When is a doctor a doctor?
Earlier this week, I wrote two blog entries that created quite a stir in the medical community which you can read at here and here. One of things you will notice is that one or two people wrote comments that poked fun of the word "doctor." This was done by referring to me with the word in quotes and by with another comments saying: "Great, a PhD posing as a doctor."
I know some are going to take this post as being defensive, but that actually is not the intent. The intent is to expose the logical fallacy behind this ridiculous argument. Trust me, I have full confidence in the fact that I am a doctor and I believe that people who use the term in a disparaging way towards others are really saying more about their low-self esteem than anything else because they appear to me to feel threatened by others use of the term.
So let's start with some facts, shall we? First, what is a doctor? The origins of the word come from the Latin word "docere," which means "to teach." According to Merriam-Webster's Online dictionary, here are the relevant definitions of doctor to this discussion, which you can see here if you want:
1: A person who has earned one of the highest academic degrees (as a PhD) conferred by a university
2. A person skilled or specializing in healing arts; especially : one (as a physician, dentist, or veterinarian) who holds an advanced degree and is licensed to practice
Now, isn't it interesting that the dictionary actually lists "PhD" as an example of a doctor? This really destroys the argument that if you have a PhD and call yourself a doctor that you are somehow "posing." Let's look at the second definition. I am a neuropsychologist and psychology is a field that does help people heal. It lists physicians, dentists, and veterinarians as examples; more on this later) but does not say these are the only people who can use the term. It also refers to having an advanced degree and a license to practice, both of which I possess.
So where does the problem lie? The problem lies in the fact that some physicians who have their bowties and penny loafers on a little too tight want to monopolize their use of this term to inflate their feelings of self-worth. I am sure you can find a definition of doctor somewhere that says "physician" as one of the lists but is not the only one by a long shot.
Now, here is where we turn the situation away from PhDs just to let you know how silly this situation gets. I cannot tell you how many times I have heard physicians (people with an MD) refer to other types of MDs as "fake doctors." The two most commonly cited groups I hear this about is psychiatrists and physiatrists. Psychiatry is put down because they see "mental health patients" and do not perform surgery. Physiatrists (who are rehabilitation medicine doctors) are often put down because some of the elitist physicians consider it too easy. Just so I am clear, I think that is absolute nonsense. I work closely with both psychiatrists and physiatrists and have great respect for them and they deserve to be called doctor if they earned the degree. I have heard physicians say many times that dentists and veterinarians are not real doctors. Gee, both prescribe medication and can do surgical procedures so I don't get that one. I guess teeth and dogs aren't difficult enough for the "good 'ol boys" perched in their ivory towers.
And lest anyone think this problem is isolated to doctors, it is not. I have also heard many bedside nurses say that nurses not providing bedside care (e.g., those who work in the OR) are not real nurses because they are not doing the "real nursing work." When will it end? When each person is capable of being comfortable in their own skin and do not need to demean others to feel better about themselves. To quote the eminent scholar, Rodney King, "Can't we all just get along?"
posted by MedFriendly | 7:30 PM
16 Comments:
Dr. Carone, Re your statement What is a Doctor:
"2. A person skilled or specializing in healing arts; especially : one (as a physician, dentist, or veterinarian) who holds an advanced degree and is licensed to practice"
I thought a medical student upon graduation from medical school could call himself doctor right away before being licensed. Am I mistaken?
True. For that person, we go back to definition #1.
Hi. I think psychiatrists are sometimes viewed as "less than" not because of the surgery issue, but because much of the work is less than "hands on"... we use talking as part of the cure. I think that aspect of Not-a-real-doctor has lessened with the psychiatrist's decreased dependence on the couch and increased use of medications to help effect the cure, a more formalized interview/evaluation system and more need for laboratory /vital signs/electrocardiographic monitoring of the patient while on psychotropics.
I still don't wear a white coat.
Thanks for the post!
--Dinah Of Shrink Rap
As an unabashed cheerleader of PM&R physicians, I hear that sometimes too, most notably from orthopaedic surgeons. I have to wonder if their enmity comes from the reality that cold hard steel and orthopaedist ego treatment frequently has outcomes comparable to the results PM&R docs get from conservative measures, especially for such common indications like lower back pain, knee pain and shoulder injury.
Eric
Please. A PhD is not a professional degree. Society understands "doctor," when referring to the medical profession, to mean an individual that has been able to earn an MD. You, whether due to lack of motivation, or more likely lack of aptitude, have not. I'm glad Webster's dictionary validates your semantic point but for a thinking person, that's clearly not the point of how "doctor" is perceived. Fortunately for you, it appears the sort of fans you attract don't spend a lot of time thinking that hard.
The above post is a classic example of the MD God-complex. No one besides the "MD" can call himself a doctor. Please. Read a dictionary and get yourself educated. For all I know, you are not even a doctor since no one knows who you are since you continue to shroud yourself in anonomynity. This is type of person who everyone on the hospital staff can't stand, along with patients. Get over yourself, pal. Yawn.
Now that last response IS defensive.
As you know, I am an MD and I respect the intellectual attributes required of scholarship. As such, I must apologize to my medical colleagues in regarding PhD's as the true doctors. I think in many parts of Europe and other parts of the world, the use of "doctor" is more likely to imply an advanced degree than physicianship.
And for the record, surgeons were considered the equal to barbers in most parts of the world until the early part of the 20th century. To this day, they are referred to as "mister" by non-surgeon physicians in England.
I think part of the problem is that we as a collective society (in the US) have so narrowed our minds that we can't think hard enough to remember or understand the correct origins or use of the term "doctor". It refers not to a specific degree, but to the fact that it is the highest degree conferred in an academic area. That's why we call college professors and others in the higher levels of academia "doctor" as well as MDs, DOs, dentists and DVMs.
It is fudging a bit to call a newly graduated and not yet fully licensed medical student "doctor", but that's a matter of convention rather than fact. Perhaps the underlying problem is not the title itself but the hierarchy imposed on the various branches of medicine and/or academia; we need to get it through our collective heads somehow that a psychiatrist, a vet, a Ph.D.-holding prof, and a surgeon are all rightful holders of the title "doctor", without resorting to puerile name-calling and one-upmanship. Just my $.02, anyhow.
I am actually surprised. Since all physicians are, by definition, college educated, they should understand the simple, irrefutable fact that PhD = "doctor," having taken all those undergraduate courses. I can see that as a clinical PhD in a hospital setting there might be need to clarify the difference between you and physicians, particularly in the eyes of patients who wouldn't know the difference, but nobody should be questioning your right to use the title.
I honestly don't get it. Even chiropractors call themselves "Doctor!" (and I'd be more steamed at that, quite frankly...)
The word "doctor" comes from latin and greek words that mean "teacher". Why do we call people who practice medicine "doctors" at all? They aren't really teaching anyone. According to word etymology, only professors with PhDs should be called "doctors", as it has been for over 1000 years. The medical profession didn't adopt the term "doctor" until the 19th century. The legal system soon followed. It seems to me that the medical and legal professions jumped on the "doctor" bandwagon. Perhaps they weren't clever enough to come up with their own cool-sounding titles.
There is only one real Doctor and he's from Gallifrey.. Please.. People need to get over themselves and respect the time, effort and skill it takes to be any of the different number of Doctors mentioned.
Is it not true that to become a medcal doctor you only need to have one degree (albeit a long, tough one to get) whereas PhDs will always have a primary degree, sometimes a masters degree and also the higher PhD degree?
This is a question not a statement.
If this is the case then really it's the medical doctors who should have the title revision. Name S. Urname, MD. and PhDs get the "Dr." status.
Of course many PhDs shy away from this lofty title and go by Name S. Urname, PhD. You won't find many medical doctors showing similar bashfulness.
I find it interesting that if I refer to a patient as "Mr." and he has his doctorate, he'll be quick to correct me and be quite rude about it. However, if a call an MD "Mr." he doesn't. I'll be the one to correct myself later and the MD always says, "No problem."
I have to say that as a new M.D. I'm quite disappointed to see the widespread antagonistic attitude toward medical doctors. I harbor no ill-will towards those who have achieved the title of doctor in their respective fields, and while I can only speak for myself, I don't get the impression that many of my colleagues feel that way either. It seems that the issue most M.D.s have with the "unsolicited" use of the term "Doctor" relates mainly to the clinical setting where it can elicit confusion among patients who expect that person to be a licensed medical physician. It seems that many people immediately adopt a defensive attitude, assuming that M.D.s want to "sit in their ivory tower" and lay judgment upon others. I would never begrudge a person with a PhD, DPT, etc., calling themselves a doctor in the academic setting or anywhere else--I would just hope they would clarify the distinction in the hospital setting. If you've put the work and effort into getting a PhD/PharmD/DPT by all means call yourself "Dr." However, referring to yourself as a doctor in the medical setting is misleading and implies you possess a skill set that you do not. I don't see how this makes me an insecure, power-hungry tyrant out to demean those in other professions. The training is different--not inherently superior, just different. I would never stroll into a physics conference and introduce myself as “Dr. M”, misleading those around me to believe I possess knowledge that I don’t. It seems to me that people in other fields are quick to jump to the conclusion that the M.D. is judging others' accomplishments and reveling in their own unparalleled success, which is not the case. The snarky, belittling rebuttals that ensue when an M.D. wants recognition for a skill set they worked very hard to achieve only reek of the commentor's own insecurities. Maybe people on this board have come into contact with M.D.s who think that title should be reserved to them in all instances, but it my experience the vast majority do not. To label and judge the group as a whole on that assumption is a grossly unfair generalization.
It's not just the "doctor" issue at the medical office or hospital. There is a lot of obvious spin control going on to establish a hierarchy (i.e., me God, you meat). The same goes for calling those already in pain, "patient" rather than "paying customer." If you are a Ph.D., you deserve that dignity and respect.
Who cares where the word doctor comes from? It makes no difference what it was used for in Latin 2000 years ago. Are we going to start calling lawyers doctor because they have a Juris Doctor (JD)? Its latin...
In vernacular doctor means physician to most people and to us college graduates it could also mean professor. People know when they are REAL doctors. They have an MD, DDS or DVM, etc. They administer controlled substances and society hold them to high ethical standards. I get annoyed when opticians pretend to be ophthalmologist. Its misleading.
Its also misleading when moronic chiropractors pretend to be doctors. I absolutely refuse to call them such. They do a lot of physical damage to people who assume they are medical doctors and thus trust them. The term doctor is used to falsely build the confidence of the patient. I'd rather have someone say, hi my name is Bob, I'll be your Crack-o-practor for today.
And to the issue that psychiatrists are less than surgeons. Its true, but so what. Surgeons look down on lessor surgeons who look down on family doctors, etc. Its the name of the game. http://www.youtube.com/watch?v=THNPmhBl-8I
Oh and my final point. If you ask a professor what they do, they never say... "I am a doctor" but instead say something like "I am a professor of marketing at UNC" When you ask a DVM, they say... "I am a vet". A DDS would reply "a dentist.". When you ask an MD what they do for a living, they always say "I'm a doctor" and that's how it should be.
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