Distinctions That Define and Divide   /   Summer 2021   /    Essays

Too Many Doctors in the House

The use and abuse of a title.

Ronald W. Dworkin

Scholars at a Lecture, 1736–37, by William Hogarth (1697–1764); Artokoloro/Alamy Stock Photo.

Fifteen years ago, when a book I wrote went to press, I had a fight with my editor, who wanted my name on the front cover to be followed by my credentials: MD, PhD. (I am an anesthesiologist. I also have a PhD in political science.) I threw a fit because I did not want to be called “doctor.”

More recently, the writer Joseph Epstein criticized First Lady Jill Biden, who holds an EdD, for calling herself “doctor.”11xJoseph Epstein, “Is There a Doctor in the White House? Not if You Need an MD,” Wall Street Journal, December 11, 2020, https://www.wsj.com/articles/is-there-a-doctor-in-the-white-house-not-if-you-need-an-m-d-11607727380. Biden’s defenders responded by saying anyone who has earned an MD a PhD, or a professional doctorate should be called “doctor.”

Why this confusion and controversy over who should be called “doctor”?

Another mystery is the explosion in the number of non-MD doctors over the last century. In 1900, there was one physician for every 568 persons in the United States. Today, there is one physician for every 290 persons.22x“How to Study Medicine” and “The Obligations of the University to Medical Education” (pamphlets, 1910), Carnegie Endowment Archives, Columbia University, File: Medical Education: 1900 to 1920; https://www.unz.com/print/Outlook-1910oct01-00272/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986669/, respectively. Aaron Young et al., “A Census of Actively Licensed Physicians in the United States, 2016,” Journal of Medical Regulation 103, no. 2 (2017): 7–21, https://web.archive.org/web/20171215170531/http://www.fsmb.org/Media/Default/PDF/Census/2016census.pdf. In 1900, there was one PhD for every 200,000 persons in the United States and no one who held a professional doctorate. Today, there is one non-MD doctor for every fifty-eight persons, a more than 3,400-fold increase since 1900. By comparison, there was a mere twofold increase in the number of physicians over the same period.33xLori Thurgood, Mary J. Golladay, and Susan T. Hill, US Doctorates in the 20th Century: Special Report (Arlington, VA: National Science Foundation, 2006), http://link.umsl.edu/portal/U.S.-doctorates-in-the-20th-century-electronic/yRXZYe9EV6g/. Reid Wilson, “Census: More Americans Have College Degrees Than Ever Before,” The Hill, April 3, 2017, https://thehill.com/homenews/state-watch/326995-census-more-americans-have-college-degrees-than-ever-before. Wilson reports that 2 percent of Americans have doctorates. Subtracting the number of physicians from the total produces the datum one in fifty-eight.

What explains the increase?

The answers to these questions lie in a deeper understanding of how science has changed the meaning of the doctorate.

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