Is there a ‘doctor’ in the house?

Hey there, time traveller!
This article was published 23/12/2020 (2109 days ago), so information in it may no longer be current.

Dr. Jill Biden, who holds a EdD (Doctor of Education), was recently criticized in a Wall Street Journal column for using the honorific “doctor.” Her use of the title was described as “fraudulent, even comic.” Fox News host Tucker Carlson was dismissive of her doctorate, comparing her to Dr. Pepper. Both Carlson and Joseph Epstein, author of the WSJ piece, hold the view that you are not a “real” doctor unless you have delivered a baby, or the equivalent.

Dr. Biden has not (though she has given birth to one). Her EdD thesis was on student retention at community colleges. That is a serious research question. It is more important now than ever, as governments across the western world look to boost participation in higher education. To mock her credentials has more than just a whiff of misogyny.

While he makes an exception for the sciences, where men outnumber women in some but not all fields, Epstein suggests that PhDs in the social sciences and humanities, where women predominate, are “bush league.”

Epstein further suggests the prestige of the PhD has been eroded by the habit of conferring honorary doctorates on the unworthy, such as celebrities and politicians. Oh, and by the way, on Epstein himself. He seems to agree with Groucho Marx that he’d never want to belong to a club that would accept him as a member. But comparing honorary doctorates to the real thing is specious, like comparing real combat to playing Call of Duty. It’s hardly the same.

A chorus of voices has chimed support for Epstein, most coming from the right of the political spectrum. While these people are quite certain of the meaning of the word “doctor,” they appear unfamiliar with the meaning of the word “hypocrisy.” Until now, they have been just fine with Dr. Henry Kissinger or Trump economic advisor Dr. Peter Navarro, both of whom hold PhDs in “bush league” social sciences. Both are men. Neither has delivered a baby.

The current contretemps over the use of the term “doctor” ignores the definition of the term, its original use, and subsequent history. It is the PhDs who are the real doctors. The medical doctors are the Johnny-come-latelys, by about four centuries.

The Latin term “doctor” derives from “docere,” which means “to teach.” It was used in the first European universities in Bologna and Paris in the 14th century to confer distinction on those who had achieved the highest level in academia.

The term was appropriated by the medical profession in the 18th century, when the discipline needed a boost in prestige. At that time it included an eclectic collection of barber-surgeons, apothecaries, physicians and a fair number of cranks and charlatans promoting quack cures, leeches and blood-letting. For the barber-surgeons, the medieval antecedent of modern-day surgeons, surgery was more of a sideline. Their day job was cutting hair.

The University of Glasgow first issued the academic degree “Doctor of Medicine” in 1703, and universities elsewhere followed suit later that century. Over time, the prestige of the medical doctor or MD grew, especially as the field embraced evidence-based medicine. But one wonders if there is not an erosion of that prestige taking place today.

Just as MDs co-opted the term doctor from academics, the term MD is being co-opted by Johnny-come-lately chiropractors and naturopaths, who provide health care, call themselves doctors and largely do not rely upon evidence-based medicine. Some are the same people who lead anti-mask and anti-vaccine protests. Some even promote “natural” alternatives to vaccines, such as the nosodes made with rabid dog saliva. Are they real doctors?

When it comes to basic medical research, such as vaccine development, that work is done not by MDs, but mainly by PhDs and their lab groups in molecular biology, virology, microbiology, cell biology or biochemistry. Most MDs lack the specialized training to do that research (MD-PhDs being the exception) and rely upon the work of PhDs to get to clinical stage trials where MDs participate.

Those who mock the credentials of the PhD often use the story of the apocryphal cocktail party to make their point. A guest has a serious medical event and the “doctor” at the party is unmasked as a PhD and of no real help.

I have not been to such a party. I gather they are rare. While I certainly have full respect for medical doctors, many of whom I have taught, I suggest a different cocktail party story that goes like this:

“Oh you are a doctor. What do you teach?”

“I don’t teach. I’m an MD.”

“Oh, so you are not a ‘real’ doctor. You’re a ‘medical’ doctor. You don’t happen to be a surgeon, do you? With the pandemic and alI, I could really use a haircut.”

Scott Forbes is a professor of biology, with a PhD, at the University of Winnipeg.