When Your “Doctor” Isn’t a Physician
Delaware patients should know the credentials of the healthcare professional diagnosing and treating them.
The following is a condensed version of an article originally published by the Caesar Rodney Institute’s Center for Health Policy. Read the full CRI article here.
By Michelle Parsons, M.D., Center for Health Policy, Caesar Rodney Institute
Earlier this year, Delaware lawmakers acted to prevent patients from mistaking artificial intelligence for a healthcare professional. House Bill 191, signed into law on April 23, prohibits a nonhuman entity—including an AI agent—from being licensed as a physician, nurse, advanced practice registered nurse, or physician assistant. It also prohibits AI from using protected professional titles, including “Doctor” and “Dr.” The principle is simple: patients deserve to know who—or what—is providing their healthcare.
That same principle should apply when the provider is human. Delaware has expanded the authority of nonphysician healthcare professionals, like nurse practitioners, to independently diagnose and treat patients, but patients may not always know whether the person treating them is a physician. Lawmakers attempted to strengthen those protections in 2024 with House Bill 447, the Healthcare Professional Transparency Act, but the bill was pulled before a committee vote and never brought back.
If Delaware believes patients have a right to know when their “doctor” is AI, surely they have a right to know when their “doctor” isn't a physician.
The distinction matters because Delaware now allows nurse practitioners to practice medicine independently, without physician supervision. They may evaluate patients, diagnose illnesses, order and interpret diagnostic tests, manage treatment, prescribe medications, and make referrals. In 2021, House Bill 141 eliminated Delaware’s prior collaborative-practice requirement for advanced practice registered nurses, which includes nurse practitioners.
Nurse practitioners are not the only healthcare professionals whose authority Delaware has expanded. In 2022, House Bill 399 allowed pharmacists, under statewide protocols, to test, screen, and treat certain health conditions. In 2026, Senate Bill 320 went further, allowing pharmacists to independently evaluate patients, identify health conditions, order and prescribe laboratory tests, and prescribe certain drugs and devices.
Some nurse practitioners also earn a Doctor of Nursing Practice (DNP), an academic nursing doctorate. But their education and clinical training are very different from those of physicians. According to the American Medical Association, nurse practitioners complete approximately 500 to 750 hours of clinical training as part of their graduate-level NP education, while physicians complete approximately 12,000 to 16,000 hours through medical school and residency.
Those differences may be familiar to healthcare professionals, but they aren't necessarily clear to patients. MD, DO, APRN, NP, DNP, PA—the alphabet soup gets complicated quickly, particularly when several types of providers may perform many of the same functions in an exam room. The confusion becomes even greater when a nonphysician with a doctoral degree uses the title “Doctor.” Patients shouldn't need to decipher healthcare credentials to know whether the person diagnosing and treating them is a physician. They should simply be told.
And the confusion is real. An American Medical Association survey found that 39% of respondents identified a Doctor of Nursing Practice as a physician. Nineteen percent thought a nurse practitioner was a physician, and 17% thought a physician assistant was a physician.
Delaware law already recognizes that medical titles matter. Section 1703 of the Medical Practice Act states that when someone uses “Doctor” in matters related to medicine or health, the type of doctorate held must be specified. But existing law primarily governs what healthcare professionals may call themselves; it does not require patients to be affirmatively told who is treating them.
House Bill 447 would have required practitioners using “Doctor” to identify their educational degree and professional license, most practitioners to wear visible identification showing their license type, and healthcare advertisements to accurately identify practitioners' licenses. But HB 447 never became law.
Other states already require this transparency. Georgia requires practitioners to communicate their specific license, and nurse practitioners and physician assistants to verbally identify their profession. Illinois also requires advanced practice nurses to verbally identify themselves.
The General Assembly should bring HB 447 back in 2027—and strengthen it. Patients should be clearly told whether the person diagnosing and treating them is a physician, nurse practitioner, physician assistant, or another licensed healthcare professional before non-emergency care. If a nonphysician uses “Doctor,” their profession should be disclosed at the same time.
This isn't about prohibiting earned academic titles or telling patients whom to choose. It's about giving patients the information to make that choice for themselves.
Patients shouldn't have to ask whether their doctor is actually a physician. They should already know.
Learn More & Take Action
Read the full article: Read the original article at the Caesar Rodney Institute
Prefer to listen? Listen to an easy-to-digest podcast discussion of the article here
Support healthcare transparency in Delaware: Sign the Healthcare Professional Transparency Petition
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