Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
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.”
Our presenting sponsor is DAX Copilot by Microsoft.
DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more.
70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences.
Discover AI-powered solutions for clinical documentation and workflows. Click here to see a 12-minute DAX Copilot demo.
VISIT SPONSOR → https://aka.ms/kevinmd
SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast
RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended
GET CME FOR THIS EPISODE → https://kevinmd.com/cme
I’m partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://kevinmd.com/learnerplus
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 “Stop calling me ‘doctor’: the nurse practitioner’s fight for recognition.” Joseph, welcome to the show.
Joseph Lanctot: Thank you so much for having me.
Kevin Pho: So let’s start by briefly sharing your story and journey.
Joseph Lanctot: So I’ve been in nursing for quite some time. I started in the hospital just as a volunteer. I was going through depression. 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. And I went through the ranks from volunteer to CNA to RN to where I am now as a family nurse practitioner.
Real physician voices, twice a week
Free, and one click to unsubscribe.
Kevin Pho: All right. Your KevinMD article talks about calling doctor versus nurse practitioner. It’s titled “Stop calling me ‘doctor’: the nurse practitioner’s fight for recognition.” Now, before going to 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: For the article, 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, Dr. Lanctot.” And I’m very quick to correct: “No, I’m a nurse practitioner.”
And it sits wrong with me for several reasons. First is I am not a doctor. I have not earned my doctorate. I am not a medical doctor, obviously. And even if I had earned my doctorate in nursing practice, I would still want to be called a nurse for the reasons in the article. I don’t think it’s demeaning. I think 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.” And I always thought that was funny. And I know in some states it’s legal. Some states, I think it’s settled in courts if, in clinical practice, a nurse practitioner can refer to themselves as doctor. But I always got the impression it was to confuse people that they’re a physician. Maybe that’s not the case, but some people, I think it rubbed me that way. And I do not think that’s an honest thing to do.
Kevin Pho: So when you’re in clinic and your staff or colleagues or patients call you doctor, how do you navigate that situation?
Joseph Lanctot: First, I’ll just, “I’m Joe. I’m the nurse practitioner.” And if it continues, I’ll say, “Oh, just call me Joe. Just call me Joe.”
If the opportunity presents, of course, with the patient, you’re always squeezed for time, and you can’t tell them the nuances of the differences between the specialties. But when the opportunity allows, I tell them, “Nursing has its own history. It’s got its own strengths. And call me nurse. I’m proud of it.”
Kevin Pho: So let’s talk about those differences. So talk about those 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 that really led health care into the community all around the world, into war zones. Even if you look back to Florence Nightingale, the effect that nurses have had deserves a lot more respect than I think people give it. I think nurses have been stereotyped into being seen as a person in the hospital giving you the meds and doing the quick assessment, when it’s much more broad than that.
Starting with Florence Nightingale, of course, she went into the war zone hospitals. I think it was Crimea. Actually, I would be curious what the nursing front is right now in Ukraine. I know I see a lot of Ukrainian immigrants myself for immigration. However, she cleaned up the hospitals. Immediately, there was a turnaround in patient mortality and healing. It was spectacular. That spread throughout the region, Europe, and landed in America, I believe it was about the Civil War time, with just astounding results.
But beyond that is, say, Lillian Wald, who I reference in the article. She created the first, it’s in New York City still, Henry Street Settlement, which started community nursing in the United States. And God, if anything is needed in the United States more right now, it’s more community nursing. I mean, if we’re talking, I think 80 percent of expenditures of hospitals are for lifestyle illnesses or chronic illnesses. We need more. We need to empower our nurses to do what they’ve already started to do, and that’s leading the community. Give them the tools and give them the respect. Call them a nurse and make them proud of that calling.
Kevin Pho: Now, when you talk to patients and you clarify that you’re a nurse practitioner versus a physician, in general, do you have a spectrum of reactions? Do they just not care? What kind of reactions do you get?
Joseph Lanctot: Yeah, blank face. They don’t know the difference. No, occasionally, it would be like, “Is there a doctor?” And I’m like, “We can get you a physician if needed, but let’s talk about what your issue is and see if I’m comfortable, if you’re comfortable with me treating it.”
Kevin Pho: So as you know, a lot of large medical centers have that blanket term for nurse practitioners, physician assistants, and physicians. They simply just call them providers as a kind of a uniform term. So what’s your thoughts about that?
Joseph Lanctot: I think my thoughts, I hope we can call them a little bit beyond the time. But when we look at the landscape, because it goes beyond providers of those three, but we’re talking physical therapists are now doctor-mandatory. I’m sure occupational therapists will soon be needing to earn their doctorate. Dietitians can have their doctorate. We have a lot of different specialties that earn their doctorate.
And I think, as a term of appreciation, anybody that can order anything should be able to be called doctor, in my opinion. But I don’t want them to want to be called doctor. If you want the physician, it’d be beautiful. I can get the physician in here. I want the physical therapist. I know they’re a doctor too. They earned their doctorate. They do know clinical stuff and their own specialty. But can’t I get the physical therapist in here? Can I get the nurse in here who’s earned their doctorate? I think that would create just a lot more respect straight across the spectrum and honestly might provide more clarity, too, and more confidence in patients.
Kevin Pho: So not everyone across the nurse practitioner profession feels the same way as you do. Have you run into any resistance in expressing this opinion?
Joseph Lanctot: With my last article about my experience in my schooling, which unfortunately wasn’t ideal, it’s been like, “Well, why are you teaming up with the physicians? Why are you teaming up with the physicians? Why are you knocking down nurse practitioners?” And so, between that, I get some feedback about that, which, it’s a good conversation. It’s an ongoing conversation across health care, to be honest.
But when I talk about the strengths of nursing, there’s no critique there. People love it. People love their ego fed. And I think if we could keep that going, and straight across health care remind nurses of their strengths, don’t beat them down. Don’t push them down. Don’t just say, “Hey, go give them their meds and do their assessment,” but actually look at their strengths and know what they can do for the patient. I think there would be a whole entire positive feedback to that.
Kevin Pho: So those who get their doctorates in things outside of medicine, for instance, those who have a doctorate of nursing, for instance, how, in your ideal world, do you prefer they should call themselves?
Joseph Lanctot: In my ideal world, they would want to be called a nurse. Legally, I think it should be doctor. They did earn it. But I think ethically they should not want to be confused with physicians. And I think personally they should prefer to be called nurse, not by forcing them, but by them actually wanting to, by taking pride in their profession.
Kevin Pho: So let’s talk about the place of nurse practitioners in the health care landscape going forward. You mentioned you’re a family nurse practitioner. Tell us about that role of nurse practitioners in primary care. What is it now? What’s it like in your practice? And how do you see the role of nurse practitioners going forward in the health care team?
Joseph Lanctot: What I think nurse practitioners’ role could be, should be, and is are absolutely different things for different reasons. But I think in an ideal world, nurse practitioners would be seen as a specialty unto their own. Of course, they still need to continually earn that every single day and through each level of patient care, of course.
But if nurse practitioners could really hound down on a huge need in the community, reaching out into the community, getting back into the homes where they started, getting back into the schools where they’re being pushed out of, getting into community centers and helping people stem the flow of chronic disease the best they can, that would be ideal. That would be amazing.
Now, where they are right now, I think a lot of medical centers and groups are using them based on the research that they provide pretty much the same care as a physician, but, oh, are they cheaper. And I think that’s pushing them into their desired want-to-be-a-doctor role. But I don’t see the individuals overly desiring that when I talk to them in school and the papers I read.
Of course, prescribing and diagnosing are very important, and we’ve been trained to do so. But a lot of us have wanted to go into helping people that are falling through the cracks. So many papers about that. You ask a nurse practitioner, “Why’d you be a nurse practitioner?” And most of the time it’d be rural care, or it was underprivileged people, or, “I saw a need. I wanted to help out psychiatry more than is being done.” But that’s not where the money is at. That’s not where the jobs are being offered, and that’s not where the whole entire health care industry is pushing them.
My practice, it’s an urgent care. I absolutely love it. I do not do rural. I’m in the suburbs of New York City, but I do see the spectrum from, I’ll have homeless patients, and then patients pull in Rolls-Royces or Bentleys right after them because of the community I live in. I see the full gamut, and I absolutely love it.
So just yesterday, I was helping a lady overcome alcoholism who was homeless. We’ve got her housed. Helping another individual who’s not quite sure his psych diagnosis. That’s not my specialty, but it doesn’t matter because we’re helping him out, and we’re getting the help he needs. And he’s with psychiatry, but psychiatry, he doesn’t like him. He likes me more, and we’ve been able to do a lot of work together. I love it.
Kevin Pho: So you mentioned earlier about the economics dictating where nurse practitioners are finding jobs. So what is the job market like for nurse practitioners, and where are those economic incentives pushing them towards?
Joseph Lanctot: I just saw a paper right before we got on. I think the American Medical Association released something in three years showing, I did not review this article, so I can’t say it’s right, or my inputter didn’t critique it, but I think it showed that cost or the care of patients in the emergency room is not as good with a nurse practitioner, which I’m very saddened to hear. I want to read that paper.
But it doesn’t matter. I’m a family nurse practitioner. I do not have experience in emergency room. Yet when I go onto the job boards, I see a lot of jobs for each of the emergency rooms around here. I see jobs thrown at me every day on LinkedIn. I have basically job recruiters and job offers wanting to interview me for areas I don’t have experience in.
So I really do feel the pressure of being cheap labor, if you will, in the community. I don’t get the holistic and the broader picture of broadening health care with this family nurse practitioner certificate and why I earned it, and I think the essence behind it. The economics is not reflecting that.
Kevin Pho: Do you feel like these economic incentives are pushing nurse practitioners into roles, like you said, that are outside their scope of training?
Joseph Lanctot: I would say there’s a push for that. I do trust nurse practitioners well enough, the vast majority of them, the ones I’ve encountered, to humbly say, “No, thank you.” I think the fault does not lie with nurse practitioners for this happening, or even their associations. I really think it comes down to, I don’t want to marginalize a single group, but the people behind closed doors that are making the budget decisions.
Money wins wars. Money wins elections. Money pushes people, things. I don’t want to villainize the wrong group, but who’s controlling the money is the one trying to stamate this. I think the further nurse practitioners say yes to these roles and push into these spots where they may know that they may not belong, it’s maybe good for them economically, maybe good for their schedule. But as a profession, I think each one’s just a little, little drop out of the ocean of the good rapport that we’ve spent so many decades building.
So I would really ask nurse practitioners to really actually, not if you could do it, but should you do it?
Kevin Pho: And are you seeing a lot of your nurse practitioner colleagues having those same questions if they’re seeing these job offers for things that may be outside their scope of training?
Joseph Lanctot: From my experience, yes. Either that or they ensure that there is training on the other side. We can’t be experts in everything, but family nurse practitioners can practice a lot of places. I have seen very good things. I don’t think it’s publicized or recognized enough, the maturity of nurse practitioners in seeking mature roles for themselves.
Kevin Pho: We’re talking with Joseph Lanctot. He’s a nurse practitioner. Today’s KevinMD article is “Stop calling me ‘doctor’: the nurse practitioner’s fight for recognition.” Joseph, we’ll 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, earned your doctorate in a different health care regime or specialty, or a nurse, or even an administrator, to get back down to the basics. What is a nurse? What is a nurse? And recognize a nurse for what they are, people that have lifted entire communities up, and empower them.
And recognize that they may be the best tool. They are also the most trusted profession in the United States for decades, but they may be the best tool to actually solve our health care crisis, but not being in the roles that they’re being pushed into being. They’re not being pushed. They’re not taking these roles always willingly. It’s an economic thing. But help them. Help them. Remind them. Give them pride in what they are.
Kevin Pho: Joseph, thank you so much for sharing your insight and perspective, and thanks again for coming on the show.
Joseph Lanctot: Absolutely.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
