Physicians play different roles for different people and in different situations. We fix, educate, nurture, counsel, and sometimes just comfort. We inevitably broadcast our own feelings and values through our words, gestures and physical appearance.
Sometimes patients put us in the same sort of role as clergy; sometimes we take on a parental role.
I often see colleagues who insist on being called “Doctor”, even in non-medical situations. I also have colleagues in nearby towns that dress very casually and insist that patients call them by first name.
In the past few years I have read several articles about patients’ expectations and preferences in physician dress and titulature. The message seems to be that patients tend to prefer their doctors to be a bit on the conservative side.
Since I work in a small clinic, and also because I have been here for a long time, most people I see in my capacity as a physician know that I am a doctor. When I walk into the exam room, dressed in cuffed wool slacks, a crisp shirt and tie and an embroidered, long white lab coat with a stethoscope sticking out from my right coat pocket, I introduce myself by first and last name. I have never had anybody ask me if I really was a doctor in that situation. When I introduce myself to a child, I say, ” I am Doctor X—-“.
Some patients respond to my first-and-last-name greeting by repeating my first name and their pleasure in doing so doesn’t offend me. I simply let the patient decide how to address me, just the way I have to deal with what role they need me as a doctor to play in their illness or in their life.
I have found that even the most sophisticated patients appreciate when I speak plain English. I only use technical terms when I can introduce them and explain them; I never assume my patient is familiar with them.
I have found that comparing the workings of the human body to motors, household appliances and other everyday things helps establish a rapport with my patients and ensures I don’t get misunderstood.
One pet peeve I have is when doctors call patients by first name and themselves “Doctor”. I always found that to sound very disrespectful. We must be respectful of patients, who entrust us with their bodies and allow us to see their suffering and their fears.
Most patients are very respectful of me in return, except for the fact that many have trouble pronouncing my name; many adults and children alike call me by the initial of my last name, which, I guess, is a term of endearment in a way.
A Country Doctor Writes: 
Very interesting. I have to say that I like being called Mrs …. when I’m having undignified things done to me. Maybe it’s my age (58) – though I’m fine with being called by my first name in most circumstances, I do think that a little distance is good when unusually intimate things are being done by a relative stranger.
I’m very glad you broached this subject.
I call my GP by his first name when I consult him in private but I would always refer to him as Dr X when mentioning him to someone else. This feels comfortable and suitably respectful to me.
However, my GP has never warmed to me using his first name although he’s never objected either. He uses my first name when in contact by phone but tends to avoid using my name at all in his consultation room except of course when calling me from the waiting area. He then quite rightly, adds my surname.
I decided long ago to continue using his first name regardless as I like to think of my doctor as a person as well as a doctor.
I consult a specialist surgeon regularly and we are perfectly comfortable on first name terms with each other. In fact, I’m certain we BOTH feel more at ease in a consultation as a result.
I think everyone just has to go with what feels comfortable for them and most docs are happy to respond accordingly.
Calling a doctor, “Dr” irritates me. As a result, I do not directly address my vet, dentist, doctor, or chiropractor, although I try to be very polite otherwise. They don’t call me “Dr” even though as a DHA I deserve it. We don’t call our PharmD pharmacists at work “Dr” either. What makes people with a medical school education entitled to that honorary when others with a doctorate do not automatically get the same?
Honestly, I’ve been too chicken to call any of the above by their first name. I’ve been afraid of the response. If the “Dr” were to ask me to do call him or her by the first name, the doctor would earn my boundless respect.
If a clinician is part of a medical community that believes they are entitled to the title of “Dr”, but does not personally feel like its necessary, that would be pretty neat. If a person feels like they have to be called “Dr” to earn the respect of their patients, doesn’t that suggest the doctor is a little lacking in self respect? That their worth as a clinician is all in what they’re called?
Just my two cents. This has ircked me for a few years. Good of you to bring the topic up.
Perhaps I can relate to Steph’s GP a bit–I was raised half-in and half-out of a culture where almost nobody is addressed by their personal names. My father has trouble remembering the names of his oldest sisters (he is much younger) because he was expected to call them “older sister” or “ma’am.” As a result I am uncomfortable addressing anyone but familiar friends by first name unless invited to. At work, I prefer to be Dr. Bean, and address the patient as Ms. Smith, etc. unless they are a child. I feel put down if someone I have just addressed as Ms. Smith insists on my first name without first offering hers. Outside work, I go with the casual culture and invite others to use my first name; however my psyche often goes to great lengths behind my back to avoid first names, hence I will often find myself calling people “sir,” “my friend,” “pretty lady,” “neighbor,” etc. I trust no-one is put off, because I don’t intend to be stand-offish, and I think my manner is friendly.
Interesting topic. I do call my son’s ped by her first name, as well as his ENT. My son is medically fragile so we see these two docs alot (as an infant, my son only had 1 well baby check and he wasn’t that well at the time!) and depend on them. However, I do feel a partnership in my son’s care. I do participate in his care as a case manager. At my fingertips I have all his surgeries, all his illnesses, all his meds, what has worked in the past, what hasn’t. I have only one child to manage.
After reading your post, I am now wondering if, in my ped’s eyes, I have diminished her role in some respect? Have I tried to elevate myself to her level, although she’s the one who spent years in med school and residency and years with on the job training, while my training is measured by days in the NICU, days in hospital, hours in ER waiting rooms, exam rooms, hours waiting for test results and hours discussing those results, not to mention numerous phone calls to one specialist or the other? I always felt the partner… but maybe I am doing her a disservice, maybe I am dismissing her role in this? I’m now wondering if “feeling the partner” has helped me feel in control of my son’s medical situations, when in reality I have no control. Maybe it gives me comfort to feel like she’s a partner, we discuss, she doesn’t dictate, we make descisions. And I trust her and she trusts me as the Mom!
Funny thing is, my own doctors are all “Dr So and So” never John or George or Mary. Does it make a difference if your medical situation is life threatening? Do you need to feel connected to your doctor on some personal level in order to trust?
WOW! Food for thought for me. Thanks for sharing your side of the equation.
I have the same problem but in a slightly different light. Because I am a Family Nurse Practitioner with a Master’s Degree and no doctorate yet, my patients call me by my first name. That’s the norm but I have to constantly remind them not to call me “Doc”. I tell them over and over again that I am a NP and I refuse to refer to myself as a doctor when I am not one. They insist anyway with the usual quip of “Your my doctor even though I know you aren’t one so I will call you what I want.” It’s flattering but frustrating at times. There is another local NP that is referred to as “Dr. So and So” and he doesn’t correct people. Burns my toast!
I am a Family Nurse Practitioner also, and have had the same issues. To me it is fairly simple, and once i say this to my patients, there is no further issue and they are very comfortable with me from that point forward.No matter what they say, no matter what they ask, or call me, i simply say “call me by my first name if its ok if i call you by yours, I prefer to feel like i am close enough with my patients to do this”. I usually still will call them Mrs. or Mr. for a while out of habit, but it depends on the setting. If it is my old high school chemistry teacher, I call them Mr. outside the office and by their first name in the office. But if anyone calls me Dr., I most definately correct them, if they call me Mrs, I say “just call me —(first name)., they soon feel more comfortable with me and treat me like family. They treat me as their “doc” and their “daughter’ at the same time. Its great. (The homemade biscuits and pies are a plus also!)
Wouldnt it be nice to go back to the days of treating patients without worrying about lawsuits,HMO’s, reimbursement,etc? I am young for my field, and do not even remember these times. But this is where i belong, and will keep working toward. I have heard many many stories of old local rural GA docs and their magic “concoctions” of treatments, and of not having money for paying for services and people bringing chickens and vegetables,etc. as payment. Wouldnt that be something now? What has happened to the world? I may never make a fortune, but I have patients who i feel are like family. I can sleep at night knowing i truly cared for them to the best of my ability and usually the rewards for this eventually come one way or another. These are true country docs, and good ones. Thanks for the website!