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Join us for an enlightening conversation with Joseph Lanctot, a nurse practitioner, as he explores the significance of professional identity in healthcare. Joseph shares his personal experiences of being mislabelled as a doctor and explains why embracing the title of nurse is essential for preserving the unique legacy of nursing. Delving into the distinct skills and versatile roles that nurse practitioners bring to patient care, Joseph highlights the challenges and triumphs of advocating for respect and recognition within the medical community.
Joseph Lanctot is a nurse practitioner.
He discusses the KevinMD article, “Stop calling me ‘doctor’: the nurse practitioner’s fight for recognition.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Joseph Lanctot. He’s a nurse practitioner. Today’s KevinMD article is titled “Stop Calling Me Doctor: Do Nurse Practitioners Fight for Recognition?” Joseph, welcome to the show.
Joseph Lanctot: Oh, thank you so much for having me.
Kevin Pho: So let’s start by briefly sharing your story and journey.
Joseph Lanctot: Yeah. So I’ve been in nursing for quite some time. I started in the hospital just as a volunteer. I was going through depression, and I noticed that was something that helped me out. And I had always struggled to find out what my calling was in life. And sure enough, that just lit me on fire.
I went through the ranks from volunteer to CNA to RN to where I am now as a family nurse practitioner.
Kevin Pho: All right. Your KevinMD article talks about being called “doctor” versus “nurse practitioner.” The article is titled Stop Calling Me Doctor: The Nurse Practitioner’s Fight for Recognition. Now, before going into the article itself, tell me what led you to write this article in the first place, and then, of course, talk about the article.
Joseph Lanctot: The impetus for the article was that I don’t like being called “doctor.” I think people call me “doctor” out of respect. Even sometimes my staff, who I try to correct, call me “doctor.” Here’s Dr. Joe or Dr. Lanctot. And I’m very quick to correct them, saying, “I’m a nurse practitioner.” It sits wrong with me for several reasons. First, I am not a doctor. I have not earned my doctorate. I am not a medical doctor, obviously.
Even if I had earned my doctorate in nursing practice, I would still want to be called a nurse for the reasons I mentioned in the article. It’s not that I think it’s demeaning. People think it is, but when you look at the strengths of being a nurse and what a nurse brings to health care, it has just as many strengths as being a physician.
The other reason that got me thinking like this was years ago when I would see nurse practitioners who had earned their doctorate either openly or behind closed doors say, “I want to be called ‘doctor.’” I always thought that was funny. I know in some states it’s legal; some states, I think, it’s still in the courts if a nurse practitioner can refer to themselves as “doctor” in clinical practice. But I always got the impression it was to confuse people into thinking they were a physician. Maybe that’s not the case, but some people come across that way, and I do not think that’s an honest thing to do.
Kevin Pho: So when you’re in a clinic and your staff, colleagues, or patients call you “doctor,” how do you navigate that situation?
Joseph Lanctot: First, I’ll just say, “I’m Joe. I’m the nurse practitioner.” If it continues, I’ll say, “Oh, just call me Joe.” If the opportunity presents itself—because with patients, you’re always squeezed for time, and you can’t explain the nuances of the differences between the specialties—but when the opportunity allows, I tell them, “Nursing has its own history. It has its own strengths, and just call me a nurse. I’m proud of it.”
Kevin Pho: So let’s talk about those differences. Talk about the unique skills and experiences that nurse practitioners bring to patient care that differentiate them from physicians.
Joseph Lanctot: It goes beyond even just patient care. Nurses are the ones who really led health care into the community all around the world, even into war zones. If you look back to Florence Nightingale, the effect that nurses have had deserves a lot more respect than people give them. Nurses have been seen as the person in the hospital giving you meds and doing the quick assessments, but it’s much more broad than that.
Starting with Florence Nightingale, she went into war zone hospitals—I’d be curious what the nursing front is like right now in Ukraine—and cleaned up the hospitals. Immediately, there was a turnaround in patient mortality and healing. It was spectacular. That spread throughout Europe and landed in America, I believe, around the Civil War time, with astounding results.
Beyond that, Lillian Wald, whom I referenced in the article, created the first community nursing program in New York City—the Henry Street Settlement, which still exists. That started community nursing in the United States. If anything is needed more right now in the U.S., it’s more community nursing. If you’re talking about the fact that 80 percent of hospital expenditures are for lifestyle and chronic illnesses, we need more nurses. We need to empower our nurses to do what they’ve already started to do, which is leading the community, giving tools, and giving respect. Call them “nurse” and make them proud of that calling.
Kevin Pho: Now, when you talk to patients and clarify that you’re a nurse practitioner versus a physician, in general, do you get a spectrum of reactions? Do they just not care? What kind of reactions do you get?
Joseph Lanctot: Yeah, mostly blank faces. They don’t know the difference. Occasionally, they’ll ask, “Is there a doctor?” I’ll say, “You know, we can get you a physician if needed, but let’s talk about your issue and see if I’m comfortable—and if you’re comfortable—with me treating it.”
Kevin Pho: As you know, a lot of large medical centers use a blanket term for nurse practitioners, physician assistants, and physicians: “providers.” What’s your thought about that?
Joseph Lanctot: Yeah, I think my thoughts may go beyond our time. When we look at the landscape, it’s not just providers of those three. We’re talking about physical therapists, who now need a doctorate to practice. I’m sure occupational therapists will soon need to earn their doctorate. Dietitians can earn a doctorate. We have a lot of different specialties that require doctorates. I appreciate anyone who earns anything and can be called “doctor” in their field, but ethically, I think there’s a line. If you want a physician, you should get one. If you want a physical therapist who has earned their doctorate, that’s wonderful, but they shouldn’t be confused with a physician. The same goes for nurses.
Kevin Pho: Not everyone across the nurse practitioner profession feels the same way as you do. Have you run into resistance in expressing this opinion?
Joseph Lanctot: You know, with my last article about my experience in schooling, which wasn’t ideal, some said, “Why are you teaming up with physicians? Why are you knocking down nurse practitioners?” I get some feedback about that, which leads to good conversations across health care. But when I talk about the strengths of nursing, there’s no critique there. People love it. People love their ego fed. If we can continue feeding that across health care and remind nurses of their strengths, it would lead to positive feedback for the whole field.
Kevin Pho: So those who get their doctorates in fields outside of medicine, like a doctorate of nursing, for instance—how, in your ideal world, would you prefer they refer to themselves?
Joseph Lanctot: In my ideal world, they would want to be called “nurse.” Legally, I think they should be called “doctor” because they earned it, but ethically, they should not want to be confused with physicians. Personally, they should prefer to be called “nurse,” not by being forced to, but by actually wanting to take pride in their profession.
Kevin Pho: Let’s talk about the role of nurse practitioners in the health care landscape going forward. You mentioned you’re a family nurse practitioner. Tell us about the role of nurse practitioners in primary care: What is it like now in your practice, and how do you see it evolving?
Joseph Lanctot: You know, what I think nurse practitioners’ roles could be, should be, and are—those are three different things for various reasons. Ideally, nurse practitioners would be seen as a specialty in their own right. Of course, they need to continually earn that through each level of patient care. But if nurse practitioners could really focus on the huge need in the community—getting back into homes, schools, and community centers, helping to stem the flow of chronic disease—that would be amazing.
Currently, I think a lot of medical centers and groups use them based on research that shows they provide pretty much the same care as physicians but at a lower cost. This pushes nurse practitioners into the role of wanting to be doctors. However, from what I’ve seen, many nurse practitioners want to address the gaps in care—helping underserved populations or focusing on areas like psychiatry, where there’s a need. But that’s not where the money is. That’s not where the jobs are being offered, and that’s not where the whole health care industry is pushing them.
In my practice, which is in urgent care, I absolutely love it. I’m in the suburbs of New York City, and I see a full spectrum of patients—from homeless individuals to those arriving in Bentleys. I see it all, and I love it. Just yesterday, I helped a homeless woman struggling with alcoholism get housed. I’m also working with a patient with a complex psychiatric diagnosis. Psychiatry isn’t my specialty, but he trusts me, and we’ve been able to make a lot of progress together.
Kevin Pho: You mentioned earlier about economics dictating where nurse practitioners are finding jobs. What is the job market like for nurse practitioners, and where are the economic incentives pushing them?
Joseph Lanctot: I just saw a paper before we got on the podcast, released by the American Medical Association a few years ago. It claimed that the care provided by nurse practitioners in emergency rooms isn’t as good as that provided by physicians, which saddened me to hear. I haven’t had a chance to review it yet, so I can’t comment fully on its accuracy. But I’m a family nurse practitioner—I don’t have experience in emergency rooms. Yet, when I look at job boards, I see lots of ER jobs being offered to nurse practitioners like me, which doesn’t seem to align with our training.
I get job offers every day on LinkedIn for roles in areas I don’t have experience in. I feel the pressure of being seen as cheap labor. The economics is not reflecting the broader purpose of why I earned my Family Nurse Practitioner Certificate, and it’s not reflecting the essence of the profession.
Kevin Pho: Do you feel like these economic incentives are pushing nurse practitioners into roles outside their scope of training?
Joseph Lanctot: I would say there’s definitely a push for that. But I trust the vast majority of nurse practitioners to humbly say, “No, thank you.” I don’t think the fault lies with nurse practitioners or their associations. It comes down to the people making budget decisions behind closed doors. Money drives a lot of things—elections, wars, and, in this case, job roles in health care. I don’t want to villainize any group, but the people controlling the money are steering nurse practitioners into these roles.
The more nurse practitioners say yes to these roles that may be outside their scope, the more we risk diminishing the good reputation we’ve spent decades building. I would encourage nurse practitioners to ask themselves, not just “Can I do this?” but “Should I do this?”
Kevin Pho: Are you seeing a lot of your nurse practitioner colleagues facing those same questions when they’re offered jobs outside their scope of training?
Joseph Lanctot: From my experience, yes. Either that, or they ensure that there’s proper training on the other side. We can’t be experts in everything, but family nurse practitioners can practice in a lot of areas. I’ve seen a lot of maturity among nurse practitioners in seeking roles that align with their training and ethics, but I don’t think it’s publicized or recognized enough.
Kevin Pho: We’re talking to Joseph Lanctot, a nurse practitioner. Today’s KevinMD article is “Stop Calling Me Doctor: Do Nurse Practitioners Fight for Recognition?” Joseph, let’s end with some of your take-home messages that you want to leave with the KevinMD audience.
Joseph Lanctot: Absolutely. Thank you for asking. I would love the audience—whether you’re a physician, a doctor in a different health care specialty, a nurse, or even an administrator—to get back to the basics. Ask yourself, “What is a nurse?” and recognize a nurse for who they are—people who have lifted entire communities up. Empower them and recognize that they may be the best tool we have to actually solve our health care crisis. But they shouldn’t be pushed into roles they’re not prepared for. Help them take pride in what they are—nurses.
Kevin Pho: Joseph, thank you so much for sharing your insight and perspective. Thanks again for coming on the show.
Joseph Lanctot: Absolutely. You take care.
