It can be confusing and overwhelming for patients to navigate the medical system and get the care they need, at the time they need it, and within the parameters of their insurance. There are many layers of challenges in getting information and understanding it, and that is only more difficult for those who do not speak English. We have a responsibility as healthcare providers to try to give as much clarity and support as possible to patients throughout their treatment process — and that includes providing clear title and qualification information about who the different members of the healthcare team are, what their role is, and how they will work together to provide care.
Unfortunately, there have been accounts of patients being misled or misinformed about who is providing their care. There have even been lawsuits and complaints against healthcare practitioners who are labeling themselves as “doctor” but are not actually physicians. California law already dictates who can and cannot use the term “doctor,” however, there are still unclear areas that cause confusion. In a college lecture hall or academic setting, the title “doctor” could easily be understood to apply to someone with a PhD and/or who is a professor, but certainly does not assume or imply a medical doctor. But in a hospital or clinical setting, the context matters, and the word “doctor” is going to be interpreted as a medical doctor who has gone through medical school, residency, and clinical training programs to be qualified to diagnose and treat patients.
Patients deserve clear communication about the role, training, and qualifications of their healthcare provider. That’s why we support strengthening existing California healthcare provider title protection laws. Other states should do so as well.
Unfortunately, we are seeing with increasing frequency situations where the roles or qualifications of non-physician providers are becoming blurred. Some non-physician providers are adding the physician specialty-specific “-ologist” terms to their title, like “anesthesiologist,” “dermatologist,” “cardiologist,” etc., or including the word “surgeon,” or substituting the word “associate” for “assistant.” For example, the American Association of Nurse Anesthetists rebranded to the American Association of Nurse Anesthesiology. National University is using the designations of “nurse anesthetist” and “nurse anesthesiologist” interchangeably. Some certified registered nurse anesthetists list “nurse anesthesiologist” in their professional profiles online. For a professional that has never been labeled this way, why make the change and risk confusing patients?
Of course, in most cases this likely isn’t being done with malicious intent. However, when a non-physician uses language that suggests they have more training, qualifications, or capabilities than they actually do, it threatens the ability of patients to make informed decisions about their care and it threatens the credibility of our entire healthcare system.
Particularly in this age of misinformation, when patients can so easily stumble upon false or misleading content online, it is essential that the information they are given about their healthcare providers is accurate. If it is not, misleading information about a healthcare provider’s capabilities and licensure status can put patient safety at risk in some cases.
Recently in California, a legislative effort led by the California Medical Association and supported by the California Society of Anesthesiologists attempted to create clear protections around the “-ologist” terminology. The goal was to ensure that “physician-equivalent” terms could only be used by the physicians who have such qualifications. The measure ultimately failed to pass this year, but the issue deserves renewed attention and a fix by legislators in the coming year.
In all walks of life, professional designations are important in assuring consumers that the services they receive are from trained professionals (i.e., plumbers, electricians, auto mechanics, etc.). In healthcare, the stakes are high and lives are on the line. Patients should have the right to know who they are speaking to, how to evaluate that person’s recommendations, and how to determine their next steps for care.
In healthcare, we work to prevent harm every day. Strengthening our healthcare provider title protection rules so that physician-equivalent terms are protected is the right, logical step to prevent harm and to give healthcare consumers the information they deserve. It does not change the scope of practice of any particular practitioner in any way. Improved “title protection” legislation will simply empower patients at the right time and place with more information about their healthcare providers, enabling them to make informed decisions that meet their personal needs and protect their safety. Our patients deserve nothing less.
Antonio Hernandez Conte, MD, MBA, is an anesthesiologist and the president of the California Society of Anesthesiologists.