Doctor title/health provider

AN ACT Relating to promoting accurate communications between 1
patients and health care providers; amending RCW 18.79.030, 2
18.79.030, and 18.71A.030; creating a new section; providing an 3
effective date; and providing an expiration date. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
NEW SECTION. Sec. 1. (1) The legislature finds that:6
(a) The terms and titles used by health care professionals in 7
clinical settings play a critical role in ensuring transparency and 8
trust between patients and their providers. Misunderstandings about a 9
health care provider's credentials can lead to patient confusion, 10
erode trust, and impact the quality of care; 11
(b) While physician assistants and advanced registered nurse 12
practitioners are highly trained professionals who provide essential 13
care, they are not licensed physicians or osteopathic physicians. The 14
use of the title "doctor" in clinical settings, without clear 15
clarification, may inadvertently lead patients to believe that these 16
providers have attained a doctor of medicine or doctor of osteopathic 17
medicine degree, which require different training and scope of 18
practice; 19
(c) Many patients may not fully understand the distinctions 20
between different health care credentials. Studies have shown that 21
H-1064.1
HOUSE BILL 1780
State of Washington 69th Legislature 2025 Regular Session
By Representatives Marshall, Schmidt, and Eslick
Read first time 02/03/25. Referred to Committee on Health Care &
Wellness.
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clarity in provider titles improves patient satisfaction and ensures 1
that individuals are better informed about the qualifications of the 2
professionals treating them; and 3
(d) Protecting patients from potential misrepresentation is 4
critical to maintaining the integrity of the health care system. 5
Transparency in provider titles allows patients to make informed 6
decisions and understand the roles of each member of their care team.7
(2) The legislature intends to prohibit physician assistants and 8
advanced registered nurse practitioners from referring to themselves 9
as "doctor" in clinical settings. This policy is designed to preserve 10
trust, ensure transparency, and protect patients from unnecessary 11
confusion about the qualifications of their health care providers.12
Sec. 2. RCW 18.79.030 and 2023 c 123 s 19 are each amended to 13
read as follows: 14
(1) It is unlawful for a person to practice or to offer to 15
practice as a registered nurse in this state unless that person has 16
been licensed under this chapter or holds a valid multistate license 17
under chapter 18.80 RCW. A person who holds a license to practice as 18
a registered nurse in this state may use the titles "registered 19
nurse" and "nurse" and the abbreviation "R.N." No other person may 20
assume those titles or use the abbreviation or any other words, 21
letters, signs, or figures to indicate that the person using them is 22
a registered nurse. 23
(2)(a) It is unlawful for a person to practice or to offer to 24
practice as an advanced registered nurse practitioner or as a nurse 25
practitioner in this state unless that person has been licensed under 26
this chapter. A person who holds a license to practice as an advanced 27
registered nurse practitioner in this state may use the titles 28
"advanced registered nurse practitioner," "nurse practitioner," and 29
"nurse" and the abbreviations "A.R.N.P." and "N.P." No other person 30
may assume those titles or use those abbreviations or any other 31
words, letters, signs, or figures to indicate that the person using 32
them is an advanced registered nurse practitioner or nurse 33
practitioner. 34
(b) It shall be unprofessional conduct under chapter 18.130 RCW 35
for an advanced registered nurse practitioner to refer to themselves 36
as a "doctor" when providing care to a patient in a clinical setting.37
(3) It is unlawful for a person to practice or to offer to 38
practice as a licensed practical nurse in this state unless that 39
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person has been licensed under this chapter or holds a valid 1
multistate license under chapter 18.80 RCW. A person who holds a 2
license to practice as a licensed practical nurse in this state may 3
use the titles "licensed practical nurse" and "nurse" and the 4
abbreviation "L.P.N." No other person may assume those titles or use 5
that abbreviation or any other words, letters, signs, or figures to 6
indicate that the person using them is a licensed practical nurse.7
(4) Nothing in this section shall prohibit a person listed as a 8
Christian Science nurse in the Christian Science Journal published by 9
the Christian Science Publishing Society, Boston, Massachusetts, from 10
using the title "Christian Science nurse," so long as such person 11
does not hold himself or herself out as a registered nurse, advanced 12
registered nurse practitioner, nurse practitioner, or licensed 13
practical nurse, unless otherwise authorized by law to do so.14
Sec. 3. RCW 18.79.030 and 2024 c 239 s 1 are each amended to 15
read as follows: 16
(1) It is unlawful for a person to practice or to offer to 17
practice as a registered nurse in this state unless that person has 18
been licensed under this chapter or holds a valid multistate license 19
under chapter 18.80 RCW. A person who holds a license to practice as 20
a registered nurse in this state may use the titles "registered 21
nurse" and "nurse" and the abbreviation "R.N." No other person may 22
assume those titles or use the abbreviation or any other words, 23
letters, signs, or figures to indicate that the person using them is 24
a registered nurse. 25
(2)(a) It is unlawful for a person to practice or to offer to 26
practice as an advanced practice registered nurse or as a nurse 27
practitioner in this state unless that person has been licensed under 28
this chapter. A person who holds a license to practice as an advanced 29
practice registered nurse in this state may use the titles "advanced 30
practice registered nurse," "nurse practitioner," and "nurse" and the 31
abbreviations "A.P.R.N." and "N.P." No other person may assume those 32
titles or use those abbreviations or any other words, letters, signs, 33
or figures to indicate that the person using them is an advanced 34
practice registered nurse or nurse practitioner. 35
(b) It shall be unprofessional conduct under chapter 18.130 RCW 36
for an advanced practice registered nurse to refer to themselves as a 37
"doctor" when providing care to a patient in a clinical setting.38
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(3) It is unlawful for a person to practice or to offer to 1
practice as a licensed practical nurse in this state unless that 2
person has been licensed under this chapter or holds a valid 3
multistate license under chapter 18.80 RCW. A person who holds a 4
license to practice as a licensed practical nurse in this state may 5
use the titles "licensed practical nurse" and "nurse" and the 6
abbreviation "L.P.N." No other person may assume those titles or use 7
that abbreviation or any other words, letters, signs, or figures to 8
indicate that the person using them is a licensed practical nurse.9
(4) Nothing in this section shall prohibit a person listed as a 10
Christian Science nurse in the Christian Science Journal published by 11
the Christian Science Publishing Society, Boston, Massachusetts, from 12
using the title "Christian Science nurse," so long as such person 13
does not hold himself or herself out as a registered nurse, advanced 14
practice registered nurse, nurse practitioner, or licensed practical 15
nurse, unless otherwise authorized by law to do so.16
Sec. 4. RCW 18.71A.030 and 2024 c 62 s 5 are each amended to 17
read as follows: 18
(1) A physician assistant may practice medicine in this state to 19
the extent permitted by the collaboration agreement. A physician 20
assistant shall be subject to discipline under chapter 18.130 RCW.21
(2)(a) A physician assistant who has completed fewer than 4,000 22
hours of postgraduate clinical practice must work under the 23
supervision of a participating physician, as described in the 24
collaboration agreement and determined at the practice site. A 25
physician assistant with 4,000 or more hours of postgraduate clinical 26
practice may work in collaboration with a participating physician, if 27
the physician assistant has completed 2,000 or more supervised hours 28
in the physician assistant's chosen specialty. 29
(b) If a physician assistant chooses to change specialties after 30
the completion of 4,000 hours of postgraduate clinical practice, the 31
first 2,000 hours of postgraduate clinical practice in the new 32
specialty must be completed under the supervision of a participating 33
physician, as described in the collaboration agreement and determined 34
at the practice site. 35
(c) Supervision shall not be construed to necessarily require the 36
personal presence of the participating physician or physicians at the 37
place where services are rendered. 38
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(3)(a) Physician assistants may provide services that they are 1
competent to perform based on their education, training, and 2
experience and that are consistent with their collaboration 3
agreement. The participating physician or physicians, or the 4
physician assistant's employer, and the physician assistant shall 5
determine which procedures may be performed and the degree of 6
autonomy under which the procedure is performed. 7
(b) Physician assistants may practice in any area of medicine or 8
surgery as long as the practice is not beyond the scope of expertise 9
and clinical practice of the participating physician or physicians or 10
the group of physicians within the department or specialty areas in 11
which the physician assistant practices. 12
(c) A physician assistant who has at least 10 years or 20,000 13
hours of postgraduate clinical experience in a specialty may continue 14
to provide those specialty services if the physician assistant is 15
employed in a practice setting where those services are outside the 16
specialty of the physician assistant's participating physician or 17
physicians, as outlined in the collaboration agreement, if the 18
practice is located in a rural area as identified by the department 19
under RCW 70.180.011 or in an underserved area as designated by the 20
health resources and services administration as a medically 21
underserved area or having a medically underserved population. The 22
physician assistant must complete continuing education related to 23
that specialty while performing services outside the specialty of the 24
physician assistant's participating physician or physicians.25
(4) A physician assistant working with an anesthesiologist who is 26
acting as a participating physician as defined in RCW 18.71A.010 to 27
deliver general anesthesia or intrathecal anesthesia pursuant to a 28
collaboration agreement shall show evidence of adequate education and 29
training in the delivery of the type of anesthesia being delivered on 30
the physician assistant's collaboration agreement as stipulated by 31
the commission. 32
(5) It shall be unprofessional conduct under chapter 18.130 RCW 33
for a physician assistant to refer to themselves as a "doctor" when 34
providing care to a patient in a clinical setting.35
NEW SECTION. Sec. 5. Section 2 of this act expires June 30, 36
2027.37
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NEW SECTION. Sec. 6. Section 3 of this act takes effect June 1
30, 2027.2
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