wa-law.org > bill > 2025-26 > HB 1780 > Original Bill
The legislature finds that:
The terms and titles used by health care professionals in clinical settings play a critical role in ensuring transparency and trust between patients and their providers. Misunderstandings about a health care provider's credentials can lead to patient confusion, erode trust, and impact the quality of care;
While physician assistants and advanced registered nurse practitioners are highly trained professionals who provide essential care, they are not licensed physicians or osteopathic physicians. The use of the title "doctor" in clinical settings, without clear clarification, may inadvertently lead patients to believe that these providers have attained a doctor of medicine or doctor of osteopathic medicine degree, which require different training and scope of practice;
Many patients may not fully understand the distinctions between different health care credentials. Studies have shown that clarity in provider titles improves patient satisfaction and ensures that individuals are better informed about the qualifications of the professionals treating them; and
Protecting patients from potential misrepresentation is critical to maintaining the integrity of the health care system. Transparency in provider titles allows patients to make informed decisions and understand the roles of each member of their care team.
The legislature intends to prohibit physician assistants and advanced registered nurse practitioners from referring to themselves as "doctor" in clinical settings. This policy is designed to preserve trust, ensure transparency, and protect patients from unnecessary confusion about the qualifications of their health care providers.
It is unlawful for a person to practice or to offer to practice as a registered nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a registered nurse in this state may use the titles "registered nurse" and "nurse" and the abbreviation "R.N." No other person may assume those titles or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a registered nurse.
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It is unlawful for a person to practice or to offer to practice as an advanced registered nurse practitioner or as a nurse practitioner in this state unless that person has been licensed under this chapter. A person who holds a license to practice as an advanced registered nurse practitioner in this state may use the titles "advanced registered nurse practitioner," "nurse practitioner," and "nurse" and the abbreviations "A.R.N.P." and "N.P." No other person may assume those titles or use those abbreviations or any other words, letters, signs, or figures to indicate that the person using them is an advanced registered nurse practitioner or nurse practitioner.
It shall be unprofessional conduct under chapter 18.130 RCW for an advanced registered nurse practitioner to refer to themselves as a "doctor" when providing care to a patient in a clinical setting.
It is unlawful for a person to practice or to offer to practice as a licensed practical nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a licensed practical nurse in this state may use the titles "licensed practical nurse" and "nurse" and the abbreviation "L.P.N." No other person may assume those titles or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a licensed practical nurse.
Nothing in this section shall prohibit a person listed as a Christian Science nurse in the Christian Science Journal published by the Christian Science Publishing Society, Boston, Massachusetts, from using the title "Christian Science nurse," so long as such person does not hold himself or herself out as a registered nurse, advanced registered nurse practitioner, nurse practitioner, or licensed practical nurse, unless otherwise authorized by law to do so.
It is unlawful for a person to practice or to offer to practice as a registered nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a registered nurse in this state may use the titles "registered nurse" and "nurse" and the abbreviation "R.N." No other person may assume those titles or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a registered nurse.
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It is unlawful for a person to practice or to offer to practice as an advanced practice registered nurse or as a nurse practitioner in this state unless that person has been licensed under this chapter. A person who holds a license to practice as an advanced practice registered nurse in this state may use the titles "advanced practice registered nurse," "nurse practitioner," and "nurse" and the abbreviations "A.P.R.N." and "N.P." No other person may assume those titles or use those abbreviations or any other words, letters, signs, or figures to indicate that the person using them is an advanced practice registered nurse or nurse practitioner.
It shall be unprofessional conduct under chapter 18.130 RCW for an advanced practice registered nurse to refer to themselves as a "doctor" when providing care to a patient in a clinical setting.
It is unlawful for a person to practice or to offer to practice as a licensed practical nurse in this state unless that person has been licensed under this chapter or holds a valid multistate license under chapter 18.80 RCW. A person who holds a license to practice as a licensed practical nurse in this state may use the titles "licensed practical nurse" and "nurse" and the abbreviation "L.P.N." No other person may assume those titles or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a licensed practical nurse.
Nothing in this section shall prohibit a person listed as a Christian Science nurse in the Christian Science Journal published by the Christian Science Publishing Society, Boston, Massachusetts, from using the title "Christian Science nurse," so long as such person does not hold himself or herself out as a registered nurse, advanced practice registered nurse, nurse practitioner, or licensed practical nurse, unless otherwise authorized by law to do so.
A physician assistant may practice medicine in this state to the extent permitted by the collaboration agreement. A physician assistant shall be subject to discipline under chapter 18.130 RCW.
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A physician assistant who has completed fewer than 4,000 hours of postgraduate clinical practice must work under the supervision of a participating physician, as described in the collaboration agreement and determined at the practice site. A physician assistant with 4,000 or more hours of postgraduate clinical practice may work in collaboration with a participating physician, if the physician assistant has completed 2,000 or more supervised hours in the physician assistant's chosen specialty.
If a physician assistant chooses to change specialties after the completion of 4,000 hours of postgraduate clinical practice, the first 2,000 hours of postgraduate clinical practice in the new specialty must be completed under the supervision of a participating physician, as described in the collaboration agreement and determined at the practice site.
Supervision shall not be construed to necessarily require the personal presence of the participating physician or physicians at the place where services are rendered.
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Physician assistants may provide services that they are competent to perform based on their education, training, and experience and that are consistent with their collaboration agreement. The participating physician or physicians, or the physician assistant's employer, and the physician assistant shall determine which procedures may be performed and the degree of autonomy under which the procedure is performed.
Physician assistants may practice in any area of medicine or surgery as long as the practice is not beyond the scope of expertise and clinical practice of the participating physician or physicians or the group of physicians within the department or specialty areas in which the physician assistant practices.
A physician assistant who has at least 10 years or 20,000 hours of postgraduate clinical experience in a specialty may continue to provide those specialty services if the physician assistant is employed in a practice setting where those services are outside the specialty of the physician assistant's participating physician or physicians, as outlined in the collaboration agreement, if the practice is located in a rural area as identified by the department under RCW 70.180.011 or in an underserved area as designated by the health resources and services administration as a medically underserved area or having a medically underserved population. The physician assistant must complete continuing education related to that specialty while performing services outside the specialty of the physician assistant's participating physician or physicians.
A physician assistant working with an anesthesiologist who is acting as a participating physician as defined in RCW 18.71A.010 to deliver general anesthesia or intrathecal anesthesia pursuant to a collaboration agreement shall show evidence of adequate education and training in the delivery of the type of anesthesia being delivered on the physician assistant's collaboration agreement as stipulated by the commission.
It shall be unprofessional conduct under chapter 18.130 RCW for a physician assistant to refer to themselves as a "doctor" when providing care to a patient in a clinical setting.
Section 2 of this act expires June 30, 2027.
Section 3 of this act takes effect June 30, 2027.