A federal court has delivered a decisive victory for patient safety and transparency, rejecting an attempt to overturn California’s Truth in Advertising law. The statute (Business and Professions Code § 2054) prohibits the use of the title “doctor” in health care settings by anyone other than licensed physicians. The decision followed more than five months of procedural delays while both sides asked the judge to decide the case without a trial.

In Palmer v. Bonta, three nurse practitioners with Doctor of Nursing Practice degrees argued that the law violated their First Amendment rights. On September 19, 2025, U.S. District Judge Jesus G. Bernal rejected their claim, finding that the use of “Dr.” or “doctor” by non-physicians in clinical contexts is “inherently misleading” commercial speech and not protected under the Constitution.

The court pointed to evidence that patients often assume “doctor” means physician and noted that even the plaintiffs acknowledged such confusion occurs. Judge Bernal concluded: “The record indicates that Plaintiffs’ particular form or method of advertising has in fact been deceptive, and thus the speech enjoys no First Amendment protection.”

CMA and the American Medical Association (AMA) filed amicus briefs in the case, stressing that misuse of the physician title can confuse patients and erode trust. Significantly, in construing the purpose and meaning of § 2054, the court relied on case law and arguments raised in CMA’s amicus brief concerning the impact of state law precedents. The court also cited survey evidence from AMA’s Truth in Advertising campaign demonstrating patient confusion. Though amicus briefs are uncommon at the trial court level, CMA’s and AMA’s participation appears to have had a positive influence.

California’s nearly 90-year-old statute is designed to prevent patients from being misled into believing a practitioner is a physician when they are not. Physicians undergo deeper and more extensive training than any other health care professional, and both industry practice and law continue to place physicians at the center of medical care.

Misrepresentation of a provider’s level of licensing can jeopardize patient safety, leading patients to mistakenly believe they are being treated by someone with physician-level training and qualifications. In today’s complex health care system, where it is already difficult for patients to distinguish between physicians and non-physicians, the Truth in Advertising law plays a vital role in safeguarding trust and promoting informed decision-making.

“CMA welcomes the court’s determination that upholds California's well-established prohibition against non-physicians using the title ‘doctor’ in health care settings,” said CMA President Shannon Udovic-Constant, M.D. “This decision protects patients by providing clarity and transparency about the level of training and education of the person providing their care. Allowing patients to make informed decisions is foundational to our health care system.”