Brian Morton: Protecting our title

WHAT sort of doctor are you? If asked in general conversation what I do for a living, my reply is “GP”, not the generic “doctor”.

In the written form, the answer is not as simple. My credit card lists me as “Dr Brian Morton” and when a transaction is processed I am usually asked about the discipline of medicine I practise.

This emphasises the point that common usage of the title “Dr” in Australia in the main refers to medical practitioners.

The Australian Health Practitioner Regulation Agency says the courtesy title Dr is not a protected title and may be used by non-medical practitioners as long as they do not induce a belief that they are a registered medical practitioner.

The first entry in the online Oxford English Dictionary defines a doctor as “a person who is qualified to treat people who are ill”. However, Wiktionary’s first listing includes the definition of “a teacher”.

It seems that even we in the medical profession are not quite sure when the title of Dr should apply. Surgeons often use the title “Mr”, and when we achieve a higher academic status we use Associate Professor or Professor.

General practice is a recognised specialty and I can state that I am a “medical specialist” (which is a protected title), but is this another example of the confusion about medical titles?

What is amusing is that when doctor is used as a verb, it can convey the meaning of our complaints about misuse of the title — doctoring: “to change the content or appearance in order to deceive; falsify; eg, he denied doctoring the report”.

A title that is protected by the Health Practitioner Regulation National Law Act is “medical practitioner”. Section 117 of the Act prohibits a person from knowingly or recklessly taking or using any title that could be reasonably understood to induce a belief that the person is registered in a health profession or a division of a health profession in which the person is not registered.

Technology can also blur the lines, with some of my patients seeking instantaneous health advice through internet search engines such as Google — Dr Google. The first problem with the internet doctor is the implicit belief in the veracity of the advice proffered; but this doctor is often hopelessly conflicted.

Unlike consulting room interactions, many patients are not readily able to determine whether the information they discover is from a medical practitioner or a reputable site, and most would not perform due diligence to filter that advice.

So is the title Dr being used deceptively in the Australian community?

The media are usually careful with attribution of comments and identification of those quoted. A recent newspaper article about attention deficit hyperactivity disorder quoted a doctor, but there was no attribution giving the qualifications of the interviewee. Where there is overlap of expertise — in this case, educational, medical or psychological — it is unusual that the journalist did not make the expertise clear.

Those with a PhD, who certainly deserve the recognition for such hard work, would be well advised to indicate they are not medical doctors. The real concern is that the use of doctor implies to the public the skill, training, standards and evidence base that medical practice has established.

The difficulty for the public in knowing who is an expert was highlighted by the recent furore over the misleading and inaccurate statements by a chiropractor concerning vaccination, which raised questions over expertise and his ability to use the title Dr when outside his paradigm of care.

Should we follow the German example — Dr med Morton or Dr Morton (med) — or should all others using the “Dr” title distinguish their health practice registration with an appropriate postnominal?

Do other practitioners who use the title Dr have an obligation to change, or should we be proactive at protecting the community from deception — intentional or otherwise?

Dr Brian Morton is a GP in Sydney and a former president of the NSW AMA.

Posted 5 September 2011

[poll id="117"]