When Your "Doctor" Isn't A Physician

Updated: 2 hours ago

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Should patients have the right to clearly know the credentials of the healthcare professional treating them?

Delaware just protected patients from artificial intelligence using medical titles. Now it should make sure patients know the credentials of the humans diagnosing and treating them.

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. Delaware already regulates medical titles, and 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. The next step is clear: bring the Healthcare Professional Transparency Act back and ensure Delaware patients know the professional license of the person diagnosing and treating them.

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. That wasn’t always the case. In 2021, House Bill 141 eliminated Delaware’s prior collaborative-practice requirement for advanced practice registered nurses, which includes nurse practitioners. Many Delaware patients may not realize that change occurred—or that the person independently diagnosing and treating them may not be a physician and may have no physician oversight.

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, Delaware went further with Senate Bill 320, allowing pharmacists to independently evaluate patients, identify health conditions, order and prescribe laboratory tests, and prescribe certain drugs and devices. As Delaware expands the number and types of healthcare professionals who may diagnose and treat patients —in other words, practice medicine— knowing exactly who is providing that care becomes more important—not less.

Those distinctions are more than differences in initials after someone’s name. Some nurse practitioners (NPs) 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 of clinical training through medical school and residency. The precise training varies by program and specialty, but these are different professions with substantially different levels and pathways of clinical training.

In Delaware, nurse practitioners can diagnose and treat patients without physician supervision.

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.” Confused? So are patients. They shouldn't need to decipher healthcare credentials to know whether the person diagnosing and treating them is a physician. They should simply be told.

Context matters. In a university classroom, “doctor” may mean a professor with a PhD. At a dentist's office, it means a dentist. But in a medical examination room, when someone is evaluating symptoms, diagnosing disease, ordering tests, and prescribing medication, many patients understand “doctor” to mean physician. 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.

Confusion doesn't require someone to explicitly say, “I am a physician.” Patients form impressions from scheduling, practice websites, introductions, identification badges, professional titles, and even familiar cues such as white coats and stethoscopes. A provider who walks into the room and says, “Hi, I'm Susan,” may sound warm and informal, but the patient still hasn't been told whether Susan is a physician, nurse practitioner, physician assistant, or another healthcare professional.

Patients have a right to know whether the person diagnosing and treating them is 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. This isn't merely professional guidance. Under Section 1766, violations of the Medical Practice Act for which no other penalty is specified are Class B misdemeanors, enforced by the Delaware Attorney General. In other words, Delaware already recognizes accurate disclosure of medical titles as a legal requirement—not simply professional courtesy.

But that doesn't solve the larger problem. Existing law primarily governs what healthcare professionals may call themselves; it does not require patients to be affirmatively told who is treating them. A healthcare professional can comply with the title law and never claim to be a physician, yet a patient can still leave the appointment believing that is exactly who diagnosed and treated them.

Delaware lawmakers recognized the need for greater transparency in 2024. House Bill 447 would have required healthcare practitioners using “Doctor” to identify their educational degree and professional license. It also would have required most healthcare practitioners to wear visible identification showing their name and license type, and healthcare advertisements to accurately identify practitioners' licenses. Violations would have been treated as unprofessional conduct through the practitioner's licensing authority. But HB 447 never became law.

Other states already require healthcare professionals to clearly identify their profession or license to patients.

Delaware would not be breaking new ground. Other states already require healthcare professionals to clearly identify themselves to patients. Georgia requires healthcare practitioners to clearly communicate their specific license to patients. Nurse practitioners and physician assistants must also verbally identify their profession during each patient interaction, and a nurse practitioner who uses the title “Doctor” must make clear that they are not a physician. Illinois also requires advanced practice nurses to verbally identify themselves to patients, while California has gone further by restricting how the title “doctor” may be used in medical settings. Delaware can do the same: simply make sure patients know what type of healthcare professional is treating them.

The General Assembly should bring HB 447 back in 2027—and strengthen it. In addition to its original disclosure requirements, the bill should require patients to 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 is provided. If a nonphysician uses “Doctor” in a clinical setting, their profession should be disclosed at the same time.

This isn't about prohibiting earned academic titles or telling patients which healthcare professional to choose. It's about giving patients the information they need to make that choice for themselves.

Delaware has expanded who may independently diagnose and treat patients. It already recognizes the importance of accurate medical titles, and lawmakers have already proposed legislation to improve healthcare transparency. This year, Delaware went even further, protecting patients from artificial intelligence presenting itself as a licensed healthcare professional. Yet patients still aren't guaranteed the same basic transparency about the humans treating them.

Patients shouldn't have to ask whether their doctor is actually a physician. They should already know.

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Delaware patients deserve to know whether the healthcare professional diagnosing and treating them is a physician, nurse practitioner, physician assistant, or another licensed healthcare professional. Add your name and urge Delaware lawmakers to bring back and strengthen the Healthcare Professional Transparency Act.

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