Is There ‘a Doctor’ in the House? The Answer Depends on Where You’re Located

The fight by nurse practitioners to be addressed as “Dr.” (and by some physicians to keep them from doing so) has reached the litigious stage in California. As reported by The Washington Post, three NPs there are suing to prevent enforcement of a state law under which physicians and surgeons have the exclusive right to refer to themselves as “doctor” or to use “Dr.” before their name. And the state does, in fact, take an aggressive stance toward enforcing the law; California NP was fined $20,000 by the state and $2,500 by the state medical association for referring to herself as a doctor. Physician groups in California and other states have objected strenuously to the practice on the grounds that patients may be misled as to the level of training undertaken by the healthcare provider treating them. It’s undeniable that NPs and physician assistants—indispensable members of the clinical team in many urgent care centers—don’t have the same requirements to meet that physicians do. That doesn’t mean opportunities to further that training don’t exist, however. An article in the JUCM archive, The Case for an Interprofessional, Postgraduate NP/PA Fellowship in Urgent Care, presents the rationale for pursuing a higher level of training and ways that could be accomplished for the benefit of the NP, PA, operator, and patients.