I think it was carol brussel who wrote:

> there aren't any "almost doctors" that have different initials but can
practice medicine.

Sure there are!  There are a whole range of different levels of medical
expertise, ranging from nurses, to certified nurse practitioners, to
physician's assistants, to the regular doctors.  At a big teaching hospital
there will be people fresh out of medical school, who have the MD after
their name and are referred to as "doctors," but are just starting their
internships, then there are 1st, 2nd, 3rd, and 4th year residents, chief
residents, and so on up the line to people who have decades of experience
and are the Chief of Surgery, or whatever.  Just seeing the MD after the
name doesn't tell you everything you need to know, but it means something
different than the PA or the RN initials.

There is a tendency for people without the initials to make certain
assumptions about the knowledge and wisdom of the people with the initials
(whether those initials are MD or PhD or EdD or MA or RN or IBCLC or
whatever).  People with the initials, however, usually recognize that within
their group, there will be people who are knowledgeable and people who are
idiots, people was are honest and people who are dishonest, people who are
nice and people who are jerks.

Thus, people with Ph.D.s who work outside of academia often get tons of
respect and everyone calls them "doctor."  People with Ph.D.s who work
inside academia, where everyone has a Ph.D., insist on more evidence of
widsom and respect-worthiness before conferring respect (because we all know
too many people with Ph.D.s who are morons).  And we don't go around
referring to each other as "Dr. So-and-so."

And in the US, the initials MD seem to automatically confer a ton of respect
and assumptions about wisdom even when those are not deserved.  So that a
person can say that they'll believe their pediatrician's advice about
breastfeeding over mine, because even though I have a research degree
specializing in the topic and 18 years of experience, I am "not an MD."

Kathy Dettwyler, off to chemo

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