The "Doctor" Debate: Title Protection, Power Struggles, and the Mental Health of Nurse Practitioners
Introduction
The word “doctor” has long been associated with physicians, but it is not exclusive to them. In fact, “doctor” is an academic title earned by anyone who completes a doctoral-level education, including those in nursing, education, psychology, pharmacy, physical therapy, and more. However, in recent years, several state medical boards have pushed to legally restrict the use of the “doctor” title in clinical settings, claiming it creates confusion for patients.
This growing controversy not only misrepresents what the title truly signifies, it also perpetuates professional division and damages the mental health and morale of nurse practitioners (NPs) who have rightfully earned the title through doctoral study.
In this post, we’ll explore:
The meaning and origin of the title “doctor”
The growing efforts to monopolize the title within medicine
Real-world examples and legal challenges
How this battle affects nurse practitioners, especially those with a Doctor of Nursing Practice (DNP) degree
The mental health toll of professional invalidation
Why this conversation matters for the future of collaborative care
1. What Does “Doctor” Really Mean?
The word doctor comes from the Latin docere, meaning "to teach." Originally, it referred to scholars in philosophy, theology, and law. The use of the title in medicine came later.
Today, “doctor” denotes the completion of a terminal degree, a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Doctor of Nursing Practice (DNP), Doctor of Education (EdD), Doctor of Psychology (PsyD), Doctor of Pharmacy (PharmD), etc.
It is an academic distinction, not a profession-specific one.
🔹 A nurse with a DNP has the same level of academic achievement as a physician with an MD, just in a different discipline.
🔹 In both cases, they have completed rigorous doctoral-level coursework, research, and clinical training.
2. State Medical Boards and the Title Tug-of-War
In recent years, state medical boards and physician organizations have lobbied to restrict the use of the title “doctor” in clinical settings to only physicians (MDs/DOs).
Real-World Examples:
California (2023): Nurse practitioner Dr. Kimi Arantes, DNP, was fined $20,000 by the state for identifying herself as “Dr. Kimi” in her practice, even though she holds a Doctor of Nursing Practice degree and clearly identified herself as a nurse practitioner.
Georgia (2021): Proposed legislation sought to prohibit any healthcare professional other than physicians from using the title “doctor” in clinical environments, regardless of degree earned.
Florida & Texas have considered or passed similar bills aimed at limiting title usage, citing “patient confusion” as justification.
Ironically, research consistently shows that patients care more about provider competence, communication, and compassion than about titles.
3. Who Gets to Be Called “Doctor”? A Matter of Power, Not Clarity
At the heart of this debate is not confusion, but control.
Physician groups argue that using “doctor” in a clinical setting should be reserved for MDs/DOs to avoid misleading patients. But this argument fails to recognize:
That nurse practitioners with DNP degrees clearly state their role and title (e.g., "Dr. Jane Smith, DNP, Nurse Practitioner")
That PhDs, PsyDs, and PharmDs routinely use the title in clinical and academic environments without scrutiny
That transparency, not title restriction, is the key to preventing patient confusion
These efforts are often rooted in protectionism, not patient advocacy.
4. The Mental Health Impact on Nurse Practitioners
For nurse practitioners who have devoted years, and often over $100,000 in tuition and fees, to earn a doctoral degree, being told they cannot use the title “doctor” is more than a semantic dispute. It’s a direct blow to their identity, validation, and professional autonomy.
Mental Health Consequences Include:
Imposter syndrome: Being told your education is “less than” others’ can erode confidence.
Burnout: Constantly battling for professional recognition adds to emotional exhaustion.
Decreased morale: Feeling marginalized or undervalued contributes to disengagement and job dissatisfaction.
Identity invalidation: The denial of a hard-earned title damages self-worth and professional pride.
Statistics to Consider:
According to the American Association of Nurse Practitioners (AANP), there are over 36,000 NPs with doctoral degrees in the U.S. and that number is growing each year.
A 2022 survey of nurse practitioners by MedPage Today found that 48% of DNPs reported feeling disrespected by physician colleagues and 27% reported that conflicts over title usage negatively impacted their mental health.
Burnout rates among NPs now exceed 45%, with lack of professional respect cited as a leading contributor.
5. What Needs to Change
A. Acknowledge the Academic Achievement
A DNP is a doctoral degree. Full stop.
Professional titles should reflect earned credentials, not be dictated by professional turf wars.
B. Educate the Public
Rather than restrict titles, focus on clarifying roles and scope of practice.
Patients can and do understand that a "Doctor of Nursing Practice" is a different role from a physician.
C. Promote Interdisciplinary Respect
Healthcare is a team effort. Undermining one profession diminishes all others.
Mutual respect leads to better patient outcomes and better mental health for providers.
D. Protect Mental Health
Provide safe spaces for nurse practitioners to discuss professional stressors, identity challenges, and workplace inequities.
Encourage therapy, peer support, and policy advocacy as tools for empowerment.
Conclusion: “Doctor” Is Earned…Not Owned
The attempt by some state medical boards to monopolize the title “doctor” reflects a deeper struggle over power and recognition in healthcare. But words matter and so does respect.
Nurse practitioners who have earned doctoral degrees deserve to be recognized for their achievement. Their expertise, care, and education are not diminished by professional insecurities in other fields. Denying them the right to use the title they’ve rightfully earned only fuels stigma, conflict, and mental distress.
It’s time to end the debate and focus on what matters most: team-based care, patient-centered outcomes, and mutual respect among healthcare professionals.
If you or someone close to you is a nurse struggling with imposter syndrome or declining mental health, Desert Willow Behavioral Health is here to help. Schedule a free consultation today!
