The term “doctor-nurse game” was coined in 1967 to refer to a “clear agreement between doctors and nurses that their relationship was hierarchical and that physicians were superior.” However, Dr. Libster said the game is over in 2023 and practitioners with a doctoral degree may also be “doctors.”
“Not physicians, but doctors. Patients’ needs are complex and there really is no more time for games,” she said. “We too have earned and are entitled to be called ‘doctor.’ We don’t lobby to be called ‘physician,’ already a protected title for those with medical degrees. If we wanted the physician title and all that it represents to physicians and the public, we would have gone to medical school. Instead, we chose nursing.”
Some argue that nonphysicians referring to themselves as doctors is misleading and puts patients at risk.
“This is inaccurate. Having worked in the mental health field for 25 years, I have never observed evidence for patient confusion about these roles. More often, professionals’ titles are just not the priority issue for people in distress,” Dr. Libster said. “In the field of psychiatric mental health care, there are two professional groups who use the title ‘doctor,’ psychiatrists and psychologists. Now the DNP has joined the group.”
Dr. Libster said that everyone who earns a doctoral degree has a right to call themselves a doctor if they wish.
“Doctorally prepared nurses have a right, if not an ethical responsibility, to identify themselves as ‘doctors.’ Universities graduating these nurse doctors and the boards of education and national bodies accrediting them have deemed our expertise and training worthy of this respect.”
California and Georgia have passed laws banning the use of “doctor” for clinicians with doctoral degrees, but lawsuits are challenging these bans. If physicians are successful in achieving title protection for the “doctor” title, then nurses with DNPs or PhDs would be entitled to reparations from the educational institutions that told them they would be “doctors” without stipulation upon graduation.
Debating title recognition should take a back seat to advancing precision science and person-centered care, Dr. Libster said. “Nurse doctors do not need to engage in title debates and turf wars.”
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