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An Alphabet Soup of Healthcare Professionals

Posted Jan 26th, 2009 by Trisha Torrey

Have you ever noticed all those letters after a doctor or other medical provider’s name? MD, DO, DC, RN, PA, NP…. There are dozens, and when put together, they can spell confusion. Even when we know the words they stand for, we don’t always know what those words mean for our improving our health.

Those letters are credentials, indicating the level and focus of a provider’s education. They can help you determine whether the provider is licensed to perform the medical services you want and need, and may help determine whether those services are covered by your insurance.

The Doctor’s Alphabet of Credentials

Here are some of the credentials doctors earn through education and licensing in the United States:

An MD is a Medical Doctor, who is trained and licensed to diagnose and treat us at the most complicated level. MDs practice conventional or "allopathic" medicine. They generally rely on what we consider to be traditional types of treatments, such as drugs or surgeries.  Their services are usually covered by insurance because they generally rely on evidence-based medicine or standards of care to do their work.

Many MDs are specialists in specific body systems, diseases or skills. Additional initials designate additional credentials. For example, "MPH" indicates a Masters level degree in public health. "FACS" indicates Fellow, American College of Surgeons. Surgeons with the FACS designation have spent extra time learning the skills needed for their surgical specialties.

A DO is a Doctor of Osteopathic Medicine. A DO credential has similar education requirements to an MD. Osteopaths differentiate themselves from MDs by their whole body, or "holistic" approach to prevention or treatment, rather than focusing on one organ or body system. They base their treatment recommendations on the theory that the human body can heal itself, so their job is to give that body whatever it needs to do that healing.  That may mean a prescription drug, or it may mean a recommendation of a more complementary type therapy.

More than half of American DOs are primary care doctors in areas such as pediatrics, obstetrics, gynecology or internal medicine. They may prescribe drugs, order medical tests and do surgery. Other DOs specialize in areas similar to MDs, like cardiology, dermatology, orthopedic surgery, even preventive medicine.

A DC is a Doctor of Chiropractic. A DC credential requires a similar amount of education to an MD or DO, but with a different emphasis. Chiropractic, considered by many to be an alternative or complementary approach to medicine, focuses on manipulating the spines and nervous systems of patients.

Chiropractors do not prescribe drugs or perform surgeries. Some chiropractors expand their practices to include treatments such as acupuncture or herbal remedies, which many of the more conventional MDs or DOs will not, or may not legally be allowed, to prescribe.

One other physician designation is gaining more attention as we patients find more interest in alternative and complementary medicine.  An ND is a Naturopathic Doctor, not to be confused with a naturopath who does not have that same, physician-training based background.  A doctor with ND after her name is an integrative doctor, meaning, she has training in both allopathic and alternative medicines.  NDs are not licensed in every state, so a smart patient will want to double check to be sure that any ND she might choose to see is credentialed and licensed. 

Beyond Doctors – The Alphabet of Additional Healthcare Providers

Physicians aren’t the only healthcare professionals who earn these forms of credentials.

Perhaps the most recognizable designation is RN.  RNs are Registered Nurses, and you’ll find them in almost any health care setting. While doctors and others may do the diagnosing and prescribing, nurses are found in every support role there is, mostly providing treatment and monitoring to carry out other provider’s orders.

Some RNs have a two-year, associate’s degree, but additional designations and initials may indicate additional education and training.  For example, a BSRN is a nurse with a four-year, bachelor’s degree. CRNAs are Certified Registered Nurse Anesthetists who provide anesthesia to patients prior to surgery, baby deliveries, dental procedures and other situations.

Sometimes, however, more than two initials may mean less training, and different responsibilities.  A CNA is a Certified Nursing Assistant and an LPN is a Licensed Practical Nurse.  Neither of these credentials requires a post-high school degree, but they do require special skills training. 

In some cases, fewer initials mean more education.  An NP is a Nurse Practitioner.  Nurse practitioners have completed a registered nursing degree, plus an additional degree, usually a masters.  An NP must be certified in a specialty area, such as family health, oncology, or pediatrics. An NP can serve as a patient’s regular health care provider, and may diagnose, order tests, develop treatment plans and write prescriptions.

NPs may practice on their own, but under the auspices of a medical doctor.  As access to primary care doctors becomes more difficult, NPs are filling the role for patients who need primary care providers.  They may diagnose and prescribe in a primary care capacity and call in the MD or DO they practice under when a patient presents with more difficult symptoms.

A PA is a Physician’s Assistant.  PAs are licensed to practice medicine under the supervision of private practice physicians or hospitals. Their education requires a bachelor's degree, then two to three years of additional training that results in a master's degree relevant to the area in which they will practice.  PAs may diagnose and treat patients, prescribe medicine and some may be surgical assistants after training.

While NPs and PAs may seem to function in similar capacities, there are some important differences.  NPs have focused all their education on healthcare, PAs may have earned a bachelor’s degree in any subject at all.  Further, NPs may practice in a separate location from the doctor they work with, while a PA must always practice in the doctor’s office.

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What’s the bottom line for us patients?  Understanding basic designations can help us make the right provider choice, setting the stage for a good partnership, and a better medical outcome.

There are dozens more initials a doctor or other healthcare practitioner may earn and add to his or her name.  For a master list of physician designations, check out MedHunters Directory.

 

About the author

Trisha Torrey is Every Patient's Advocate. She is a newspaper columnist, radio talk show host, national speaker, and the guide to patient empowerment at About.com.

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