The word "doctor" comes from the Latin term doctoris, meaning teacher. This nomenclature has historically been used to describe someone who has achieved a terminal academic degree, such as a Doctor of Philosophy or Doctor of Education, or a professional medical degree, such as a Doctor of Medicine or Doctor of Dentistry. However, with the current changes in academic requirements, other healthcare clinicians are also earning doctorates. The academic entry level to practice pharmacology now requires a Doctor of Pharmacy degree, and to practice physical therapy requires practitioners to earn a Doctor of Physical Therapy. The most recent advanced practice nursing degree is the Doctor of Nursing Practice (DNP). In 2004, the American Association of Colleges of Nursing published a position paper requiring that by 2015 nurses must earn a DNP before practicing in an advanced practice role. It's anticipated that most traditional master's programs in nursing will become extinct and be replaced by DNP programs.
With the advent of these new academic requirements, often referred to as clinical or practice doctorates, the American Medical Association and other subspecialty medical organizations have decried these graduates using the term doctor because they believe it will confuse the public. Many physicians believe that the term doctor should be reserved for those who have attained a professional medical degree. They aren't alone in this opinion-lawyers who earn a Juris Doctor degree don't commonly refer to themselves as doctor. This is because their professional organizations have taken the stance that using the term is self-laudation. These organizations believe that doctor should be used only to describe those who have attained terminal academic degrees or professional degrees in medicine.1 But the question remains: Should nurses and other health professionals who earn clinical doctorates be referred to as doctor?
If we return to the root of the word doctor and its meaning, we must remember that it's used to describe a learned individual who has developed expertise in a subject matter and who shares that information with others by teaching. It's reasonable to assume that those who have earned a clinical doctorate are teachers, by nature of their education and responsibility to their profession, and must be accountable for sharing their knowledge with others to improve the health of the community. It's postulated that all those who practice at the doctoral level will enhance the profession by imparting distinct principles to their patients and colleagues and being responsible for sparking new knowledge and innovation within their respective professions.
The curriculum and expectations of academic performance in the clinical doctorate programs are far more extensive than those in a traditional graduate program. The focus of these programs is to prepare learned practitioners who focus on advancements in practice, whereas traditional Ph.D. programs focus on the development of theory and preparing scientists. The academic curriculum is arguably different, but I would suggest that one isn't better than the other; rather, the focus is uniquely different. Although there's a tendency to compare the two curricula, they should be viewed as exclusive from each other and valued for their unique contributions.
All professionals who have earned a practice doctorate should be entitled to address themselves as doctor. All have earned the title because of the rigor of academic preparation needed to achieve this level of preparation. The public will need to be educated on the fact that doctor is no longer used exclusively for professors or physicians-it's a term used to denote excellence in academic achievement in a chosen profession.
Richard Hader
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