Use of medical titles by non-doctors can mislead patientsBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4241 (Published 20 July 2011) Cite this as: BMJ 2011;343:d4241
- Waseem Jerjes, research registrar in surgery, Chase Farm Hospital, London,
- Tahwinder Upile, consultant surgeon, Chase Farm Hospital, London
The increasingly widespread use of doctors’ titles by non-medical professionals in clinical settings is a serious concern. The BMA has commented on the problem of job titles that confuse patients, suggesting that those such as “consultant” and “surgeon” should not be used by non-clinicians because they cause confusion among patients (www.bma.org.uk/patients_public/whos_who_healthcare/glossallied.jsp).
In a survey of 262 members of the public by the British Orthopaedic Trainees Association 95% of the public and 84% of healthcare professionals thought that a person using the title “consultant podiatric surgeon” had a registered medical qualification—that is, that he or she was a medically qualified doctor. Obviously when these titles are used in hospitals or elsewhere in the NHS confusion can occur that may potentially endanger patients. There is public outrage at counterfeit or mislabelled drugs, logically should this be extended to those administering or directing treatments?
Another concern is the use of a doctor’s title in an NHS context by non-medical personnel holding a doctor of philosophy degree (PhD). A technician or a nurse specialist with a PhD may call themselves “doctor” when meeting patients. Patients are likely to assume that these doctors are medical personnel, and unlikely to ask whether they are “medical” doctors or whether they have earned PhDs. It is possible that patients will discuss confidential problems believing that the professional is medically qualified. How can we be sure that these other professionals will uphold the duties of a doctor, or should we just assume that they will?
I was misled one day when I was asked to go to clinic and take an impression for a patient for a dental prosthesis. A man who introduced himself as “doctor” was standing in the clinic talking to the patient. The patient was openly discussing her disease, assuming she was talking to a medical doctor, and that all was confidential. I later learnt that the man was a technician with a PhD.
Another time I was asked to contact a “doctor” to discuss a patient’s case for follow-up in the community. After speaking on the phone I found that I was discussing the management of my patient with a specialist nurse with a PhD and not a medical doctor. These events made me think about the implications of these misunderstandings for both doctors and patients. I am bound by the General Medical Council’s regulations for good medical practice, this is not necessarily the case for some allied healthcare professionals.
Holding a PhD is a great academic achievement, and holders of this degree should be respected. The use of the title “doctor” in hospitals or elsewhere in the NHS by non-medical personnel, however, is likely to lead to confusion that may affect doctors and patients alike.
The problem may lie in the public perception of non-medical practitioners and perhaps it is their profile that needs to be raised. My aim is not to devalue them, instead I hope that their roles can be valued without “hijacking” another profession’s. Political correctness should not overshadow clarity or honesty. I ask the BMA and concerned medical societies and associations to take unified action to prevent these acts of unintentional deception.
Cite this as: BMJ 2011;343:d4241
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.