What's Up, Doc?

In an era of health care reform, whom should we call “doctor”?
An opinion by Michael Monasky

Who's your doctor? Is she an educator with an Ed.D or LLD? Is he a sociologist or an anthropologist? Any other variety of Ph.D? Let's not forget J.D. It's likely this editorial will anger most doctors who've never seen a patient, human or animal. I don't care.

It's interesting that the Vatican triggered this tumult with the establishment of Doctors of the Church. St. Thomas Aquinas most famously comes to mind, the guy who tried to count angels on the head of a pin, and prove the existence of God. He failed at both. Unfortunately, the cohort includes the likes of Mother Teresa, who was a devotee of St. Therese of Lisieux (France), who is famously known as the Doctor of Love (no kidding-- step aside, Leo Buscaglia). Christopher Hitchens' tome, The Missionary Position, was a scathing blast at Mother Teresa and her religious order's use of donated funds from 1980's Savings and Loan swindler Charles Keating, and Haitian president/serial killer “Baby Doc” Duvalier. Hitchens surely burns in hell today for that report. To me, none of these players are doctors.

Considering this clerical fraud, my skeptical mind differentiates between whom I call doctor and who would like the title. I see the moniker similar to father or mother. Not anybody can be a mommy or daddy. We're particular whom we call that name, and usually restrict it to one. We want our family doctors to be trustworthy like Marcus Welby, MD: singular, well known, all-knowing, and quaint.

As a human being I reserve the right to be inconsistent and make exceptions to whom I call doctor. Physical therapists have battled the agencies of physician-dom successfully in Arizona, and are still fighting that battle in the California State Legislature. Doctors of Physical Therapy know a boatload more about our joints, muscles, back, spine, hands and feet than most physicians. I have a childhood friend I would not dream of addressing except as Doctor Carl, DPT. Then there are Doctors of Pharmacy, who round with MD's, RN's, and the rest of the medical staff every morning figuring the effects of the mass of medicines put into you. Yup, they're doctors, too.

Physicians in England get a Bachelor of Medicine and don't receive a Medical Doctor assignation as MD's do in the USA. Confusing things further, the USA grants dual MD/Ph.D Research degrees. I won't call you doctor if you don't diagnose, medicate, and surgerize me. Research doesn't count. And chiropractors, who have far less training and know-how, don't get my vote to be called doctor, either. Podiatrists are another class. They actually cut into my feet, which is scary, but necessary, since a lot of regular doctors have deferred to them. OK, so they're doctors. I could make a chart and a list, but you get the point.

Why am I ranting on this seemingly trivial tangent? There's a lot of talk amongst policymakers about health care reform. It runs the gamut, but most of the discussion involves the economics of markets and is guided by economists and marketeers. Some of these have Ph.D's in economics and marketing; some are lawyers with J.D. They are the majority stakeholders in the current health care reform process. Never mind the patients. Never mind their doctors, nurses and practitioners who actually deliver health care services.

I should mention, by the way, that I am not a neutral observer, but a respiratory care practitioner. Not to worry if you don't know what it is that I do; most folks, including the educated of our fold, don't know, either. That includes a lot of those “doctors” I wouldn't call doctor.