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Sam Leinster states that the titles of nurse and doctor will become obsolete in the brave new world of healthcare because practitioners will be identified not by professional label but by their competences ("An unconventional treatment", THES , October 26) While few would disagree with sharing aspects of professional education and loosening professional boundaries, there are two disadvantages.

First, a professional title is useful shorthand for knowing what competences a staff member has in the hurly-burly world of healthcare delivery where staff and patients are constantly changing. It is the basis of teamwork and helps to maintain high standards.

Second, professional titles and the associated skills are powerful recruitment incentives. Young people are attracted to careers in the health service because they want to be doctors, nurses, physiotherapists, midwives and all that that entails. They do not come aspiring to be multi-tasking generic healthcare workers.

Claire Hale
Professor of clinical nursing
University of Leeds