The criminalization of a truth
By: Conner Drigotas
The Doctor is in
If something doesn't change, Heather Lewis is facing fines or jail time. Her crime, according to California State Officials, is continuing to go by Doctor Heather Lewis in the three clinics where she serves patients.
Heather is, in fact, a Doctor. She graduated from Aspen University with a Doctor of Nursing Practice (DNP) degree and earned that title at the culmination of more than 15 years of education. She holds an associate degree, bachelor's degree, and two master's degrees as well.
California Officials, however, say that being a Doctor is not enough to use the title. According to the state’s Medical Practice Act, it is a crime for any healthcare professional, other than licensed physicians or surgeons, to call themselves “doctor” or “Dr.” on signs, business cards, letterhead, or in ads. Anyone caught violating this prohibition faces fines and loss of license.
Despite the risk, Heather is upbeat as she describes her predicament: “If I'm arrested, please come get me. While I look good in orange, I don't want to wear it forever,” she says.
Her legal team at the Pacific Legal Foundation lays out the reason why Heather’s situation needs court intervention: “The government cannot hijack a commonly used word and reserve it for a narrow range of preferred jobs. Nor can the state police the use of truthful language to limit career opportunities.”
Should Heather have to correct each patient who calls her Doctor Heather? Should she be required to make her accomplishments lesser to appease California lawmakers? Should policymakers have the power to threaten and punish Doctors of Nursing Practice for truthfully stating their degrees and accolades?
Of course not.
Heather’s degrees took a long time to earn, and she isn’t giving up her title without a fight.
Earning it
Doctor Lewis is the first person in her family to have a college degree, and in her own life the odds at one time seemed stacked against her rise into the highest degrees of nursing. “I come from a background where my grandmother was pregnant at 16, my mother was pregnant at 16. I had my first baby at 16, too,” Heather told Respect America in an interview.
It was not until after becoming a parent that Heather started her higher education journey and, as she puts it “I went, ah! there's this whole other life out here that I didn't even know about!”
Between 1993 and 2002, Heather dedicated herself to both her education and her other responsibilities. “I went nights, I took one class at a time, and then once I got into it full time, I switched to working weekends only so I could attend nursing school all day.”
Never one to slack, and with her kids a few years older, she then took on a more advanced challenge:
“Then I thought, well, heck, now I'm into my 40’s, maybe I should start working on something for retirement. So I went back and I got my master's degree in nursing education, thinking, okay, when I can't nurse anymore, I'll have a backup plan. I'll teach.”
For her, losing the title of doctor is a slap in the face, both because of her own journey and the message it sends to young people who overcome trying circumstances.
“I did it. I made all of my accomplishments. I didn't do it by 50 like I wanted to, but shortly thereafter, and I think it sets a precedent for my kids and for others that grew up like me.”
Working with at-risk youths and low-income families, Heather believes her Doctoral achievement is key to inspiring others, “I go, let me tell you my story. I was a 16-year-old mom, you can do it. It's slow and tedious, but you can do it.”
California officials, however, are trying to put an end to that inspiring narrative. Despite the use of the title Doctor not hurting patients in any way, California officials are using taxpayer time and dollars to manufacture a new class of criminal.
If Heather continues to use her earned title, she will first be fined. If she continues refusing to cooperate, the California Medical Practice Act will be enforced by an arms-bearing agent who will forcibly take her to prison.
Is that a reasonable consequence for someone truthfully using a title that they earned?
Realignment
While putting in full-time hours across three clinics, Doctor Lewis, along with two others, is embroiled in a lawsuit against the Medical Board of California, the San Luis Obispo County District Attorney’s Office, and the Board of Registered Nursing to push back against the bureaucrats seeking to define and limit their use of language.
Sarah Erny, another individual bringing a lawsuit to protect her ability to use the title “Doctor,” has already been fined $19,750 and left California in the rearview as a result, instead having to continue her practice in Washington.
Heather, however, is staying put in California and says there is much work to be done that is well worth her time and energy.
“It's not like we could just pack up,” she says, “I mean, I guess we could, but it wouldn't be fun... even in the California Association of Nurse Practitioners, we're still chipping away at full practice authority.”
In other words, Heather is working to hold space for nurses present and future so the industry can be less bogged down with administrative interference, and focus on the job of helping people. “The California Medical Board is trying to make an example of NP's to put us in our place no matter what we've done to help our patients.” she says, “‘Doctor’ does not harm our patients.”
Punishing Heather with fines or jail would only serve to exacerbate the state's medical services shortage. According to the American Hospital Association, “Almost a quarter of California's nearly 40 million residents live in areas that lack sufficient primary care providers, and the state needs to add 500,000 new professionals to ensure their access to care.”
Heather is standing up against a behemoth. The Medical Board of California has a budget of more than $70 million, 71% of which (>$41 million) is spent on Enforcement Operations and Legal & Hearing Services.
Still, Heather is particularly optimistic that there is a broad coalition standing behind her. This lawsuit can fix the title problem for not just DNP degrees, but also dentists, veterinarians, and educators who the Medical Practice Act also impacts.
“You have to fight or we're never going to get anywhere.” Heather says, “It's about each little thing that we chip away at in the system to make it better in the long run.”
