Few things have riled up the Glibertariat lately as much as the title of Dr. for PhDs and Doctorates. It’s currently 4:30am but DST (another hot topic) tricked me into thinking it’s 5:30am. The idea of this article started running through my head so, what the hell, let’s give it a try.

I’m going to take the unpopular position here that PhDs have just as much a right to the Dr. title as physicians. For full disclosure, I am working towards my PhD now, but this has been my inclination since well before going back to school.

I am not a linguist, so HM feel free to jump in here about how wrong I am, but I believe Dr. was originally reserved for teachers. Not the half-educated babysitters we largely have now in the teaching profession, but rather actual learned men who would be the precursor to the PhD. It wasn’t until much later did physicians also receive the title of doctor. According to Merriam-Webster:

Richard Rolle, 14th century theologian and mystic

The English language history of doctor starts in the early 14th century, when the word was first applied to a select few who likely knew neither bloodwork nor basketwork. They were equipped for dealing with matters of the soul: they were eminent theologians who had a special seal of approval from the Roman Catholic Church as people able to talk about and explain the doctrines of the Church. They were teachers of a kind, and the word’s origin makes this connection. The word doctor comes from the Latin word for “teacher,” itself from docēre, meaning “to teach”.

So we’ve established that PhDs were using the title well before physicians. If there’s going to be a dispute about this, then MDs should really go by Physician X, not Dr. X. Still, there’s been a lot of chatter about physicians having a right to the title and not PhDs. This hasn’t been my experience at all coming from physicians or shot callers in the health industry. When you’re giving a presentation to a group of physicians, hospital administrators, or regulators on an innovation, they want the presenter to be announced as Dr. X, PhD or MD. As it’s been explained to me by the pros who wine and dine these groups for a living, all they really care about is that the presenter can be called Dr. So and So. Which is why I don’t understand the “Is there a doctor in the house argument?”. This is a colloquial phrase, and really should be asked is if there is a physician in the house. Which is kind of stupid because, again, MD is a highly specialized and technical skillset. Unless if the MD is trained in the ER specialty, they are going to bring the same kind of skills that a paramedic or nurse would. In fact, if I’m having a health emergency in public, I’d much rather a paramedic step forward to help than a psychiatrist or an ophthalmologist. Let’s put this “doctor in the house” saying to bed.

The next argument I’ve been reading is that MDs go through rigorous training that has a narrow cutoff that makes them somehow above us other mortals and uniquely qualified for the title of “Dr”. That may have been true once upon a time, but just isn’t the case anymore. Medical school admittance is tightly controlled by the AAMC guild. Capacity has not kept up with the demand, and it is now at the point where they have easily double the number of qualified applicants versus open spots. This means the best and brightest no longer need to be selected for medical school but rather so many candidates meet the technical bar that other attributes can be selected for. I don’t remember the exact saying we use here on the Glibs, but the whole progressives infiltrate a respected institution, gut it, and wear it as a skinsuit applies to medical schools. The MCAT, the medical school admissions test, now screens for social justice warrior attributes through a recently added test section. From the Washington Examiner:

But it is Kirch’s reform of the MCAT that raises the most concern. The AAMC began redesigning the test in 2009, but only received approval for the revisions in 2012. In an announcement reported by the New York Times that year, Kirch explained, “The goal is to improve the medical admissions process to find the people who you and I would want as our doctors. Being a good doctor isn’t just about understanding science, it’s about understanding people.” One new section of the exam, entitled “Psychological, Social, and Biological Foundations of Behavior,” requires test-takers to respond to multiple-choice questions in which both the question’s premise and the available answers are, at best, often distantly related to medicine.

“New” is the MCAT 2015 version


One MCAT practice question (from a collaboration between the AAMC and online-education nonprofit Khan Academy), for example, asks whether the wage gap between men and women is the result of bigotry, sexism, racism, or biological differences (no other options are provided, and the “correct” answer is sexism). Another asks whether the “lack of minorities such as African Americans or Latinos/Latinas among university faculty members” is due to symbolic racism, institutional racism, hidden racism, or personal bias (the correct answer is institutional racism). Yet another asks test-takers to select from a list of debatable definitions for “the terms ‘sex’ and ‘gender.’ “

Here’s a quote on the AAMC’s website from an accepted student that illustrates what their “right fit” student is:

“I personally see medicine as a component of social progress and justice. Loyola Stritch School of Medicine is immensely dedicated to social justice and involvement with marginalized and vulnerable populations, therefore it was a great fit for me.” 

-Moron, accepted student to Loyola Stritch School of Medicine

And of course, lest you think that this just applies to entry classes and not the curriculum, Medical Schools are adjusting their curriculum to incorporate less medical knowledge in favor of adding social justice components. Here’s a blurb about the newly redesigned curriculum at Yale, School of Medicine:

Although that night’s class imparted a specific lesson, it was part of an 11-session course with a larger purpose. Its goal was to teach students in the health professions how to speak to people who come from different backgrounds and life experiences and help students develop the skills to serve as advocates for vulnerable populations. Two second-year med students, Tehreem Rehman and Robert Rock, saw a need for this type of training in the medical school curriculum, as well as more discussion of health equity. “We only had one or two sessions on health disparities,” Rehman said. “We felt a dearth of that.” With support from faculty, they designed U.S. Health Justice and offered it for the first time last fall. Their model was a global health program that had also been initiated by students and ultimately became a course of study that now offers the Certificate in Global Medicine. “We didn’t want this to be a one-time class,” said Rehman. “We really were hoping this would start momentum and get health equity in our education.”

The students’ proposal came as the medical school is launching a revised curriculum, and a key element is medicine’s responsibility to society. “We were aware of the school’s ongoing initiatives to reform the curriculum and sought to use that to our advantage,” Rehman said.

So can we put this notion to rest that today’s physicians are gods above men that somehow uniquely deserve the title of “Dr.”? The next argument I’ve heard is that PhD should only use their title on the conference circuit or while teaching and not elsewhere. I don’t really understand this. A title is a title. No, you shouldn’t introduce yourselves to your neighbors as Dr. X when you have a PhD. But you shouldn’t do this with an MD either. I think it’s obnoxious to use a title at all in friendly social contexts. There was a lot of sneering at Christine Ford for being referred to as Dr. Ford. Frankly though, there’s no way in hell I wouldn’t put Dr. SSD for anything involving my interaction with the government. The government and private institutions thrive on credentialism these days and, right or wrong, you’re intentionally shooting yourself in the foot if not listing your credentials. You can bet when I’m going up against the assholes on the local school board or zoning committee that I’ll be using Dr. SSD and not Mr.

 

Finally, the last argument is that if PhD can use the title “Dr.”, what about those with doctorates? I don’t know, the rapid growth of doctorates is a recent phenomenon and goes hand in hand with the above credentialism point. PhD programs are much more rigorous than a doctorate and involve original research components. In Europe, doctorates are viewed more as a technical degree. Here in America, many programs that were formerly master’s level are now calling themselves doctorates without any real difference. For example, new physical therapists are now required to obtain a doctorate in physical therapy to practice. However, the doctorate program just replaced the former master’s program without any progression. This move to doctorates is coming for the other types of therapists too. And yes, I have seen a physical therapist introduce themselves in social situations as Dr. X because of that doctorate. It’s bizarre, but again, still obnoxious for anyone to introduce themselves as Dr. X in social situations. There are older professions, such as lawyers, with a more rigorous and traditional doctorate. Should lawyers be titled with Doctor? I think they have more of a right to it than the PTs. Lawyers used to have esquire after their name, and this is still frequently used in the South. Perhaps lawyers should have their own title… it would certainly help to identify them as a warning to others.

Just kidding to our resident Glib lawyers… well kind of.

 

SSD Note: this article is partly tongue-in-cheek ….no offense intended to our resident Glib physicians… unless if you answered the above practice MCAT questions correctly.