Dr. Roland Goertz, the board chairman of the American Academy of Family Physicians, says that physicians are worried that losing control over "doctor," a word that has defined their profession for centuries, will be followed by the loss of control over the profession itself. He said that patients could be confused about the roles of various health professionals who all call themselves doctors.
The deeper battle is over who gets to treat patients first. Pharmacists, physical therapists and nurses largely play secondary roles to physicians, since patients tend to go to them only after a prescription, a referral or instructions from a physician. By requiring doctorates of new entrants, leaders of the pharmacy and physical therapy <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics /physicaltherapy/index.html?inline=nyt-classifier> professions hope their members will be able to treat patients directly and thereby get a larger share of money spent on patient care. As demand for health care services has grown, physicians have stopped serving as the sole gatekeepers for their patients' entry into the system. So physicians must increasingly share their patients - not only with one another but also with other professions. Teamwork is the new mantra of medicine, and nurse practitioners <http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics /nursing_and_nurses/index.html?inline=nyt-classifier> and physician assistants (sometimes known as midlevels or physician extenders) have become increasingly important care providers, particularly in rural areas. But while all physician organizations support the idea of teamwork, not all physicians are willing to surrender the traditional understanding that they should be the ones to lead the team. Their training is so extensive, physicians argue, that they alone should diagnose illnesses. Nurses respond that they are perfectly capable of recognizing a vast majority of patient problems, and they have the studies to prove it. The battle over the title "doctor" is in many ways a proxy for this larger struggle http://www.nytimes.com/2011/10/02/health/policy/02docs.html?nl=todaysheadlin es <http://www.nytimes.com/2011/10/02/health/policy/02docs.html?nl=todaysheadli nes&emc=tha2> &emc=tha2
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