What’s the news: The U.S. District Court for the Central District of California Riverside Division has dismissed a case brought by three nurse practitioners (NPs) with doctorates in nursing practice. They claimed that a state law that only allows California-licensed allopathic and osteopathic physicians to use the terms “doctor” and “Dr.” was unconstitutional. The ruling is a win for patients and physicians.
The restriction, which is Section 2054 of the California Business and Professions Code, has been on the books since at least 1937 to avoid patient confusion over the level of education their health professionals have achieved.
In his ruling, U.S. District Judge Jesus G. Bernal treated the use of the titles as commercial speech and rejected the nurse practitioners’ First Amendment challenges. Notably, the judge relied on AMA survey research (PDF) showing that 39% of patients are confused and wrongly believe that a person holding a docotorate in nursing practice is a physician.
“The record and common sense support the conclusion that Section 2054 directly advances California’s substantial interest in protecting consumers from misleading advertising by medical professionals,” Judge Bernal wrote in the ruling. The nurse-practitioner plaintiffs have appealed the ruling the 9th U.S. Circuit Court of Appeals.
In an amicus brief, the Litigation Center of the American Medical Association and State Medical Societies and the California Medical Association supported the state’s request that the court dismiss the lawsuit, Palmer et al. v. Bonta et al.
The AMA is fighting scope creep, defending the practice of medicine against scope of practice expansions that threaten patient safety and undermine physician-led, team-based care.
Why it’s important: With nearly 200 unique combinations of acronyms next to primary care health professionals’ names, the potential for patient confusion over who is treating them has only grown since California first required that only MDs and DOs could use the terms “doctor” or “Dr.” And the California law isn’t unique, with Indiana, Minnesota and Tennessee among the states that have such truth-in-advertising laws.
The AMA’s research found that 45% of the adults surveyed “did not agree that it was easy to identify who is or is not a licensed medical doctor by reading what services they offer, their title, and other licensing credentials in advertising materials,” the AMA Litigation Center and CMA brief told the district court.
The AMA survey also found that 91% of the respondents “strongly support and prefer” a health care team that is led by a physician, saying that their “years of medical education and training (compared to a nurse practitioner) are vital to optimal care, especially in the event of a complication or a medical emergency.”
Read more from the AMA on what sets apart physicians and nurse practitioners.
Learn more: The AMA Truth in Advertising Campaign has resource materials (PDF) to support state legislative and regulatory campaigns aimed to ensure that health care professionals clearly and honestly state their level of training, education and licensing whether it is a face-to-face encounter or in advertising, marketing or other communication materials.
Also, visit AMA Advocacy in Action to find out what’s at stake in fighting scope creep and other advocacy priorities the AMA is actively working on.
Explore further the cases in which the AMA Litigation Center is providing assistance and learn about the Litigation Center’s case-selection criteria.
