When you visit a medical practice or a hospital, you’re probably expecting to see a doctor. But in recent years, there has been an increase in non-physician clinicians, also called mid-level providers or advanced practice providers, providing health care. These include nurse practitioners and physician assistants. All of these providers have requirements and standards in order to deliver care and can do an excellent job — but one thing that has surprised me as a doctor is just how often my patients don’t seem to know when they’ve seen a doctor and when they haven’t.
In 2010, Pennsylvania, where I practice, passed a law mandating that all physicians, nurses and other health care professionals wear photo identification badges that state their credentials clearly, such as “physician” or “registered nurse.”
The American Medical Association has its own “Truth in Advertising” campaign asking that all health care professionals clearly identify themselves in all writings, advertisements and communications; that health care professionals wear name tags that identify the licenses they hold; and that prohibits advertisements or websites that might mislead or deceive patients.
Mid-level or advanced practice providers have a different level of training and qualifications than physicians. These providers, such as nurse practitioners (NPs) and physician assistants (PAs), undergo graduate-level programs after completing their undergraduate degrees. While their training is comprehensive and includes clinical experience, it is typically shorter in duration compared to that of physicians.
To become a board-certified dermatologist, for instance, you must complete eight years of training (four years of medical school and four years of residency) and pass a board exam. NP and PA school are each two years total without specialty training or board exams.
NPs in Pennsylvania, for example, work collaboratively with physicians, while PAs are supervised by physicians. Both can provide primary care, preventive care and specialized care. However, their scope of practice may be limited in certain areas, and they often refer more complex cases to physicians.
What should you do as a patient seeking expert care?
PAs and NPs play important roles on a health care team — I know, since they’ve been an important part of our team at my practices. Still, you should make sure you know who is and who is not a doctor, because their training is not equivalent to medical residencies and board-certification. If you want to see a doctor, insist on it — even if that means waiting longer to get an appointment.
Check the credentials of the person wearing the white coat or scrubs who will be caring for you — are they a physician, PA, or NP? For example, is the person claiming to have expertise in dermatology actually a board-certified dermatologist who completed medical school and four years of a residency? Is the person who introduces himself or herself as “doctor” a medical or osteopathic physician or do they hold a doctorate in another field? Indiana passed a so-called “ologist” law in 2022 prohibiting anyone who is not a physician from using medical specialty titles or designations, including “anesthesiologist,” “cardiologist” and “dermatologist.” It also prohibits health care professionals from using deceptive or misleading advertising that misrepresents or falsely describes their profession, education or skills.
Truth in advertising means you know what you are getting. Make sure you are seeing providers with the level of training you and your loved ones deserve. It’s not right if providers without a MD/DO degree call themselves doctors without clarifying to the public they are not a medical or osteopathic physician. You deserve the best healthcare, and it should be transparent who is providing that care.
Jules Lipoff practices as a board-certified dermatologist and serves as a clinical associate professor (adjunct) in the Department of Dermatology, Lewis Katz School of Medicine, Temple University.