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Posted

Scuba, you will find that you are in the minority and I admire you for that. There is a big push by Mundinger, et al, who want to practice and be paid like doctors (and want to be called doctors). It's interesting that they are using the argument that using a DNP will decrease costs because they get paid less, but yet they want to be paid the same.

Posted

If you want to be a doctor, be a doctor and get paid like a doctor. I wouldn't expect to be paid as a doctor even with a DNP title because nurses don't have the 4 years, we have on average 2, and no prolonged residency/fellowship requirements.

  • 2 weeks later...
Posted

Per Mr. Webster, a medic is, " one engaged in medical work or study; especially "

So while colloquially, a medic is a paramedic, the reality is, there's nothing actually written to specify that, and if someone wants to get all bent out of shape about it, then they probably need to worry more about patient care than their title.

Unless the guy is saying he is a "Paramedic", or heaven forbid, practicing above his scope of practice, it's not an issue.

And in all reality, EMT-B, I, or P, 95% of your patients don't understand our colloquial language, and don't know that typically a medic is a "paramedic".

There's a similar (but slightly different) argument with some MD's. Their PAs, and CRNP's who have PhD's introducing themselves as Dr. so and so, they really aren't wrong, as long as it's made clear that they aren't an MD.

The point is, stick within your scope of practice, don't call yourself an official title that you aren't.

When I was an Army Medic, they called me, and most other medics "Doc". They all knew I wasn't a physician, and I never acted as one, so there was no problem, even when the physicians heard it, they didn't have a problem with it, because I conducted myself with a proper scope of practice.

Posted

Your dictionary definition will vary depending on what dictionary you are looking at. Most ambulances I have been on don't carry a dictionary so that the pt can determine what kind of 'medic' they are dealing with. Yes, there is something wrong with that. It is someone identifying himself as something he is not. As with everything in the real world it is all a matter of context/situation. It is no big deal if they are doing it in a non-medical setting where it has no meaning or significance. It is dishonesty when you do it to a pt or other providers in a healthcare setting. If you want the title then get the title but don't be dishonest to your pts and other providers. As for the distinction of 'doctor' with the other providers, there are many that don't clarify that they are not an MD/DO which is just as dishonest. Again, it is all about the setting and pretext. In your Army example, that is again situational. It has a well establish history and meaning and is common among all services. Navy corpsmen are also called 'doc'. The soldier/sailor/Marine/airman understands exactly who is taking care of them and quite honestly, most service medics probably could function as physicians and deserve to be called doc.

Posted

I've always found the formality in medicine a little strange. Something I've liked about EMS, is that I don't have this barrier of formality between me and my patients, I can walk in and say, "Hi, I'm <firstname>, and I'm a paramedic...", and the assumption is we're going to operate on a first name basis on the same social level, and treat each other, patient and provider, as peers. There's a certain authority I derive my uniform, my presence, and the simple fact that the patient, generally, has called for my help, but it doesn't come from the title of paramedic.

I've noticed that the physicians I really respect seem to embrace that viewpoint as well. I remember one of our crews, 10 years ago, bringing in an elderly patient with a large anterior wall MI. The attending walks straight up to the wife, "Hi, I'm Andy, I'm going to be your doctor today, I realise that you probably have a lot of questions, and I'm going to come back and answer them in a few minutes, but right now I have a couple of things I have to do first, please sit here.". These are people I respect. I don't mean to tar all of medicine with one brush, but I have met too many people who hide behind a white coat (or, a paramedic uniform, or a set of scrubs), and use this as an excuse to treat people like meat. I think that, in some strange alter-universe, if I was a physician, this forced formality would irritate me.

I have a friend who has a doctorate in international relations law, who like to sit in his family doctor's office, and when the nurse comes out and says, "John, Dr. Smith is ready to see you", he says, "Tell Dr. Smith, Dr Kxxxxxx is ready to see him". It's a rather uncommon last name. It's not that typical to use the title "Dr." in the academic world, as pretty much everyone has a PhD, or MD, or MD/PhD. It's largely reserved for undergraduates, or perhaps for a visiting guest.

The debate here, to me, is whether a DNP introducing themself as a "doctor" is misleading towards the patient in a healthcare context. To me, there's no question as to whether they've earned the right to call themselves doctor --- they have a doctoral degree from a university. They have that title. But to use it in this context seems potentially misleading, unless it's clarified as, "I'm a doctor of nursing practice", or "I'm a doctor of pharmacy". It does seem strange to me, though, that physicians are quite willing to accept a blurring of lines between, "I'm Dr Kevorkian, a board-certified emergency medicine physician, providing care in this ER", and "Hi, I'm Dr. D'eath, a family medicine physician with a one year emergency medicine subspecialty certification", without complaining as loudly. This seems to be a bit of a double-standard.

If non-MDs can provide medical care, at an acceptable standard, while working independently, let them do it. But, if they're going to do that, let them also be honest about what their background is. Either the physicians need to move towards, "I'm a physician", or "I'm a doctor of medicine", or the nursing DNPs need to clarify "of nursing practice". The patient shouldn't be left in a state of confusion as to who is looking after them.

Posted

But, would your brother stop at an accident scene and say, "Hi, I'm Dr. RichBBrother. What happened?" On the flip side, if I were to give a lecture that had nothing to do with medicine, I would never refer to myself as doctor and if the MD was irrelevant to the course or whatever I was doing, I wouldn't include it. MD is the degree I earned and the job I do, but it does not define who I am.

Posted

I know one thing. If I make it through grad school, I'm making everybody refer to me as "master." Those who know my last name will understand how much fun I can have. I will make sure that master is used in all settings, clinical or otherwise.

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