Issue 33 / 5 September 2011

WHAT sort of doctor are you? If asked in general conversation what I do for a living, my reply is “GP”, not the generic “doctor”.

In the written form, the answer is not as simple. My credit card lists me as “Dr Brian Morton” and when a transaction is processed I am usually asked about the discipline of medicine I practise.

This emphasises the point that common usage of the title “Dr” in Australia in the main refers to medical practitioners.

The Australian Health Practitioner Regulation Agency says the courtesy title Dr is not a protected title and may be used by non-medical practitioners as long as they do not induce a belief that they are a registered medical practitioner.

The first entry in the online Oxford English Dictionary defines a doctor as “a person who is qualified to treat people who are ill”. However, Wiktionary’s first listing includes the definition of “a teacher”.

It seems that even we in the medical profession are not quite sure when the title of Dr should apply. Surgeons often use the title “Mr”, and when we achieve a higher academic status we use Associate Professor or Professor.

General practice is a recognised specialty and I can state that I am a “medical specialist” (which is a protected title), but is this another example of the confusion about medical titles?

What is amusing is that when doctor is used as a verb, it can convey the meaning of our complaints about misuse of the title — doctoring: “to change the content or appearance in order to deceive; falsify; eg, he denied doctoring the report”.

A title that is protected by the Health Practitioner Regulation National Law Act is “medical practitioner”. Section 117 of the Act prohibits a person from knowingly or recklessly taking or using any title that could be reasonably understood to induce a belief that the person is registered in a health profession or a division of a health profession in which the person is not registered.

Technology can also blur the lines, with some of my patients seeking instantaneous health advice through internet search engines such as Google — Dr Google. The first problem with the internet doctor is the implicit belief in the veracity of the advice proffered; but this doctor is often hopelessly conflicted.

Unlike consulting room interactions, many patients are not readily able to determine whether the information they discover is from a medical practitioner or a reputable site, and most would not perform due diligence to filter that advice.

So is the title Dr being used deceptively in the Australian community?

The media are usually careful with attribution of comments and identification of those quoted. A recent newspaper article about attention deficit hyperactivity disorder quoted a doctor, but there was no attribution giving the qualifications of the interviewee. Where there is overlap of expertise — in this case, educational, medical or psychological — it is unusual that the journalist did not make the expertise clear.

Those with a PhD, who certainly deserve the recognition for such hard work, would be well advised to indicate they are not medical doctors. The real concern is that the use of doctor implies to the public the skill, training, standards and evidence base that medical practice has established.

The difficulty for the public in knowing who is an expert was highlighted by the recent furore over the misleading and inaccurate statements by a chiropractor concerning vaccination, which raised questions over expertise and his ability to use the title Dr when outside his paradigm of care.

Should we follow the German example — Dr med Morton or Dr Morton (med) — or should all others using the “Dr” title distinguish their health practice registration with an appropriate postnominal?

Do other practitioners who use the title Dr have an obligation to change, or should we be proactive at protecting the community from deception — intentional or otherwise?

Dr Brian Morton is a GP in Sydney and a former president of the NSW AMA.

Posted 5 September 2011

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9 thoughts on “Brian Morton: Protecting our title

  1. Roger Paterson says:

    Good idea. We medicos should get over the inertia, and the feelings of ownership of the title “doctor” and start regularly calling ourselves “Dr Med”, as a proactive way of preventing non-medically trained people from hijacking health care and the health debate.

  2. Mike Busby says:

    I wonder if chiropractors, naturopaths, osteopaths, homeopaths and other cereal packet doctors stand up when they hear “Is there a doctor on board this aircraft” ?

  3. Stan Stylis says:

    What about the AMA registering the name “TruDoc” & “TrueDoctor” & “TDr” and medical practitioners be referred to as TruDoctor Smith…. and written as TDr Smith.
    This way we also accentuate the fact that others are not true doctors. (Once in general use it sounds better!)

  4. paul gatenby says:

    I agree with Dr Morton’s sentiments. I have always thought the simplist way to deal with this issue is for our medical graduates to graduate MD, as they do in most of the world. Everyone knows an MD is not a vet or a dentist or a nurse educator with a PhD. Those amongst us who earned their MD as a research degree, something that mystifies most of the world can get an up-grade “DMedSci”

  5. Glen Quinn says:

    As an RN (without Doctoral quals) the argument has always been, for me, that like me, entry level medical officers historically held undergraduate degrees as did allied health professionals and nurses. Claiming the MD status, surely has to carry the equivalence of study as other doctoral studies. This has been the respect that I have always shown the Australian-trained MBBS. They studied 6 long years but came out with double undergrad degrees, not doctoral qualifications.
    As pointed out in the article “the Act” protected “medical practitioner” not “doctor”.
    Just MHO.

  6. S says:

    Glen’s comment unfortunately just goes to show how the respect for a medical degree has been watered down over the years to where it is now – just another undergraduate degree like nursing and allied health. I always thought that the academic rigour and gruelling years of study in the medical course was considered equivalent to doctoral studies (despite not being by research), and that is why medical graduates are given the title ‘doctor’, and given honour at graduation ceremonies over other bachelors degree graduates. With the title also comes great responsibility (unfortunately not least of which is medicolegal!), which is similarly not shared to the same degree by nursing and allied health professionals.
    With all respect to Glen I’m sure that my opinions are coloured by my own experiences as a young doctor in the hospital system, where I see doctors undervalued by the system everyday, including by a proportion of the nursing staff who believe they can ‘do what the doctor does’, without any understanding of the vast differences between a medical and nursing education (and of course without taking on any of the legal responsibilities).

  7. j says:

    It is annoying when overseas that we have a bachelor degree whilst others are awarded an MD for completing a degree of the same rigour. Perhaps this needs to be considered in Australia. It might then be less confusing for the poor public as we could be referred to as Dr Smith MD for example versus Dr Smith PhD.

  8. Anonymous says:

    Melb Uni now has made Medicine ( as well as other degrees ) a postgraduate degree anyway, so graduates will from now on be awarded MD.
    Not that I think a 4 yr postgraduate course is any better than a 6 yr undergrad course anyway…

  9. Rearguard Action says:

    I feel this is all part of a rearguard action. Respect for MBBS definitely decreasing like radioactivity.
    Whatever, I feel we have to ensure we hold up our high standards and don’t let them slip. (i.e. fatuous still ongoing discussion whether doctors need to do extensive anatomy in undergraduate courses – as they did only 20 years ago). Yes if you aren’t training doctors – they don’t need good knowledge of anatomy, etc.
    I work in rural medicine and need quite reasonable knowledge of anatomy daily. We should not underestimate the overall effort of learning needed to get to safe independent medical practice.
    Respect for doctors means they should be well trained – and on this note, I still fail to see how you can fit 6 years into 4, and how chopping out lots physiology, anatomy, microbiology, pathology, will help matters. I am not an old fogy yet.

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