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Doctor to Doctor

 
 
American Medical Association House of Delegates Resolution 303 (A-08)
Restricted Use of the Titles "Doctor," "Resident," and "Residency"

William E. Benet, Ph.D., Psy.D.
Editor, AssessmentPsychology.com

In April, 2008 the Illinois Delegation to the American Medical Association House of Delegates introduced Resolution 303 (A-08) to restrict the use of the titles "doctor", "resident" and "residency" in medical settings to physicians, dentists and podiatrists. [Read resolution 303 (A-08)]. This provoked a strong response from other health care professions and organizations, including the American Psychological Association, American Board of Professional Psychology, and National Alliance of Professional Psychology Providers:


Response from the American Psychological Association (APA.org):

June 11, 2008

Via E-Mail to: Roger.Brown@ama-assn.org

David Lichtman, MD, Chair
AMA Reference Committee C, Medical Education
c/o Roger Brown, Ph.D.
Director, Office of the House of Delegates Affairs
American Medical Association
515 N. State Street
Chicago, Il 60610

Re: American Medical Association House of Delegates Resolution 303 (A-08) Restricted Use of the Titles "Doctor," "Resident," and "Residency"

Dear Dr. Lichtman,

The American Psychological Association ("APA") strongly urges the American Medical Association House of Delegates to oppose proposed Resolution 303, which seeks to restrict the title of "doctor," "resident," and "residency" in medical settings to apply only to physicians, dentists, and podiatrists. APA is the leading scientific and professional society representing psychologists in the United States and is the world's largest association of doctorally trained psychologists, with more than 148,000 members and affiliates. Psychologists practice in all areas of health care and have a long history of using the title "doctor" in all medical settings, including hospitals, academic health centers, medical schools, clinics, and private offices.

Use of the term "doctor" recognizes psychologists' extensive education and training as well as their positions in medical settings as supervisors and managers of patient care at the highest level. Licensed psychologists spend an average of seven years, beyond college, in education and supervised training leading to licensure to practice psychology. Psychologists complete extensive doctoral level training in the diagnosis and treatment of mental disorders well beyond that which physicians receive. This training includes thousands of hours of supervised practice in psychology and a year of formal internship. Most psychologists also receive supervised post-doctoral training as one of the requirements for licensure. Psychologists are licensed to practice independently, free of physician supervision, in all 50 states and are recognized as independent practitioners by state and federal programs, including by Medicare and the Department of Veterans Affairs. Psychologists serve on the medical staffs of hundreds of hospitals, supervise treatment teams, and hold senior management positions at medical facilities. Psychologists are also routinely referred to as "doctor" in European and other countries.

Psychologists who receive training in a specialty practice area are also referred to as "residents." They train in residencies housed in academic health centers, medical schools and other medical settings. These programs are accredited by the American Psychological Association, which is recognized as an accreditation agency by both the U.S. Department of
Education and the Council for Higher Education Accreditation.

Proposed Resolution 303 would only confuse patients, who have used the word "doctor" to refer to psychologists in medical and mental health settings for decades. The term recognizes psychologists' extensive education and training and their high-level, independent management of patient care. APA strongly urges the American Medical Association House of Delegates to oppose Resolution 303.

Please feel free to contact Maureen Testoni if you have any questions.

Sincerely,


Alan E. Kazdin, Ph.D.
APA President

Norman B. Anderson, Ph.D.
Chief Executive Officer


Response from the American Board of Professional Psychology (ABPP.org):

June 14, 2008

Via E-Mail to: Roger.Brown@ama-assn.org

David Lichtman, MD, Chair
AMA Reference Committee C, Medical Education c/o Roger Brown, Ph.D.
Director, Office of the House of Delegates Affairs American Medical Association
515 N. State Street
Chicago, II 60610
Re: American Medical Association House of Delegates Resolution 303 (A-08) Restricted Use of the Titles "Doctor," "Resident," and "Residency"

Dear Dr. Lichtman:

The American Board of Professional Psychology (ABPP) strongly urges the American Medical Association House of Delegates to oppose proposed Resolution 303, which seeks to restrict the title of "doctor," "resident," and "residency" in medical settings to apply only to physicians, dentists, and podiatrists. ABPP is the leading psychology board certification organization in the United States.

The term "doctor" recognizes the extensive education and training of psychologists (who have an earned doctoral degree). Psychologists practice in many areas of health care, and have historically used the title "doctor" in hospitals, medical centers, academic health centers, medical schools, clinics, and private offices. Many psychologists hold positions in medical settings as supervisors and managers of patient care at the highest level. Psychologists serve on the medical staffs of hundreds of hospitals, many of which require board certification of psychologists just as is required of physicians. Psychologists are supervisors of treatment teams, hold senior management positions and are routinely referred to as "doctor" in the United States, Europe and throughout the world.

Recognized as independent practitioners by state and federal programs, including by Medicare and the Department of Veterans Affairs, psychologists are licensed to practice independently and without physician oversight in all 50 states.
Proposed Resolution 303 would confuse patients and the public, who are accustomed to referring to psychologists as doctors. ABPP strongly urges the American Medical Association House of Delegates to oppose Resolution 303.
Sincerely,


Christine Maguth Nezu, Ph.D., ABPP
President


David R. Cox, Ph.D., ABPP
Executive Officer


Response from the National Alliance of Professional Psychology Providers (NAPPP.org):

June 12, 2008

David Lichtman, MD, Chair
AMA Reference Committee C, Medical Education
Director, Office of the House of Delegates Affairs
American Medical Association
515 N. State Street
Chicago, Il 60610

Dear Chairman Lichtman:

Please be advised that should the AMA adopt the proposed Resolution 303, our organization will file a complaint before the Federal Trade Commission against the AMA for restraint of trade and for attempting to steal the property rights of licensed psychologists. NAPPP is an organization that represents licensed clinical psychologists only, and we will fight any attempt to restrain our trade and diminish our rights to training. As healthcare professionals, we are amazed that our physician colleagues are so insecure that you feel the need to literally hijack a title that historically was never yours. While we realize that the AMA resolution has no impact in law, and this resolution is an attempt restrain trade by influencing training regulations in hospitals and other healthcare facilities, we believe that any attempt to take what is not yours must be fought vigorously and without hesitation.

NAPPP is a strong believer in collaborative practice. We try to instill in our members the value of working with physicians. This resolution will have the effect of creating an adversarial relationship that psychologists have tried to avoid. We remain surprised and clinically interested as to why some physicians need such a resolution. Does the AMA not think that there are no other more pressing issues to deal with?

Other psychology organizations may feel the need to try to appeal to your sense of reason but NAPPP has no such intent to do this. It is clear that the AMA seeks hegemony over all of healthcare at a time when consumers need choice and access to competent practitioners. So, go ahead and pass your resolution. We accept that in a democracy, people and organizations have a right to engage in any activity or activities even if outright ridiculous and destructive.

However, these selfish activities must not butt up against the nose of the next person or limit consumer's access to care from other professionals. I would think that physicians would want to devote more attention to gaining more competencies and helping patients as opposed to spending time and resources trying to convince the public who are the "real" doctors. Psychologists need no such resolutions or laws because we have a degree and independent license that says we are doctors. Perhaps, you should take another look at your degree. If you do, I'm sure this will be all the validity that you will need to establish your appropriate title.

Very truly yours,


Dr. John Caccavale
Executive Director, NAPPP

What's in a Name
John McCoy, Ph.D.
The Clinical Practitioner. 2008 Jun, 3(6), 6-8.
National Alliance of Professional Psychology Providers

William E. Benet, Ph.D., Psy.D.
Editor, AssessmentPsychology.com

The doctoral status of psychologists is often not recognized by the media, particularly the Associated Press and Reuters. This informative article by John McCoy, PhD, a former president of the Tennessee Psychological Association, which appeared in the June, 2008, issue of The Clinical Practitioner, examines the editorial policies of AP and Reuters in regard to use of the title.

Here are some excerpts, with suggestions for addressing AP's position in regard to using the title in reference to psychologists.

"The Reuters Handbook for Journalists explains how ‘doctor’ can be used: 'When used as a title for a physician, abbreviate to Dr. without a full stop. Do not use Dr. for doctors of philosophy, etc, but it can be used for archbishops and the like in preference to honorifics like Very Rev. or the Most Rev.' "

"Recently, faced with increasing criticism about the media problem, APA staff corresponded with the overseer of the AP Stylebook, Darrell Christian, in March and April of this year, presenting the case for showing psychologists as doctor, or with their degree, and simply asking AP to change their stylebook. AP response was that the stylebook would remain the same."

"I recently testified in a trial that was covered by a newspaper from a small city with a population of 14,000. Initially in the article, I was mentioned by my name only, followed by "a clinical psychologist." From that point on, I was listed as "McCoy," such as McCoy said this, etc. A psychiatrist there, who had almost no role in the trial, was addressed as Dr. throughout the article."

"I was amazed that a newspaper this small had this policy so I called them. They stated without apology that they were 'just following the AP style.' "

Dr McCoy suggested several ways to rectify this "onerous" editorial policy:

"There are several more effective ways that the media problem might be addressed. The AP and Reuters policies can be perceived as mean spirited and unfair. The public would view the Reuters policy as carelessly written, a trait that editors aren’t supposed to have. More troubling is the likelihood that they are they have been manipulated and influenced by the medical lobby. As supposed independent and fair operations, they certainly wouldn’t like publicity to this effect."

"Neither AP nor Reuters wants the public to see them as mean or easily manipulated. After all, their credibility and independence is their most important asset. I suspect that this would happen if it came down to a lawsuit against AP or Reuters. For this reason alone, they might make favorable changes. And, of course, it might be illegal or a valid case for civil action. That would correct the problem quickly."

"When physicians, dentists, osteopaths, and podiatrists want to make a claim for the word doctor, and when media outlets oblige, they discriminate against not only us but optometrists, veterinarians, scientists, etc. Coalitions with these and other similar groups would help to change the onerous media style."

A letter-writing campaign by APA members calling on AP to revise its stylebook guidelines for using the title 'Dr' may also be effective by demanding that AP and the Associated Press Managing Editors Association, uphold APMEA's ethics code, which states in part:

ACCURACY
The newspaper should guard against inaccuracies, carelessness, bias or distortion through emphasis, omission or technological manipulation.

You can contact APMEA at:

Mark Mittelstadt, Executive Director
Associated Press Managing Editors
450 W. 33rd St. New York, NY 10001
Tel: 212-621-1838 Fax: 212-506-6102
E-mail: apme@ap.org

You can contact AP at:

William Dean Singleton, Chairman & CEO
Tom Curley, President & CEO

Board of Directors:
http://en.wikipedia.org/wiki/Associated_Press
E-mail: feedback@ap.org 

You can contact Dr. McCoy at:

John W. McCoy, PhD
Clinical Psychologist
4515 Poplar Ave., Suite 404
Memphis TN 38117-7508
Tel: 901-647-1042 Fax: 901-405-2014
E-mail: psychmccoy@mindspring.com

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