Who can call themselves a “doctor” in New Zealand?

First, a confession.  This particular bugbear is linked to an earlier one: direct-to-consumer sales of gene testing for health purposes.  I posted about that here. 

To add fuel to my already well-stoked fire of indignation, the presenter who tried to sell me gene testing and analysis services styled herself as “Dr L_____”.  Dr L’s business card gave her qualifications as “DDS, BS, Genetic Analysis and Interpretation”.  Given that she was selling gene testing, I first read this as saying that she had qualifications in the field of genetics. 

In fact, though, it turns out that Dr L is a dentist.  She doesn’t have a PhD, and she is not a medical doctor. 

The “DDS” seems to be a dental qualification from the US (although, weirdly, her dental practice website indicates that she has a BDS from Otago University in New Zealand, not a DDS).[1]  The “BS” is a reference to an undergraduate degree in psychology.

It seems likely that Dr L learnt about genetics by way of online courses provided by the gene-testing company she was representing.  The company website says that Accredited Practitioners are degree-qualified professionals “in various health fields” who have completed appropriate [company] education programs. 

Right.  So again, this raises a vast range of issues.  For example, you have to wonder about the independence and quality of the courses, and there is no way of knowing what they contain.  Plus, it is not clear how the sales presenters are remunerated; if it were a commission-based arrangement, this could give rise to various conflicts of interest.  Imagine the outcry if medical doctors were found to be getting a commission each time patients got tests done on the basis of their recommendations.

But for present purposes, let’s just focus on Dr L’s use of the term “doctor”.  I thought that the title was reserved for people with doctoral degrees and medical practitioners.  But it turns out to be much more complicated than that.  In many countries there has been controversy about whether other types of health providers, such as chiropractors, vets, osteopaths, physiotherapists and, yes, dentists can use the term as a form of courtesy title.  In New Zealand, some of these other providers can and do use the title, although there are certain legal restrictions on its use.

Section 7 of the Health Practitioners Competence Assurance Act 2003 provides that a person may only use titles stating or implying that the person is a health practitioner of a particular kind if the person is registered, and is qualified to be registered, as a health practitioner of that kind. 

Section 20 of the Summary Offences Act 1981 provides that it is an offence to use any words, initials, or abbreviation of words intended or likely to cause any person to believe, contrary to the fact, that he or she holds a degree, diploma, or certificate granted or issued by any university or other institution, society, or association, whether in New Zealand or elsewhere.

And, of course, there is the Fair Trading Act 1986, which provides that no person shall, in trade, engage in conduct that is misleading or deceptive or is likely to mislead or deceive (s9) or make false or misleading representations as to certain matters including the qualifications of a person providing services (s13).

So, dentists and other non-medical practitioner health providers do not have carte blanche to use the term “doctor” in any way whatsoever.  For example, the Vet Council of New Zealand provides guidance to vets who want to stay on the right side of the law in this regard.  It says that vets may use the courtesy title “doctor” provided that there is no inference or suggestion that the vet holds a PhD or is a medical practitioner.  It suggests that vets can ensure that they meet the statutory requirements by qualifying the title with a descriptor, such as “Dr John Doe, veterinarian.”

To my mind, the use of the courtesy title by Dr L is far removed from use such as “Dr L, dentist”.  There is no mention of anything dentistry-related on her business card at all.  That use of the term “doctor” seems to me, on its face, to be problematic.

And what does one do about such situations?  Who oversees these things?  Well, here the story ends in a cliffhanger. 

To be honest, I don’t yet know the answer, but you will be the first to know when I do.  I started with the Commerce Commission, with no luck.  And I’ve been in touch with the Dental Council of New Zealand.  I guess there is the Health and Disability Commissioner as well.  Let me know if you have any other ideas…

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[1] The Dental Council of New Zealand advises that, according to their records, Dr L graduated with a BDS from the University of Otago in 2010.  She holds a current practising certificate as a dentist, but under a different surname to the name she uses for her gene-testing business.