Yes, the Dr. is in

In regards to Dr. Norman Anderson's September "From the CEO" column, whether the source is Oxford or Webster's, the first citation of "doctor" is Latin (docre) meaning teacher, expert or authority. All of which applies to APA members who have achieved this noble honor.

Several citations suggest that in the early 1300s, learned men (teachers of the scriptures) were the first to adopt the word "doctor." Perhaps another 100 years passed before the word doctor applied to physicians.

Please continue to press for change in the AP style.

Dr. Gary Hinrichs
Denver, N.C.

As a first-year doctoral student in health psychology, I was irritated at the opposition among the Associated Press (AP) and the American Medical Association (AMA) to rightfully consider the honorific title of "doctor" among psychologists in either press or policy. I was irritated because I have witnessed this lack of "giving honor where honor is due" more among the entrenched medical establishments and media rather than the general public.

I base this observation on experience as I work for one of the nation's leading medical/mental health insurance companies. On any given week, 16 counselors field upwards of 1,000 calls that include triaging presenting issues and subsequently referring three to five contracted panel providers. These include master's-level clinicians (EAP program only), psychologists, psychiatrists, and nurses and psychologists with prescriptive privileges.

But as more states adopt parity laws, as in my state of Oregon, and bring down the barriers to make mental health access equal to that of medical care, and legislation is allowing prescriptive privileges for psychologists, along with increasing numbers of states permitting and requiring full hospital-based privileges for psychologists, it will become increasingly harder for the entrenched medical establishments to deny the title of doctor among the doctors of mental/behavioral health.

It's incredulous to me to think my 10-plus years of advanced trainings and experience in clinical neuropsychology, clinical psychopharmacology, bioethics, biopsychology and others would afford me the right to be on a hospital multidisciplinary team, but would not afford me the right to be considered a doctor of mental/behavioral health among the medical establishment. Quite the contrary, when I am in the surgery room performing vital services as a neuropsychologist along-side the neurosurgeon, I will be no less of a doctor than my medical counterparts.

Darla K. Johnson
Portland, Ore.

The September article "Charting the future of undergraduate psychology" "was very constructive but failed to address an elephant in the room: You must earn a PhD to be considered a psychologist. Having graduated with distinction and awarded student of the year for my master's thesis research, it disheartened me to learn I was discouraged to call myself a psychologist. This was echoed recently in the column, "Yes, the 'Dr.' is in": "There are many people who describe themselves as psychologists without having a PhD degree."

In other science fields, master's-level graduates are considered engineers, biologists, social workers, etc. They may become licensed professionals at the master's level. They are not called "associates" within their professional organizations but are members in good standing.

As clinical coordinator/director of a state-certified program of assertive community treatment I have attained significant job satisfaction in a well-respected, evidenced-based program. Most peers managing similar programs have master's degrees; however, few are in psychology.

I would like nothing better than to tell our well-educated master's-level psychology interns three things: Yes, you will be considered a psychologist; you can earn a form of licensure at the master's level; and you will be a member in full standing in a professional organization.

We must afford similar recognition, credentials and indeed marketability in our esteemed field as those allotted to the other sciences. Perhaps then another pressing concern noted in your September issue will begin to change: "Psychology graduates at the bachelor's and master's levels earn the lowest salaries among science professionals."

Nancy Austin
Green Bay, Wis.

The cost of discrimination

In the July/August Monitor, the graph labeled "The cost of mental illness" (page 11) makes the important point that people with serious mental illnesses earn considerably less than others, but it would be a serious mistake to assume differences in earnings are solely the direct result of symptoms and functional impairment. It is crucially important to consider how stigma-related discrimination may have an impact on earning differences, as the source article notes in its mention of the possible value of increased enforcement of provisions of the Americans with Disabilities Act (Kessler, et al., 2008).

Baldwin and Marcus (2006) found that after they controlled for functional limitations and job characteristics, there were no significant differences in wages between those who reported no serious mental illness and those who did (but did not report they experienced stigma). However, wages were significantly lower for those with serious mental illness who did report experiencing stigma.

While psychologists have good reason to do everything humanly possible to relieve the symptoms, impairment and human suffering caused by these disorders, we must also research, and target for change, the stigma that unjustly deprives people of the opportunities needed to earn a decent living and dignity that goes with it.

Jamie Walkup, PhD New Brunswick, N.J.

Please send letters to e-mail or Sara Martin, Monitor Editor, at the APA address. Letters should be more than 250 words and may be edited for clarity or space.