By Lisa Marie Reyes-Walsh, DNP, PMHNP-BC, FNP-BC, CARN-AP, CNE

A recent California court decision banning doctorally prepared nurses and other non-physician clinicians from using the title “doctor” in clinical settings should give us all pause. While the 1937 law behind the ruling was intended to protect the public from confusion, enforcing it today reveals something deeper—an outdated hierarchy that denies recognition to the many doctorally educated professionals who make modern healthcare possible.

Let’s be clear: Doctor is an academic title, not a synonym for physician. It signifies the highest level of education in a discipline—whether medicine, nursing, psychology, pharmacy, or education. When a nurse earns a Doctor of Nursing Practice (DNP) or a PhD in Nursing, that title represents years of rigorous study, research, and clinical mastery. Denying these professionals the right to use the title they have legitimately earned is both professionally dismissive and intellectually dishonest.

Patient Confusion or Professional Control?

The court cited an American Medical Association (AMA) survey suggesting that 39% of patients are confused about who is or isn’t a physician. But confusion is solved through education, not erasure. The answer is transparency, not title policing. A nurse who introduces themselves as “Dr. Reyes-Walsh, Doctor of Nursing Practice and Psychiatric Nurse Practitioner,” is being truthful and clear. The public deserves honesty, not an outdated ban designed to preserve one group’s dominance.

This ruling perpetuates physician exceptionalism—the belief that only MDs and DOs deserve full professional acknowledgment. Yet today’s healthcare system is interdisciplinary by design. Patient safety and access depend on collaborative teams that include doctorally prepared nurses, psychologists, pharmacists, and physical therapists. Their doctoral preparation enhances—not endangers—public health.

Truth in Advertising or Truth in Exclusion?

California’s “truth-in-advertising” statute was written nearly ninety years ago, long before advanced nursing practice existed. Applying a 1937 framework to 2025 healthcare ignores decades of evolution. Back then, few women held doctorates, and the idea of a nurse practitioner was unimaginable. Today, the DNP and other professional doctorates are standard pathways for clinicians dedicated to leadership, evidence-based practice, and quality improvement.

The law assumes patients can’t understand the difference between a Doctor of Nursing Practice and a Doctor of Medicine. That’s a paternalistic view of the public and a disservice to patient literacy. Americans can navigate insurance policies and treatment plans; surely, they can comprehend credentials when practitioners clearly identify their discipline and scope of practice.

Why It Matters

Restricting the use of doctor to physicians alone silences a vital part of the healthcare workforce. Nurse practitioners and other doctorally prepared clinicians provide over a billion patient visits annually, often in underserved areas where no physician is available. Their expertise improves outcomes, expands access, and saves lives.

This ruling also sends a troubling message to future healthcare leaders: that one’s highest academic achievement can be dismissed for political reasons. When the law undermines respect for education, it discourages excellence. In a system already strained by workforce shortages, that’s a loss none of us can afford.

The Way Forward

Healthcare deserves transparency, not territorialism. Every professional should disclose their credentials and scope of practice. Patients have a right to know who is treating them—but doctorally prepared nurses have a right to identify themselves accurately.

As Palmer et al. v. Bonta et al. moves to the Ninth Circuit Court of Appeals, the broader issue remains: do we value all who dedicate their lives to healing, or only those within a specific title tradition?

Respect for the word doctor should depend on education, integrity, and contribution—not on one profession’s monopoly over language.

When we start restricting who may be called doctor based on politics rather than merit, we don’t just diminish nursing—we diminish the truth itself.

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