The title “Doctor” can be used by anyone who holds a doctoral-level degree, but where and how you use it depends on your profession, your setting, and sometimes your state’s laws. The distinction that causes the most confusion is between people who earned academic doctorates (like a PhD) and those who hold professional degrees in healthcare (like an MD or DO). Both groups have legitimate claims to the title, but the rules get complicated in clinical settings where patients could be misled.
The Title Originally Belonged to Scholars
The word “doctor” comes from the Latin verb “docere,” meaning to teach. It was coined in the Middle Ages to describe eminent scholars, with the earliest doctorates dating back to the 1300s. For centuries, the title had nothing to do with medicine. It referred to people who had reached the highest level of academic achievement.
Physicians didn’t start calling themselves “doctor” until the 17th century, when medical schools in Scotland began addressing graduates with the title as a mark of prestige. The PhD, or Doctor of Philosophy, remains the highest graduate degree awarded by universities. A person who earns a PhD after completing a master’s degree and original research is fully entitled to use the title “Doctor” in academic and professional life.
Interestingly, the MD degree that physicians earn is technically a professional degree, not a graduate doctorate in the traditional academic sense. MD programs are not part of the graduate faculties at North American universities. The same is true of the Juris Doctor (JD) awarded to law school graduates. Despite the name, these are professional degrees rather than research doctorates. Yet physicians universally use the title, while lawyers generally do not.
Who Uses the Title in Healthcare
Several types of healthcare professionals use the title “Doctor” in clinical practice. Physicians with an MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) are the most recognized. Dentists (DDS or DMD), optometrists (OD), podiatrists (DPM), and chiropractors (DC) also routinely use the title when treating patients. Many state laws explicitly authorize these professionals to do so, though some states require them to clarify their specific credential. In Texas, for example, dental offices must post each dentist’s name, degree, and school attended at or near the office entrance.
Psychologists who hold a doctoral degree (PhD or PsyD) also use the title in clinical settings, as do pharmacists with a Doctor of Pharmacy (PharmD) in some contexts. The common thread is that these professionals hold doctoral-level degrees and are licensed by their states to provide patient care under that credential.
The Debate Over Nursing Doctorates
The fastest-growing controversy around the title involves nurse practitioners (NPs) who earn a Doctor of Nursing Practice (DNP). These clinicians hold a legitimate doctoral degree and may feel entitled to be called “Doctor” in their workplace. But several states restrict the title in clinical settings to licensed physicians only, on the grounds that patients hearing “doctor” in a hospital or clinic will assume they’re seeing a physician.
A federal court case in California brought this issue into sharp focus. Three nurse practitioners with DNP degrees sued, arguing that a state law reserving the terms “doctor” and “Dr.” for licensed allopathic and osteopathic physicians violated their First Amendment rights. The U.S. District Court for the Central District of California dismissed the case. Judge Jesus G. Bernal ruled that using the title in a clinical context counts as commercial speech, which the state can regulate to prevent patient confusion. The nurse practitioners appealed to the 9th Circuit, and the case continues to shape the national conversation.
The core issue isn’t whether a DNP is a real doctorate. It is. The issue is whether using the title in a healthcare setting could mislead patients about who is providing their care.
Why Lawyers Don’t Call Themselves “Doctor”
Attorneys hold a Juris Doctor degree, but professional ethics rules have long prohibited them from using the title. A Texas ethics opinion, citing repeated rulings from both state and American Bar Association committees, stated that a practicing attorney holding a JD “may not ethically use the titles ‘Doctor’ or ‘J.D.’ in any manner, either directly or indirectly, in relation to his position, his identity or his practice as a lawyer.” The reasoning is that the title would be considered self-laudatory, essentially a form of puffery that could mislead the public about the nature of the degree. This convention is so deeply established that most people don’t even realize lawyers technically hold a “doctor” degree.
PhD Holders Outside of Healthcare
If you earn a PhD in history, physics, psychology, economics, or any other field, you have every right to use the title “Doctor.” This is the original and most academically grounded use of the word. In university settings, using the title is standard and expected. Outside of academia, customs vary. A PhD holder introducing themselves as “Doctor” at a dinner party might raise eyebrows in some social circles, but there is no legal or ethical barrier to doing so.
The same applies to holders of other research doctorates like the EdD (Doctor of Education), DBA (Doctor of Business Administration), or DMA (Doctor of Musical Arts). If the degree is a recognized doctoral credential from an accredited institution, the title is yours to use.
What State Laws Actually Restrict
The legal restrictions on the title “Doctor” are narrower than many people think. They focus almost entirely on clinical healthcare settings where a patient might be confused about who is treating them. Kansas law, for example, considers anyone who attaches the title “M.D.” or similar medical designations to their name to be representing themselves as practicing medicine and surgery. A Kansas appeals court ruled in 2004 that a licensed dentist could not use an MD degree obtained from an eight-week program at a university in the West Indies.
These laws don’t prevent a PhD in biology from being called “Dr. Smith” on a university campus or in a published paper. They prevent someone without the proper medical license from implying they can diagnose and treat patients. The distinction is about context: a research scientist, a professor, and a physician can all be “Doctor,” but only the physician can use that title while providing medical care to a patient, unless state law specifically authorizes other healthcare professionals to do so.
In practice, the biggest gray area is in healthcare facilities where multiple types of doctoral-level professionals work side by side. Hospitals and clinics increasingly use name badges and introductions that specify credentials (Dr. Jones, Nurse Practitioner; Dr. Patel, Physician) to keep things clear for patients. The title itself isn’t the problem. The potential for confusion is.