Who Can Call Themselves a Doctor (in California)?
Right this minute a person can call themselves a doctor in California only if they are a Medical Board of California or Osteopathic Medical Board of California physician. However a pending California court case may change that. (Note: Chiropractors can call themselves "Dr." but must put (D.C. or chiropractor at the end of their name, suchas Dr. William Jones, D.C.)
Another related question is whether a Dentist can use the phrase "Dr.". This is not a finalized issue but the dental board has published examples of names that dentists might theoretically use when registering a fictitious business name. These include:
The fictitious name may be more than one line, and if so, the lines do not have to be of equal font size. Some examples are:
Greenhaven Dental Care
Dental Office of Dr. John Doe
A-B-C Dental
Practice of Smith Dental Corporation
Camellia Dental Center
Dental Group of John Doe, DDS, Inc.
Howe Avenue Dental Group
Drs. Jones, Smith, and Doe
The Basic "OLD" Rules
The basic law is this. Individuals who are licensed as physicians and surgeons under the Medical Practice Act are authorized to use medical titles (Crees v. California State Bd. of Medical Examiners, 213 Cal.App.2d 195 (1963)), (Oosterveen v. Board of Medical Examiners, 112 Cal.App.2d 201 (1952)) (Steinsmith v. Medical Board, 85 Cal.App.4th 458 (2000)).
The current issue is whether holding a degree in the medical field but practicing as a nurse qualifies the person to use “Doctor”. In a more subtle context you can ask whether a person with an M.D. degree from a foreign university can call themselves “doctor”. As Crees and Oosterveen make clear, the ability to be and the fact of being licensed by the medical board is the bright line. (So the answer is “no”.)
California law prohibits the use of any term or letters in a professional capacity that falsely indicate a right to practice medicine, such as "M.D." or similar, unless the individual holds the appropriate licensure. This includes situations where individuals might not be actively practicing medicine but use the title in a way that could mislead the public regarding their licensure status.
An osteopath is an “O.D.” however a specific legal provision exists for holders of a physician's and surgeon's certificate who also have an M.D. degree from an approved medical school in California before a certain date (Osteopathic Physicians and Surgeons of Cal. v. California Medical Ass'n, 224 Cal.App.2d 378 (1964)) These individuals can use the "M.D." suffix without it being considered unprofessional conduct, provided they notify the relevant boards of their choice.
The New Battle
Meanwhile there is major litigation on the limitation on the use of the term Doctor.
In Jacqueline Palmer et al v. Rob Bonta 5:23-CV-01047 (6/6/2023) Central District of California, three nurse practitioners with Ph.D’s (Doctorate of Nursing) sued to invalidate California Business and Professions Code section 2054. They claimed it infringed on their 1st Amendment rights. B&P section 2054 states that anyone using the terms “doctor”, “physician” or “Dr.” or “M.D.” cannot do so unless they are a currently licensed physician.
The California Medical Association (CMA) and the American Medical Association (AMA) filed a joint amicus curiae brief (See CMA AMA Brief here) arguing that the law in California must prohibit the use of the term “doctor” or the prefix “Dr.” by anyone other than an actual California licensed medical doctor meaning an allopathic or osteopathic physician.
The Pacific Legal Foundation which filed the lawsuit describes (on their website) the issue this way:
California’s restriction of the word “doctor” isn’t a protection against fraud and injury. Instead, the state is appropriating the word “doctor” for certain protected professions: licensed physicians and surgeons. Never mind that neither “Dr.” nor “doctor” appears anywhere on physicians’ or surgeons’ certificates.
The government cannot hijack a commonly used word and reserve it for a narrow range of preferred jobs. Nor can the state police the use of truthful language to limit career opportunities.
Forced either to lie about their qualifications and experience, stay silent, or fight back, Jacqueline, Heather, and Rodolfo are choosing the latter. Represented at no charge by Pacific Legal Foundation, the trio filed a federal lawsuit challenging California’s unjust titling law to restore their right to accurately describe themselves and their credentials and to earn an honest living.
The Amicus brief of the AMA and CMA makes many points including:
Section 2054 is colloquially known as a “truth in advertising” law in
medicine. The problem it is designed to address – confusion when non-physicians
use the term “doctor” or “Dr.” – is not unique to California.
They make the point that:
When encountering the health care system, patients immediately confront an
array of practitioners and acronyms that can cause confusion over the practitioner’s
level of licensing, education, and training. In a review of over 2,000 primary care
providers' biographies, a researcher found 181 unique combinations of alphabetic
acronyms next to the practitioners’ names (e.g., FNP-BC, PA-C).
What about California law? The Cal. Code Regs. Tit. 22, § 73085 - Physician says:
(a) Physician means a person licensed as a physician and surgeon by the Medical Board of California or by the Osteopathic Medical Board of California.
(b) Attending Physician. Attending physician means the physician responsible for the medical treatment of the patient in the facility.
(c) Advisory Physician. Advisory physician means the physician who assumes responsibility for the medical guidance of the licensed facility.
(d) Psychiatrist. Psychiatrist means a physician who has specialized training and/or experience in psychiatry.
Now there are more laws on this topic - sort of. A chiropractor in the Workers Compensation system in California is called the "treating physician" if he/she meets the qualifications below.
§ 9785. Reporting Duties of the Primary Treating Physician.
(a) For the purposes of this section, the following definitions apply:
(1) The “primary treating physician” is the physician who is primarily responsible for managing the care of an employee, and who has examined the employee at least once for the purpose of rendering or prescribing treatment and has monitored the effect of the treatment thereafter. The primary treating physician is the physician selected by the employer, the employee pursuant to Article 2 (commencing with section 4600) of Chapter 2 of Part 2 of Division 4 of the Labor Code, or under the contract or procedures applicable to a Health Care Organization certified under section 4600.5 of the Labor Code, or in accordance with the physician selection procedures contained in the medical provider network pursuant to Labor Code section 4616. For injuries on or after January 1, 2004, a chiropractor shall not be a primary treating physician after the employee has received 24 chiropractic visits, unless the employer has authorized additional visits in writing. This prohibition shall not apply to the provision of postsurgical physical medicine prescribed by the employee's surgeon, or physician designated by the surgeon pursuant to the postsurgical component of the medical treatment utilization schedule adopted by the Administrative Director pursuant to Labor Code section 5307.27. For purposes of this subdivision, the term “chiropractic visit” means any chiropractic office visit, regardless of whether the services performed involve chiropractic manipulation or are limited to evaluation and management.
When you have a Workers Compensation case going to trial for Workers Compensation fraud this designation can cause lots of confusion as people who do not specialize in Workers Compensation law don't know that it is proper to use the term "physician" for the chiropractor in these circumstances. (Note: Horowitz is NOT a specialist in WC law. However, handling many workers compensation fraud cases gives him this background.)
Presently the law is still in effect but the case is not yet decided and it is unclear when the briefings will be completed and a decision issued. Stay Tuned!
Daniel Horowitz is a medical license and physician defense attorney representing Medical Board or Osteopathic Board licensed medical doctors.