Information about differences in years of training and clinical experiences associated with professional designations should always be available 1
Doctoral Degrees in Nursing
While nursing practitioners may hold doctoral degrees, this does not make them physicians:
- The Doctor of Nursing Practice (DNP) degree is a terminal practice degree in nursing 2
- The National Organization of Nurse Practitioner Faculties has committed to move all entry-level nurse practitioner education to the DNP degree by 2025 3
- Despite holding doctoral degrees, NPs with DNPs are still distinct from physicians and should not be referred to as "doctors" in clinical settings to avoid patient confusion 1
Recommendations for Clinical Settings
The Association of Surgeons in Training makes specific recommendations regarding this issue:
- It must be clear to patients that although NPs have had training in healthcare, they are not medically qualified and are not doctors 1
- All practitioners providing healthcare should be on an authorized regulatory body's register and be subject to appropriate assessment 1
- The non-medical workforce should not be confused with physicians, as this could potentially mislead patients 1
Collaborative Team Models
The most effective approach involves clear role delineation within collaborative teams:
- High-performing cardiovascular care teams have each member practice at the top of their education, training, licensure, and experience with clearly defined roles 1
- NPs are critical to improving access to healthcare in underserved communities and work effectively in collaborative teams 1
- In well-functioning teams, leadership issues are addressed through open discussion rather than traditional hierarchy 1
In summary, while nursing practitioners play a vital role in healthcare delivery and may hold doctoral degrees, they should not be referred to as doctors in clinical settings to maintain transparency with patients and respect the distinct roles and training of different healthcare professionals.