I'm tired of expertise my title and pay never acknowledge, what should I do?

You keep the whole practice running and know the patients better than the doctors do, and you are tired of an expertise your title and pay never acknowledge. That is a real and common injustice in the way work is ranked. The people who hold the daily knowledge are often not the ones the hierarchy rewards, and that gap between what you actually do and what you are credited for wears on a person over time. First, do not let the title tell you what your knowledge is worth. What you know about the patients and the running of the place is real expertise, whatever the org chart says. The pay and the title measure a system's choices, not your value. Keep that clear in your own mind, because if you wait for the title to confirm your worth, you will wait a long time. Then decide what you want to do about the gap. Where you can, make your expertise visible and let the people who matter see what you carry. And weigh honestly whether a credential or a move could close the distance between what you do and what you are paid and called. You have earned real standing through real knowledge. You deserve to have it named, either where you are or somewhere that will.