Blurring Credentials

It is becoming more and more clear that determining who is and isn’t a doctor is confusing. It used to be quite straightforward. When I was a resident, there was still a subset of elderly patients who thought that all the females employed by the hospital were nurses and the males were doctors (!).

Of course, we have come a long way since then. What is now becoming grayer is exactly what credentials and training the people who are providing medical care have. A recent article in The Atlantic brought this to light. This particular article questions a bill allowing optometrists to expand their role to perform minor surgeries that are normally performed by an ophthalmologist. But it also points out a trend of increasing blurriness of distinctions among different levels of healthcare providers, particularly as those who have the most time and the most to gain from lobbying to congress are becoming more influential.

I recently came across the website of a naturopathic doctor who called himself “Dr. [his name], ND.” This redundancy suggests that while he would like to be called doctor, he wants to be clear that he studied naturopathic medicine. This is nice for clarity. But, I will admit that am a little nit-picky, and think he needs to use only one or the other designation when writing out his name.

Certainly, there are excellent providers who are not MDs. I have referred many patients to ARNPs and PAs and will continue to do so if they are going to provide the level of care I expect. I, myself, went to an ARNP even though I had a choice to see an MD. Most of these very qualified mid-levels are quite professional and knowledgeable and correct patients who confuse them for MDs.

Do patients want to know who is an MD and who is not? Apparently, they do. This is according to a recent article in American Medical News, which also reported on proposed federal legislation that would require health care professionals to avoid patient confusion by being transparent about their qualifications when advertising services. They also reported the results of a survey which showed that most adults find it difficult to determine who is a physician in advertising materials.

Ultimately, people should be afforded the opportunity to have their healthcare needs met whether it be via MDs or qualified non-MD healthcare providers. But at this time, they will have to do their research and be clear on who is treating them because some advertisements are vague and misleading.

And when proposing expansion of the roles of non-MDs, policy makers should find ways meet the needs of the public long-sightedly. They should ask themselves “If I or a loved one were to have [name a condition], what kind of training would I expect from the person treating me or my child?” and then ensure that an appropriate level of training is included with the role expansion.


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