Dr. Josef Bühler

Doctor is an academic title that originates from the Latin word of the same spelling and meaning. The word is originally an agentive noun of the Latin verb 'to teach'. It has been used as an academic title in Europe since the 13th century, when the first doctorates were awarded at the University of Bologna and the University of Paris.

Having become established in European universities, this usage spread around the world. Contracted "Dr" or "Dr.", it is used as a designation for a person who has obtained a doctorate (commonly a PhD/DPhil). In many parts of the world it is also used by medical practitioners, regardless of whether they hold a doctoral-level degree.

Origins

The doctorate ( la, doceō, lit=I teach) appeared in medieval Europe as a license to teach ( la, licentia docendi, links=no) at a medieval university. Its roots can be traced to the early church when the term "doctor" referred to the Apostles, church fathers and other Christian authorities who taught and interpreted the Bible. The right to grant a ''licentia docendi'' was originally reserved to the church which required the applicant to pass a test, take an Oath of allegiance and pay a fee. The Third Council of the Lateran of 1179 guaranteed the access – now largely free of charge – of all able applicants, who were, however, still tested for aptitude by the ecclesiastic scholastic. This right remained a bone of contention between church authorities and the slowly emancipating universities, but was granted by the pope to the University of Paris in 1213 where it became a universal license to teach (''licentia ubiquie docendi''). However, while the licentia continued to hold a higher prestige than the bachelor's degree (''Baccalaureus''), it was ultimately reduced to an intermediate step to the Magister and doctorate, both of which now became the exclusive qualification for teaching.

The earliest doctoral degrees (theology, law, and medicine) reflected the historical separation of all university study into these three fields. Over time the Doctor of Divinity has gradually become less common and studies outside theology, law, and medicine have become more common (such studies were then called "philosophy", but are now classified as sciences and humanities – however this usage survives in the degree of Doctor of Philosophy).

The PhD was originally a degree granted by a university to learned individuals who had achieved the approval of their peers and who had demonstrated a long and productive career in the field of philosophy (in the broad sense of the term, meaning the pursuit of knowledge). The appellation "Doctor" (from Latin: teacher) was usually awarded only when the individual was in middle age. It indicated a life dedicated to learning, knowledge, and the spread of knowledge. The PhD entered widespread use in the 19th century at Friedrich Wilhelm University in Berlin as a degree to be granted to someone who had undertaken original research in the sciences or humanities. Prior to the formal degree, the contemporary doctorate (PhD), arguably, arose in Leipzig as a successor to the Master's degree in 1652 (Dr. habil).

In some European countries, such as Italy and Portugal, "Doctor" became a title given to all or most degree holders, not just those with doctorates.
As a result, the title is now used by many professionals in these countries, including those such as lawyers who are not normally granted the title elsewhere. The title is also used for lawyers in South America, where they have traditionally earned doctoral degrees, as well as in the former Portuguese territory of Macau in China.

Development in English-speaking countries

The primary meaning of ''Doctor'' in English has historically been with reference to the holder of a doctoral degree. These particularly referred to the ancient faculties of divinity, law and medicine, sometimes with the addition of music, which were the only doctoral degrees offered until the 19th century. During the 19th century, PhDs became increasingly common in Britain, although to obtain the degree it was necessary to travel to continental Europe or (from 1861) to the United States, as the degree was not awarded in the UK until 1917.

However, the title, not being protected by law, was adopted by quacks. As a result, by the mid 19th century, it was normal in the UK to omit the title "Dr" when addressing letters to those holding doctoral degrees, and instead write the abbreviated form of the degree after the name, e.g. "The Reverend Robert Phelps, D.D.", "Thomas Elliotson, Esq. M.D.", or "John Lindsey, Esq. Ph.D.", in order to avoid classing academic doctors "with the village apothecary and the farrier" and various "quacks in literature, science, or art". In the US it similarly became customary to use post-nominals rather than the title of Doctor when addressing letters. All those with doctoral degrees continued to use the title professionally and socially.

Despite being historically associated with doctorates in law, the title of ''doctor'' for lawyers has not customarily been used in English-speaking countries, where lawyers were traditionally not required to have a university degree and were trained by other lawyers by apprenticeship or in the Inns of Court. The exception being those areas where, up to the 19th century, civil law rather than common law was the governing tradition, including admiralty law, probate and ecclesiastical law: such cases were heard in the Doctor's Commons, and argued by advocates who held degrees either of doctor of civil law at Oxford or doctor of law at Cambridge. As such, lawyers practicing common law in England were not doctoral candidates and had not earned a doctorate. When university degrees became more common for those wanting to qualify as a lawyer in England, the degree awarded was the Bachelor of Laws (LLB). Similarly in the US, even though degrees became standard for lawyers much earlier, the degree was again the LLB, only becoming the Juris Doctor (JD) generally in the latter half of the 20th century.

In many English-speaking countries, it is common to refer to physicians by the title of doctor, even when they do not hold a doctoral level qualification. The word ''Doctor'' has long had a secondary meaning in English of physician, e.g. in Johnson's Dictionary, which quotes its use with this meaning by Shakespeare. In the US, the medical societies established the proprietary medical colleges in the 19th century to award their own MDs, but in the UK and the British Empire, where degree granting was strictly controlled, this was not an option. The usage of the title to refer to medical practitioners, even when they didn't hold doctoral degrees, was common by the mid 18th century. However, the first official recognition of Doctor being applied as a title to medical practitioners regardless of whether they held a doctoral degree was in 1838, when the Royal College of Physicians resolved that it would "regard in the same light, and address by the same appellation, all who have obtained its diploma, whether they have graduated elsewhere or not."

The Medical Act 1858 made it illegal for anyone not qualified in medicine to use a title that implied they were. This led to prosecutions of people making unauthorised use of the title "Dr". However, it also called into question the use of the title by licentiates of the Colleges of Physicians – all of whom were, under the new act, allowed to practice throughout the UK. In 1859, the London College reversed its earlier decision, resolving "That the title of Doctor shall not be given in any official document issued from this College to any person who is not possessed of the Degree of Doctor of Medicine". This was followed up in 1860 by new bylaws that stated "No Fellow, Member, or Licentiate of the College shall assume the title of Doctor of Medicine, or use any other name, title, designation or distinction implying that he is a Graduate in Medicine of an University, unless he be a Graduate in Medicine of an University". In Ireland, the question of whether the license of the Royal College of Physicians of Ireland granted the title of Doctor of Medicine led to a court case in 1861, with the conclusion that it did not. The ''British Medical Journal'' (''BMJ'') observed, however, that anyone wanting the right to the title of "Doctor" could gain it "with a five-shilling degree of Doctor of Philosophy" from abroad, or could simply assume the title, as only "Doctor of Medicine" was actually protected. Debate continued as to the use of "Doctor" as a courtesy title by those who did not use it by right as holders of doctoral degrees, with the ''BMJ'' noting in 1876 that "We have again a sort of flood of letters for and against the use of the title of Doctor by physicians" and in 1882 that "There is not any other subject which appears to excite so wide spread an interest as this". In February 1876, a report recommended that the Royal College of Physicians should use the courtesy title of Doctor for all fellows and members, but this was rejected. Then in April of the same year, the college amended its bylaws to forbid any fellow, member, extra-licentiate or licentiate from using the title of Doctor unless they had a doctorate in medicine from a recognised university – closing the loophole the ''BMJ'' had identified. It was not until the early 20th century that this was reversed. In 1905 the Royal College of Surgeons passed a motion instructing their council "to take the necessary steps in conjunction with the Royal College of Physicians to ensure that all persons who pass the Conjoint examination shall be legally entitled to call themselves Doctors". The council of the surgeons' College felt it to be impractical to secure the legal right to the title as this would mean gaining the right to award MDs, but noted that the title had been used by the public to refer to medics for generations and was used without any legal right by Bachelors of Medicine – the only obstacle to licentiates of both colleges doing the same was the prohibition in the physicians' bylaws. On this occasion the College of Physicians refused to act, but they did finally relent in 1912, removing the clause forbidding the assumption of the title of Doctor. This was described in the American press as "the British apostles of red-tape have been forced to bow to the popular will".

Regulation of the medical profession also took place in the United States in the latter half of the 19th century, preventing quacks from using the title of Doctor. However, medical usage of the title was far from exclusive, with it being acknowledged that other doctorate holders could use the title and that dentists and veterinarians frequently did. ''The Etiquette of To-day'', published in 1913, recommended addressing letters to physicians "(full name), M.D." and those to other people holding doctorates "Dr. (full name)", although both were "Dr." in the salutation and only physicians were explicitly said to include their title on their visiting card. By the 1920s there were a great variety of doctorates in the US, many of them taking entrants directly from high school, and ranging from the Doctor of Chiropractic (DC), which (at the time) required only two or three years of college-level education, up to the PhD. All doctoral degree holders, with the exception of the JD, were customarily addressed as "Doctor", but the title was also regularly used, without doctoral degrees, by pharmacists, ministers of religion, teachers and chiropodists, and sometimes by other professions such as beauty practitioners, patent medicine manufacturers, etc.

By the 1940s, the widespread usage of the title in the US was under threat. A 1944 article claimed that "the Ph.D. has immediate and far-reaching value of social as well as economic nature" due to America's "national fondness for the tinsel of titles", but went on to note that some universities were moving away from using the title, concluding that "it is ungracious in most environments not to render unto the Doctor of Philosophy his 'Doctor' title". The same writer noted in a letter to the '' Journal of Higher Education'' in 1948 that Alfred University had banned the use of the title for faculty (while retaining it for the president and deans) "in a strange move professedly designed to uphold and promote 'democracy' and 'Americanism. However, it was noted in 1959 that professors with PhDs were now generally addressed as "Doctor", with the title of "Professor" sometimes being substituted for those without doctorates, leading to a decline in the perceived value of that title.
In the 1960s the inconsistent usage at American universities and colleges was mentioned in the ''New York Times Book Review'' and the editor of '' Science'' noted that: "In some universities, administrators call all Ph.D.'s 'Mister,' but students and colleagues call them 'Doctor.' Often, but not always, Ph.D.'s are 'Misters' socially. In industry and government, both socially and professionally, they are 'Doctors,' as they are also in the pages of the ''New Yorker'', ''Time'', the ''Saturday Review'', and the New York ''Times''." In 1965, the League of Women Voters designated medical doctors "Dr." and PhDs "Mr." at a hustings in Princeton, leading to a letter of protest in ''Science''; it was reported that the League believed PhDs would be embarrassed by the title, and that etiquette writers differed in whether PhDs used the title. In 1970, reverse snobbism in the face of the rising number of "discount doctorates" was linked to professors at prestigious universities wanting to be called "mister".

In the late 1960s the rising number of American law schools awarding Juris Doctor (JD) degrees led to debate over whether lawyers could ethically use the title "Doctor". Initial informal ethics opinions, based on the Canons of Professional Ethics then in force, came down against this. These were then reinforced with a full ethics opinion that maintained the ban on using the title in legal practice as a form of self-laudation (except when dealing with countries where the use of "Doctor" by lawyers was standard practice), but allowed the use of the title in academia "if the school of graduation thinks of the J.D. degree as a doctor's degree". These opinions led to further debate. The introduction of the new Code of Professional Responsibility in 1969 seemed to settle the question – in states where this was adopted – in favour of allowing the use of the title. There was some dispute over whether only the PhD-level Doctor of Juridical Science should properly be seen as granting the title, but ethics opinions made it clear that the new Code allowed JD-holders to be called "Doctor", while reaffirming that the older Canons did not. As not all state bars adopted the new Code, and some omitted the clause permitting the use of the title, confusion over whether lawyers could ethically use the title "Doctor" continued. The introduction of further professional doctorates in the US at ISCED level 7, the same as the MD and JD, has led to continuing debate about the use of the title by holders of such degrees, particularly in medical contexts.

In 2018, a decision by ''The Globe and Mail'' newspaper in Canada to update its style guide so as to restrict the use of the title Doctor to medics led to a backlash on Twitter, particularly by women with PhDs, using the #ImmodestWomen hashtag. This was widely reported on internationally and led to ''The Globe and Mail'' reverting to its earlier style of using Doctor for both physicians and PhD holders. The Canadian University of Calgary also announced that it would adopt the use of Doctor for those with doctoral degrees, breaking with the style recommended by the Canadian Press.

Doctor as a noun

Throughout much of the academic world, the term ''Doctor'' refers to someone who has earned a doctoral degree (highest degree) from a university. This is normally the Doctor of Philosophy, abbreviated PhD (sometimes Ph.D. in North America) from the Latin ''Philosophiae Doctor'' or DPhil from its English name, or equivalent research doctorates at level 8 of the International Standard Classification of Education 2011 classifications (ISCED 2011) or level 6 of the ISCED 1997 classifications. Beyond academia (but specifically in the Anglo-Saxon world, Italy, and France), ''Doctor'' as a noun normally refers to a medical practitioner, who would usually hold a qualification at level 7 of ISCED 2011/level 5 of ISCED 1997 such as the British MBBS or the American MD or DO.

Forms of address

When addressing several people, each of whom holds a doctoral title, one may use the plural contraction "Drs" (or "Drs." in American English) – or in some languages (for example, German) "Dres." (from the Latin doctores) may be used – for example, instead of Dr. Miller and Dr. Rubinstein: Drs. Miller and Rubinstein. When referring to relatives with the same surname the form "The Doctors Smith" can be used. The abbreviation Drs. can also refer to doctorandus, a Dutch academic title that was replaced with the master title with the introduction of the master system.

In English, Dr is not usually combined with other titles, except for The Reverend in "The Revd Dr" before the surname of a minister of religion, e.g., "The Revd Dr Smith" or "The Revd John Smith, DD", and similarly "Rabbi Dr". In Caribbean English, the usage "Dr. the Honourable" is common for politicians holding doctoral degrees. Usage in many other languages is similar to English but some, notably German, allow for the stacking of titles.

Usage by medical practitioners in the UK and culturally-related countries

In the United Kingdom, India, Pakistan, Hong Kong, Trinidad and Tobago, South Africa, Australia, New Zealand, Ghana, and other countries whose cultures were recently linked to the UK, the title ''Dr'' is generally used both for those who hold doctoral degrees and for registered medical practitioners. History has dictated the use of the courtesy title ''Dr'' by physicians and general practitioners. However, surgeons do not use the title of ''Dr'' and, due to the origins of surgery with the barber surgeons, instead use '' Mr, Mrs, Ms, Miss'', etc. This custom applies to surgeons of any grade who have passed the appropriate exams and is not the exclusive province of consultant-level surgeons. In recent times, other surgically orientated specialists, such as gynaecologists, have also adopted these prefixes. A surgeon who is also a professor is usually known as "Professor" and, similarly, a surgeon who has been ennobled, knighted, created a baronet or appointed a dame uses the corresponding title (Lord, Sir, Dame). Physicians, on the other hand, when they pass their " MRCP(UK)" examinations, or equivalent, do not drop ''Dr'' but retain it, even as consultants. The status and rank of consultant surgeons, addressed as "Mister", and consultant physicians, addressed as "Doctor", is equivalent.

Worldwide usage

Asia

Bangladesh

In Bangladesh, use of the title of Doctor (Dr.) is permitted for PhD degree holders and registered medical practitioners. According to an amendment, universities are allowed to approve or reject any subject proposed for a thesis by a candidate for the degree of "Doctor" in any subject. For registered medical practitioners, only MBBS and BDS degree holders are allowed to use the title "Dr." and be called "Medical Doctors". Registered veterinary practitioners may use the title "Dr." after earning the "Doctor of Veterinary Medicine" (DVM) degree. However, Registered Homeopath practitioners also use the title "Dr." even though, according to Homeopathic Practitioners Ordinance 1983, they are only permitted to use "Homeopath". Currently, Physiotherapy has no separate council and no authorized act at present permits the use of the prefix "Dr." for physiotherapist. According to Bangladesh Unani & Ayurvedic Practitioners Ordinance 1983, practitioners of the Unani system are called "Tabib" or "Hakim" and are strictly prohibited from using the title "Dr."; similarly, practitioners of Ayurvedic system are called "Vaid" or "Kabiraj" and are also strictly prohibited from using "Dr.". Currently, medical practitioners having MBBS degree or dental surgeons having BDS are legally permitted to use "Dr." prefix. Using "Dr." for other medical practitioners remains controversial.

Hong Kong

Hong Kong follows British practice in calling physicians "Doctor" even though many of them hold only a degree of Bachelor of Medicine and Bachelor of Surgery (MBBS or MBChB). An attempt by their professional body to prevent chiropractors from calling themselves "Doctor" failed in the courts, in part because it was pointed out that practicing chiropractors may hold an academic doctorate in their discipline, and it would be anomalous to prevent them using the title when holders of doctorates in non-medical disciplines faced no such restriction.

India

In India, the title is used by qualified professional medical practitioners in the fields of allopathic medicine (MBBS), and dentistry(BDS)
as well as by other practitioners like Siddha (BSMS), Yoga and Naturopathy (BNYS), Ayurveda (BAMS), Unani (BUMS) and Homeopathy(BHMS), Veterinarians (BVSc) and holders of doctoral degrees, including PhDs and pharmacists with PharmDs. Physiotherapists (BPT) use 'Doctor' as a suffix accompanied by the prefix PT.

The usage by pharmacists is legally disputed, while the Supreme Court of India has ruled against the use of the title as a prefix by physiotherapists.

Indonesia

The Indonesian titles "dr." is used in front of the name of medical doctor who holds a specification as general practitioner, also when the doctor already holds his specialization to ___, such as "Sp.THT" or "Spesialis Telinga, Hidung, Tenggorokan" (ENT or Ear, Nose, and Throat Specialist).

Dr. is used in front of the name as the title "Doktor" for doctorate title, the same level as PhD title.

Pakistan

In Pakistan, the title of Doctor (Dr.) can be used by PhD degree holders as well as medical, dental, optometry and veterinary doctors with MBBS, BDS, OD and DVM degrees respectively. Usage by physiotherapists DPT degree respectively is disputed, with the Pakistan Medical and Dental Council saying they should not use the title, but the Pharmacy Council of Pakistan (the regulatory body for pharmacists) and the Higher Education Commission permitting and encouraging its use.

Philippines

In the Philippines, titles and names of occupations usually follow Spanish naming conventions which utilize gender-specific terms. "''Doktór''" is the masculine form, which retains the abbreviation ''Dr.''; the feminine form is "''Doktóra''", and is abbreviated usually as "''Dra.''"; others, however, some being Anglophones who wish to sound modern and Westernised (or were raised in an almost exclusively English-speaking family environment), or some who advocate gender equality, would dispense with the distinction altogether. There does exist in Filipino an equivalent, gender-neutral term for the professional that carries the more general notion of "healer", traditional (for example, an '' albuláryo'') or otherwise: ''manggagámot''. Contracted "Dr" or "Dr.", it is also used as a designation for a person who has obtained a doctorate degree (e.g. PhD, EdD, DPA).

Sri Lanka

In Sri Lanka the title doctor "Dr." is used for PhD holders and medical practitioner such as physicians, surgeons, dentists and veterinarians. However, when addressing in native Sinhalese a medical practitioner is addressed as "Vaidya" (වෛද්ය) or "Dosthara" (දොස්තර) while a PhD holder is addressed as "Aacharya" (ආචාර්ය). It is a common practice for married female medical practitioners to use the title "Dr (Mrs)" in a both professional and social capacity.

Thailand

The usage of Doctor (ดอกเตอร์) or Dr (ดร.) has been borrowed from English. It can be seen as a title in academic circles and in the mass media. In contrast to other academic titles (Professor, Associate Professor and assistant professor), the use of Doctor as a title has not been recognized by the Royal Institute of Thailand. Therefore, this title, in theory, cannot be used officially. For example, in court of justice where strictly formal Thai language is used, Dr cannot be mentioned as a person's title.

The Americas

Brazil

The 'doctor' title is used by individuals holding a PhD degree. 'Doctor' is also used as a deferential title in Brazilian Portuguese.

Canada

Canada lies somewhere between British and American usage of the degree and terminology of "doctor". Holders of research doctorates – PhDs and similar degrees – commonly use the title "doctor". A number of regulated healthcare professionals can also use the title "doctor"; in Ontario these are limited by law to physicians, dentists, optometrists, chiropractors, doctorate-level psychologists and social workers. In Alberta, Registered Nurses or Nurse Practitioners with an earned doctoral degree may use the title "doctor" in conjunction with professional practice. Some professionals earn degrees with the title of doctor but which are considered, despite their name, to be at bachelor's-level, e.g. DDS, MD, JD. In Ontario, registered naturopathic doctors may only use the title "doctor" in written format if they also use the phrase, "naturopathic doctor" immediately following their name, while a 2006 amendment that would allow practitioners of Traditional Chinese Medicine to use the title has not, , entered into force. As of 2022, in Alberta, Doctors of Acupuncture may use the doctor title.

=Quebec

=
The usage of the French ''Docteur'' and ''Docteure'', and their abbreviated forms ''Dr'', ''Dre'', ''D'' and ''D'', is controlled by the ''Code des professions''. As a pre-nominal title it can be used without any further explication by physicians, veterinarians, and dentists. It can also be used prenominally, when accompanied by the name of the profession immediately after the name, by professionals who require a doctorate for their professional licence, such as psychology, and chiropractic, e.g. ''Dr X, psychologue'' or ''Dr Y, chiropraticien''. Academic doctors, where the doctorate is not required to practice, bear the title only after their name; this is not abbreviated, e.g. ''M. Z, docteur en philosophie'' not ''M. Z, PhD''

United States

In the United States, the use of the title "Doctor" is dependent upon the setting. The title is commonly used socially by physicians and those holding doctoral degrees; however, there was formerly a division between Letitia Baldrige and Miss Manners on its social usage by those who are not physicians. Baldrige saw this usage as acceptable, while in contrast, Miss Manners wrote that "only people of the medical profession correctly use the title of doctor socially," but supports those who wish to use it in social contexts in the spirit of addressing people according to their wishes. Miss Manners has since softened her approach, noting in her '' The Washington Post'' column that there are two approaches: "having been earned, it should be used" and "that level of education being assumed, it need not be expressly mentioned"; while she maintains that everyone should be addressed according to their wishes, she no longer states that only medical professionals use the title correctly but instead acknowledges that the title has been earned by those with PhDs. The Emily Post Institute similarly advises that "Socially as well as professionally, medical doctors, dentists, and other professionals are addressed by, and introduced with, their titles. People who have earned a Ph.D. or any other academic, nonmedical doctoral degree have the choice of whether to use "Dr." both professionally and socially." Other advice columns have also noted that "it has become common to see someone with a Ph.D. addressed on the envelope as Dr., and as a consequence, deviation from convention has become acceptable." The 2017 book ''Etiquette Rules!'' gives identical forms for addressing a "doctor of medicine (MD), dental surgery (DDS), veterinary medicine (DVM), etc.", and the holder of a PhD, advising in both cases the use of initials after the name for formal correspondence and Dr. before the name for social correspondence. Although the usage of the title by Ph.D. graduates has become common, its use socially by holders of professional doctorates (other than those noted) is neither explicitly endorsed nor explicitly discouraged by writers on etiquette. Miss Manners has, however, stated that a physician who has had their license revoked should be addressed by their former preferred honorific (i.e. not according to their MD degree). It is unusual for those who hold honorary doctorates to use the title "Doctor".

Publications from the office of the President of the United States of America also refer to PhD holders as Dr. Soandso,
and Jill Biden, who holds an EdD, used the style "Dr. Jill Biden" as second lady and has continued to do so as first lady. For addresses (defined as "the conventional forms of address as determined by social and official custom"), NASA uses "Dr. (full name)" in addresses for PhD holders while for physicians it uses "(full name), MD", although both are addressed as "Dr. (surname)" in the salutation (which is described as "informal"). The National Institutes of Health similarly use "Dr. (surname)" in salutations for people with an MD, PhD or DDS. They advise using full name followed by degrees in addresses, explicitly stating not to use the title "Dr.", although an example in the following paragraph does use the title rather than giving degrees.

Most newspapers in the US follow the AP Stylebook and reserve the title for medical doctors in their house styles; notable exceptions include '' The New York Times'', which follows the preference of the individual when referring to PhD holders (although the title is not used for those with honorary doctorates),
and '' The Wall Street Journal'', which similarly prefers "Dr." for PhD holders and physicians (if this is the person's choice) while stating explicitly that the title is not used for lawyers with JDs or people with honorary doctorates. Until 1989, The Washington Post used the title for "practitioners of the healing arts (including chiropractors and osteopaths) but not for holders of PhDs or honorary degrees", after which it dropped its use entirely. Some sources state that AP style allows the use of Dr. for holders of non-medical doctoral degrees as long as their speciality is given.

The expansion of professional doctorates in clinical fields in the late 20th and early 21st centuries has led to disputes between physicians and other medical professions over who can use the title in a clinical context. This has been interpreted by some as part of larger battles within medicine, such as who gets to treat patients first and who has prescribing authority. The American Medical Association calls for non-physicians (those not holding an MD or DO) who use the title "Doctor" and are in direct contact with patients to clarify that they are not physicians and to "define the nature of their doctorate degree", while the American Osteopathic Association opposes the use of the title by non-physicians in clinical settings absolutely as (in their view) "such use deceives the public". Contrary to this, the Emergency Nurses Association has adopted as a position statement that "1. Nurses are entitled to have their educational degrees recognized and acknowledged in the same manner as other professions. 2. The proper title protection and use of accurate credentials is appropriate in the clinical setting. 3. When being addressed or introduced as doctor in the clinical environment, it is responsible practice for all healthcare providers to clarify their professional role. 4. Patients, families and the general public have a right and expectation to be informed regarding the credentials of their caregivers, including the use of the title "doctor"."

The American Medical Association launched a campaign in 2011 for states to adopt "truth in advertising" legislation. As a result, many states now have laws in place that protect the title of doctor when offering medical services. In some jurisdictions, the use of the title in health care is limited to those who have both a doctorate and are licensed to practice medicine, and there is a requirement that the field of the doctorate be disclosed. Some other jurisdictions require the practitioner to hold a doctorate and to disclose the field, but make no stipulations as to licensing. Some states require name badges to be worn in medical facilities giving first name, licensure status, and staff position, although these laws may not explicitly address the use of the title "Doctor".

Although lawyers in the United States do not customarily use the title, the law degree in that country is the Juris Doctor, a professional doctorate.Association of American Universities Data Exchange
Glossary of Terms for Graduate Education
. Accessed 26 May 2008; National Science Foundation (2006).
Time to Degree of U.S. Research Doctorate Recipients
," "InfoBrief, Science Resource Statistics" NSF 06-312, 2006, p. 7. (under "Data notes" mentions that the JD is a professional doctorate); San Diego County Bar Association (1969)

. Accessed 26 May 2008. (under "other references" discusses differences between academic and professional doctorate, and statement that the J.D. is a professional doctorate); University of Utah (2006)
University of Utah – The Graduate School – Graduate Handbook
. Accessed 28 May 2008. (the JD degree is listed under doctorate degrees); German Federal Ministry of Education
"U.S. Higher Education / Evaluation of the Almanac Chronicle of Higher Education"
. Accessed 26 May 2008. (report by the German Federal Ministry of Education analysing the Chronicle of Higher Education from the U.S. and stating that the JD is a professional doctorate); Encyclopædia Britannica. (2002). "Encyclopædia Britannica", 3:962:1a. (the JD is listed among other doctorate degrees). Some JD holders in the United States use the title of doctor in professional situations, although ethics board decisions have varied on whether this is permissible or might mislead the public into believing the lawyer was medically qualified or had a PhD.American Bar Association
Model Code of Professional Responsibility
Disciplinary Rule 2–102(E). Cornell University Law School, LLI. Accessed 10 February 2009 It is also sometimes used by JD holders in academic situations. In 2011, '' Mother Jones'' published an article claiming that Michele Bachmann was misrepresenting her qualifications by using the "bogus" title Dr. based on her JD The article was later amended to note that the use of the title by lawyers "is a (begrudgingly) accepted practice in some states and not in others", although they maintained that it was rarely used as it "suggests that you're a medical doctor or a Ph.D.—and therefore conveys a false level of expertise".

Ecclesiastical