What’s up with the name of this blog? What is a PA Doctor?

One of the questions I often get is, “Why PA Doctor?” It’s kind of confusing, I’ll admit. But it piques peoples’ interest and invites further conversation. I’m not at all advocating for misrepresentation. Are Master’s-trained PAs doctors? No, but they do what a medical doctor does and will continue to be called ‘doctor’ by endearing patients. But what about a doctoral-trained PA? Is she a doctor? Absolutely.

Docēre

The word “doctor” is derived from a Latin word that meant teacher and was first given to clergy. As time went on, doctors became known as experts in their field, with terminal degrees, thus the best suited to teach others. I once had to explain to a coworker that their spouse, as an attorney, held a JD or Juris Doctorate. The Juris Doctorate is the terminal or highest available degree to those studying law.

The battle over who gets to use the title ‘doctor’ has a long and interesting history. I’m not sure at which point physicians began using the title, but in 19th century Britain it was common for medical practitioners to avoid the title doctor because it didn’t really mean anything professionally–anyone could call themselves a doctor. To avoid confusion with those without medical training, it became common to refer to physicians using their post-nominals: MD. Novel idea, right? 

Barber Surgeons and Rocket Scientists

PhDs were the first victims of doctor discrimination and have fought a long, hard battle to use their earned title. In some agencies today, such as NASA, it’s apparently commonplace to refer to PhDs as Dr. Jones and MDs as Bob Jones, MD. Surgeons in the UK like to separate themselves from the common practitioners by eschewing the title doctor and instead preferring the honorific Mr. (which was originally given to men when knighted). 

In today’s medical environment, most clinicians have doctorate degrees. It’s not exclusive to the MD anymore and MDs are no longer the primary gateway into healthcare–your dentist is a doctor as is your optometrist, podiatrist, physical therapist, and now your PA. Some physicians might argue that this is confusing to patients–is it? It seems this problem was actually solved once, like 200 years ago–if you’re going to use the title doctor (which has long been a courtesy title versus the exclusive identification of a particular profession), be sure to give your actual credentials. In Germany, the use of the title is strictly controlled and American MDs (having a “lesser” professional doctorate vs a research doctorate) are actually prohibited from using the title ‘doctor’.

Truth in Elitism

The AMA unwittingly supports the practice of doctoral-level practitioners using the title ‘doctor’. In 2011, the “Truth in Advertising” policy sought to restrict the respected title to MDs and DOs (who were once considered by mainstream medicine to be quacks). The end result, however, was actually quite reasonable–several states passed legislation requiring that licensing and credentials be clearly listed in all advertising materials or on personal ID badges. Another revolutionary idea, isn’t it?

I fully support the AMAs stance here. No one should be allowed to run around advertising themselves as a doctor without disclosing their area of expertise. No offense to my chiropractor friends, but when I read the Sunday paper and see ads for Dr. Smith who is doing some sort of laser-something-or-other, there’s usually very little mention of his training and he typically ends up being a chiropractor (DC or Doctor of Chiropractic). That is confusing to patients. At least to those who don’t spend a few minutes online to look the guy up. 

Old Fashioned Solutions for Modern problems

What about in a hospital setting where patients don’t have the time or ability to do their due diligence? Proper identification in the form of ID badges works nicely here, too. One of the hospitals in my area uses a two-part tag with the upper portion bearing the person’s name and photo while a lower portion lists their credentials in big bold letters: MD, RN, NP, PA, PT, RT, etc. It’s not exactly rocket science (though doctors do that, too). 

Why all the fuss though? Because those who earn a doctorate have a right to use the title doctor. Period. Yes, those wishing to use the title ‘doctor’ in a clinical setting have an ethical and perhaps legal obligation to state their credentials. There’s no argument there. 

Dr. PA, DMS

It seems the last line of defense for title purists is: If you wanted to be a doctor, you should have gone to medical school. Hopefully, we’ve already proven why that’s a silly argument–if I wanted to be an MD, however, then I would have gone to medical school.  

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