Universal board certification can solve the Doctor Nurse controversy

I’m going take on the Doctor Nurse controversy.

This isn’t a new issue, as the doctorate in nursing degree has been around for awhile. But a recent piece in the New York Times gave it new life.

The topic is a ripe invitation to “doctor bash,” with the predictable arguments about physicians protecting their turf, elitism, and the like.


To sample the representative comments, consider those in the Times’ health blog, Well.

To recap, doctors are worried that diluting the doctorate pool would confuse patients, and accuse Doctor Nurses of ulterior motives:

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?

Dr. Roland Goertz, the board chairman of the American Academy of Family Physicians, says that physicians are worried that losing control over “doctor,” a word that has defined their profession for centuries, will be followed by the loss of control over the profession itself. He said that patients could be confused about the roles of various health professionals who all call themselves doctors.

“There is real concern that the use of the word ‘doctor’ will not be clear to patients,” he said.

Physicians, as always, are being reactionary and playing from behind the public relations curve. Those who earn a doctorate degree, whether it be in nursing, pharmacy, or psychology, deserve to be called “doctor.” Period.

What medical doctors need to do is to differentiate themselves and emphasize their more extensive training. The answer?

Universal board certification.

Have all doctorate-level clinical providers take the same board certification exam. It should be as rigorous as the ones currently provided by the American Board of Internal Medicine or the American Academy of Family Physicians in primary care, for instance. Those that pass truly deserve to be called “doctor,” no matter what their background.

Another, admittedly more realistic, option is to educate the public about the different “doctors” who may be treating them. Let them know that not all board certifications are alike. Physicians certified by the American Board of Internal Medicine have different training requirements from those board certified with a doctorate in nursing. It is up to physicians and our professional associations to emphasize and publicize that.

Trying to monopolizing the doctorate degree is a losing public relations strategy. What differentiates physicians is their more extensive training, symbolized by board certification status. We need to proactively capitalize on the strength, instead of reacting to the current trend of doctorate creep.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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