Dr. Susan Fernandes is an expert in health policy. She is also a skilled clinician. But Dr. Fernandes isn’t an MD. She’s a PA–a PA Doctor.
Dr. Fernandes has been a PA for over 25 years but she’s only been a doctor for 8. Already an experienced clinician, she went on to study law and policy at Northeastern University earning an LPD or Doctor of Law and Policy.
“I wanted leadership opportunities and to bring different skills to the table than my MD colleagues,” she says. She was introduced to the program by a colleague.
A Doctor of Law and Policy
After completing the LPD (also styled DLP), Dr. Fernandes says that her career changed dramatically. “After graduation, I secured a clinical director position which I don’t think I would have ever been considered for prior, I now do clinical, research and education at a major academic medical center/university and I am a full professor which would have absolutely never happened without a doctoral degree.”
The clinical directorship Dr. Fernandes is referring to is the Adult Congenital Heart Program that spans both Stanford University Hospital and Lucile Packard Children’s Hospital as well as all of Stanford’s outpatient clinics.
When asked if she refers to herself as a doctor in the clinic, she replies, “No, my doctorate is a professional doctorate. I try to not use it in the clinic setting to prevent confusion”.
Professional vs Academic Doctorates
Professional doctorates (such as the MD, JD, DMS, and LPD) stand in contrast with the academic doctorate or PhD.
UC Berkeley describes a professional doctorate as “mastery of the subject matter and techniques of a professional field to a stage of competence parallel to that required for the PhD. Although the work for the professional doctor’s degree may extend the boundaries of knowledge in the field, it is directed primarily towards distinguished practical performance.”
An academic doctorate such as the PhD, or Doctor of Philosophy, is geared toward research and teaching. Many PhD students are required to have teaching hours before graduating. PhD students are also required to submit a thesis at the conclusion of an original research project which is often published in a peer-reviewed journal.
Lux, Veritas, Virtus
Northeastern is a Boston-based private research university that has been in operation for over 100 years and offers both professional and academic doctorates as well as undergraduate and graduate degrees. With satellite campuses around the world, total enrollment tops 25,000. In 2018, both the PA and health care law programs ranked in the top 5 for US schools.
Northeastern currently offers two DLP tracks: executive and standard. The executive track requires 10 years of professional experience to matriculate. Both tracks are designed to blend online and residential learning at the university’s Boston campus as well as in Washington, DC, and abroad.
Students progress through the program as a cohort with the time of completion ranging from 2-6 years. Students study law and legal reasoning, research and quantitative methods, economics for policy analysis, and much more. Guest lecturers at Northeastern’s DLP program have included Supreme Court Justices Sonia Sotomayor, Samuel Alito, and Clarence Thomas as well as Dr. Victor Dzau, president of the National Academy of Medicine.
An Expert Clinician
Though not a physician, Dr. Fernandes is proud of her doctoral credentials. “I am a doctor, it took me a long time to get used to that. Physicians are one type of doctor but they don’t own the title.” The first “doctors”, in fact, were teachers. Dr. Fernandes certainly meets this definition as the current head of Stanford’s PA program.
She’s no slouch in the clinic either. She spent 17 years rounding at Boston Children’s Hospital before taking over at Stanford. Vital to the training of new PAs, her official academic title is Associate Dean for PA Education.
The Jones Effect
Not all PAs are ready for a shift to a doctorate, though. In fact, heated debates on the topic are common on social media outlets. Those that oppose the move usually cite a concern for increased cost and barrier to entry–after all, PAs were born out of the need to get skilled clinicians into the field sooner.
Contrarily, others believe that the doctorate is essential to their survival as a profession. “I think we need to shift public perception [about PA doctorates] and educate the public as we have PharmDs, DNPs, etc.” None are physicians, but all are doctors practicing with doctoral degrees.
But adding credentials isn’t the only thing the PA profession loves to debate.
To Assist or to Associate, That is the Question
“I believe as long as we have ‘assistant’ in our title, being a PA with a doctorate seems like an oxymoron. Once the title is fixed to reflect what we do, I believe that then the door can open for an entry-level doctorate degree for PAs.”
The name change debate, as it’s come to be known, involves rebranding PAs otherwise known as Physician Assistants. The official title simply doesn’t communicate the level of care PAs provide as well as the responsibility bestowed upon them. For example, many PAs function as their patients’ primary care provider or PCP. Dr. Fernandes supports PAs seeking advanced degrees in clinical, research, or professional training as she believes it will help advance the profession.
It’s not just PAs that are evolving, however. Education itself is undergoing a transformation. A 2017 report by the Babson Survey Research Group showed that enrollment in online courses has increased for the last 14 years with over 6 million US-based students taking at least one online class. The survey also found that the largest growth was actually among public non-profit schools that tend to attract many of their online students from within a 50-mile radius of their main campus. There is even an online medical school.
“I prefer brick and mortar or hybrid approaches personally. The relationships I established in my doctoral program were as meaningful as the additional knowledge I gained” says Dr. Fernandes.