Several states are taking on the debate of whether to prevent nonphysicians from using the doctor title, but nurse practitioners with doctorates are pushing back, The Washington Post reported Aug. 20.

Many states are contending with the question of how much independence to allow advanced practitioners, including what they can call themselves. In 2022, Indiana and Georgia attempted to pass laws that would prevented nurses from using terms such as "doctor" even if they had a doctorate degree. A 2023 Florida bill — that was vetoed in June by Gov. Ron DeSantis — would have prevented nonphysicians from using titles such as "doctor," "physician," "medical resident" and "hospitalist."

Recently, California ordered a nurse practitioner to pay nearly $20,000 for advertising herself as "Doctor Sarah," which led to a lawsuit from several nurses challenging the law.

The longstanding debate has become more relevant as the physician shortage continues. In 1994, only five states allowed nurse practitioners full practice authority. Today, 27 states and the District of Columbia no longer required physicians to oversee nurse practitioners.

According to the article, legislators are becoming tired of the decadeslong debate.

"They told us: 'We're tired of hearing this. Can you all just stop bickering?' We're not bickering," Carmen Kavali, MD, a Georgia-based plastic surgeon, told the Post. "We're trying to protect patients here."

The debate circles many of the same arguments: Physicians worry that nurse practitioners don't have the experience to properly treat patients which could lead to adverse outcomes, and nurse practitioners meanwhile point to "50 years of research" on providing similar outcomes to physicians.