As I sat through our annual division retreat, I was prepared, as a manager, to speak up when the crickets started during our microaggression training. As a former anti-defamation league facilitator in high school, I was used to the radio silence when people felt uncomfortable speaking up about things they fear may or may not insult someone else in the room. I do believe that people (especially those that dedicate their lives to helping others by working in health care) are inherently good, which is why I feel whoever created the term "microaggression" really nailed it.

The word, as you break it down, implies that the words or actions are not a full-on assault of aggression as much as a teensy tiny little "micro" aggression. A tiny little comment that just kind of zings you a bit, enough that you can maybe continue to carry on the conversation, to avoid an awkward confrontation, but that it sticks with you[horizontal ellipsis]for hours, days, weeks, or maybe even years.

I am surrounded by health care providers in our retreat and our speaker asks for examples of microaggressions they have experienced. There are lots of cringe-worthy stories of racist or sexist comments, and then I volunteer the microaggression that has stuck with me for years, which sounds more like a compliment: "You could have been a great doctor."

My incredibly kind, intelligent, well-meaning physician colleague that had said it to me on multiple occasions was sitting right next to me at the table and truly had no recollection of having ever said it. I still remember the first time she said it: as I uncovered a rare diagnosis in one of our shared hematology patients that other physicians had not picked up on for years. It was not the first time I had heard that statement. Even growing up, my mother, a nurse of 45 years used to tell me "You're smart, you should go to medical school."

I could have gone to medical school. I am confident that I would make a great doctor. I chose to become a nurse practitioner [horizontal ellipsis] and I AM a great nurse practitioner. Whether you put NP or MD after my name, I still uncovered that rare diagnosis in my patient, just as I have picked up on hundreds of clinical issues in other patients that may have been missed by other clinicians. I am also the first person to admit when I do not know something and reach out to advanced practice and physician colleagues for second opinions. Whether you put an NP or MD after my name, I will spend the extra minutes listening to your story in clinic. I will spend the extra hours at night after my kids are in bed looking for the peer-reviewed journal articles to find answers or learn more about challenging cases.

My desire to learn, to understand the mechanism of action of each of the drugs I am prescribing and have the ability to explain it in a way my pediatric patients and their parents can understand has little to do with the initials that follow my name. That curiosity, drive, and type A personality has existed in me since I was a child. It made me the overachiever I always was and will continue to be.

The number of times I have been asked "Are we going to see a DOCTOR?" when I introduce myself and my role as a nurse practitioner to a parent is hard to count-although I can still tell you exactly what examination rooms I was in when it was said to me, because those zings-those little, tiny "micro" aggressions do stick with you. I smile and politely explain that I have been in practice for 10 years specializing in blood disorders, and when they persist, I take "the patient is always right" approach and grab our recently hired physician who is in clinic who calls me every weekend they are on service if there is a hematology patient. My physician colleagues have always been more than supportive and reinforce my expertise in blood disorders to the patients, but I can not say those parents' words do not still sting a bit. Whether they said it or not, I interpret that question to mean "Can you bring in someone that knows what they're doing?"

The career I chose is in no way a reflection of my level of intellect, nor of how good a clinician I am. I chose to be a nurse practitioner for many reasons, and I would not change the path I chose to get to where I am now. I respect my physician, nurse, physician assistant, clinical nurse specialist, and other health care colleagues and the factors that went into their career-path decision-making process, so there are no reasons to validate why the decision I made was the right one for me, just as there is no reason for someone other than myself to make judgments on whether my career path is in line with my intelligence.

Do what you LOVE. LOVE what you do. I love the career I chose as a nurse practitioner, and I will continue to provide the amazing care I do as the intelligent, caring nurse practitioner I am. While nurse practitioners continue to provide excellent care, we can only hope to minimize these preconceived judgments about the initials that follow a name and instead recognize the outstanding care that is provided.