When Vernon Langford sees patients, he typically wears a white lab coat with his title — “Dr.” — and his credentials as a nurse practitioner stitched on the front.

“My credentials are on any jackets I have, the shirts I wear. If I have a name tag, it’s on that,” said Langford, who works as a primary care provider in Seminole County, Florida. He holds a doctorate of nursing practice, the highest degree available in his field. Like a Ph.D., it confers on him the “Dr.” title, but he says he explains to patients what that means, and how his role and education differ from that of a physician: “When I meet anyone, I want to make sure I’m educating them about who I am.”

A Florida bill lawmakers considered this year would have barred Langford and others with similar credentials from using the “Dr.” title in clinical settings. The bill was amended to exclude nurse practitioners before it reached the desk of Republican Gov. Ron DeSantis, who vetoed it without explanation. But Langford, who is president of the Florida Association of Nurse Practitioners, expects the legislation to reemerge.

Under pressure from physicians groups, an increasing number of states are weighing similar restrictions.

The debate is a symptom of a broader battle in health care: Amid a shortage of doctors and an explosion in the number of nurse practitioners with doctorates, many nursing groups are pushing to expand what nurses can do without physicians’ supervision. Physicians, meanwhile, are pushing to keep nurse practitioners and physician assistants under their oversight, arguing that giving more autonomy to providers with less rigorous training could put patients at risk.

Nurse practitioners and physician assistants argue they deserve to be able to practice to the fullest extent allowed by their education and credentials, and that — like anyone who’s earned a doctorate — they should be able to use the title conferred on them.

“It has nothing to do with ego or wanting to be something I’m not,” Langford said. “If I worked hard and earned a doctorate, I can use the title of ‘Dr.’”

Other non-physician providers who have doctoral degrees, such as optometrists and pharmacists, often use the “Dr.” title, although some states have considered bills backed by physicians groups that would limit those providers as well.

The American Medical Association and other physicians groups argue allowing nurse practitioners with doctoral degrees to use the “Dr.” prefix in a clinical setting will confuse patients.

“For me, it’s worrisome when a nurse practitioner or a physician assistant is being perceived as a physician,” said Dr. Rebekah Bernard, a family physician in Fort Myers, Florida, who is also the outgoing president of Physicians for Patient Protection, a group that advocates for physician-led care. “We don’t have the same training or education. Patients should know who’s taking care of them so they can make informed decisions about their health.”

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