The linguistic controversies of clinical titles

The temperature of conversations surrounding clinical titles has been rising for years. Now, heated discussions about how advanced practice providers refer to and market themselves are commonplace and coincide with conflicting views about their roles in the healthcare industry. 

In 2021, the American Academy of Physician Associates voted to adopt "physician associate" as the official title for the physician assistant profession. The rebranding, which AAPA is gradually rolling out, was met with immediate opposition with groups such as the American Medical Association and American Osteopathic Association. The associations argued that the title change will create confusion for patients about who is providing their care.

"Given the existing difficulty many patients experience in identifying who is or is not a physician, it is important to provide patients with more transparency and clarity in who is providing their care, not more confusion," AMA's former president, Susan Bailey, MD, told Becker's in 2021.

AAPA said the new title will better highlight PAs' contributions to healthcare and offer patients assurance about their abilities to provide high-quality care.

"PAs do more than assist," Jennifer Orozco, DMSc, PA-C, AAPA president and chair of the board, told Becker's last month. She pointed to a recent survey done by the analytics firm Kantar, which found 71 percent of patients agreed that the title "physician associate" matches the job description of a PA. 

More recently, Florida lawmakers have introduced legislation that seeks to clarify what titles and abbreviations healthcare practitioners can use in ads, communications and personal identification. The House and Senate have both introduced bills on the topic. If signed into law, they would prohibit nonphysician healthcare providers — such as nurse practitioners with doctorate degrees — from using the term "doctor." 

The bills have faced pushback from many nurse practitioners, who argue that the title "doctor" shouldn't be owned by any one profession. 

"To take that away and for people to say you're no longer allowed to use the title you've earned and then have other professions like a pharmacist, they can use the title doctor. … It's kind of a smudge on our profession that doesn't need to be there," Sue Hook, a nurse practitioner at the Samaritan Health and Wellness Center in Cape Coral, Fla., told NBC2 News. 

The conflicts over clinical titles come alongside equally heated discussions over advanced practitioners' scope of practice. At least eight states currently have bills proposing changes to considering changes to advanced practitioners' scope of practice or practice requirements for pharmacists, nurse practitioners and physician assistants. Advocates of the changes argue that advanced practitioners can play a crucial role in addressing the nation's healthcare staffing crisis and worsening physician shortages. However, many medical associations have spoken out against scope of practice expansions, citing patient safety concerns.  

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