Wednesday, July 19, 2006

You Can Call Me Doctor If You Want

Orange recently asked me if I ever tell my patients to call me by my first name. The answer is no, never. I don't call them by their first names, either. I call everyone "Ms." or "Mr.," unless they really insist, in which case I avoid saying their name at all. This is the only area of life in which I'm like this; for instance, the only adults I didn't call by first name when I was a child were my teachers, and I find it weird and hilarious when kids call me Ms. DoctorMama (or worse, Mrs. TrophyHusband).

I just feel that if I'm going to be poking and prodding folks in their most intimate places, I better make sure that they know I respect them first. (I do let a couple of old men get away with calling me Miss Firstname, but I still call them Mr. Thrombosis and Mr. Bad-Hip.) I especially dislike it when high SES white people call me by my first name; I feel like saying, Listen, you really don't want me to be your friend, you want me to be your doctor, so let's not muddy the waters, all right? I don't much like it when doctors I don't know personally call me by first name either. It's especially obvious to me when this happens because there are two ways to pronounce my first name, and people who don't know me usually pick the wrong one. Makes me feel like I'm being examined by a telephone solicitor. (I run into trouble with our pediatrician because she's a nurse practitioner; it feels absurd to call her Nurse, but double-standard-ish to call her by her first name.)

Orange says I've got a stick up my ass, but she also calls it "quaintly elegant" and "traditional." What do you think? Are you on a first-name basis with your doctor? Do you think it affects your relationship either way?

67 comments:

EJW said...

My RE was a nurse practitioner (as is my ob/gyn) and I call both of them by their first names. I don't know if it would have been the same for an MD. I think there's two reasons for this. One is that the RE quickly became a friend/ally in our fertility struggles and there was much less of the traditional doctor/patient relationship. She was mostly a bearer of information and an informed idea-bouncer-off-of and a shoulder to cry on, and not someone telling me what to do for my own good. I love her. I wish she could be my doctor forever, and I really think calling her by her first name changed the dynamics of our relationship.

Secondly, I work and take classes at a medical school, so I'm around doctors all the time. They're colleagues and the only ones I call Dr. X are big muckety-mucks, like deans and whatnot.

Artemis said...

I call my doctor by her first name, and she calls me by mine, but we had a very cordial doctor-doctor relationship prior to developing a doctor-patient relationship (entered into with some trepidation). BUT -- I HATE it when patients I don't know well call me by my first name, especially when I've made an effort to call them Mr. or Ms. Doe. I think that some level of formality is necessary to maintain a good working relationship. Otherwise, things get too casual and "friendly" and it feels rather whorish to charge for those visits...
A (er, Dr. A)

Anonymous said...

We have a family doctor that began treating me when i was 15 and still treats my dad. He is Dr. FamilyDoctor and always has been. Since my dad has gotten quite ill over the past several years and sees him quite often, he still remains Dr.

I think there is a professionalism to be maintained, unless there was/is a relationship (friendship) outside of the dr. patient relationship.

C.

Leggy said...

God I wouldn't dream of calling my doctor by her first name. I have a hard enough time calling the doctors I know professionally by their first names. I do very much appreciate it when my doctors call me "Ms. or Mrs. X" as I feel like if I have to be formal with them, they should be with me. And I really don't like it when kids (or the clerk at the grocery store, or worse, the telemarketer) call me by first name, but since that is the norm in our neighborhood, I'm not going to go around and correct everyone. Southerners have a tradition of doing "Ms First Name" for kids talking to adults and that's what I've taught my son, but my friends still laugh at me for that.

MJ said...

If my doctor called me Ms. Lastname I would most certainly call her Dr. Otherlastname. But she doesn't. She calls me by my first name. I'm pretty sure she doesn't want to be my friend so I've decided that she must prefer this form of address. Actually I'm being somewhat facetious here as I'm sure she'd prefer it if I called her Dr. Otherlastname but I figure courtesy works both ways. Also, I end up feeling oddly juvenile (and there's a 10-year age difference) when she calls me by my first name and I must use a honorific.

mMm said...

I call all my doctors Dr. Lastname. I call my midwife by her first name, which is how she refers to herself, and how all the other staff refer to her. I assume that's her preference, but i would love to have a title for her. Midwife Firstname? Sounds so delightfully Pilgrim.

Julie said...

I call my RE Firstname Lastname. I do it mostly to be annoying, I'll admit, because I resent that the balance of power in our relationship is so heavily on his side.

And, um, I also do it because he calls me by my first name and mispronounces it every time.

Other doctors, however, get the courtesy of a "Dr."

Monica C. said...

My OB is one of my good friends and when I am in her office (or while on the operating table for my c-section), I call her "Dr. Last Name."

I call all of my other doctors (and dentists), "Dr. Last Name".

My doctors/dentists either call me "Ms. Last Name" or by my first name. It doesn't phase me.

Epiphany Alone said...

My kids' pediatrician had someone covering for him the other day, and she called me Mrs Hubby'sLastname. I think that's proper, we hadn't met. The pediatrician usually calls me Mother which annoys me. I'm not his mother. I think it's lazy.

My obgyn calls me by my first name, and I call him Dr Lastname. I wouldn't find it offputting if he called me Ms Lastname.

Before I was home with my kids, I worked in medical education and met and worked with a lot of doctors. I always called them Dr Lastname until they asked me not to, and then I would call them whatever they asked.

Amy Elle said...

I only call one doctor by a first name, and that is my ob/gyn. He is a friend outside of being my doctor, so it fits. All other docs, I call Dr. soandso. You are right, I don't want to be intimate with my doctors. This is underscored and highlighted with every pelvic I have done. If I didn't adore him so much, I would find a new gyno. When I was nursing I didn't call the doctors by their first names either. I was told some where along the way that the best way to decide what to call the doctor is to judge based off what they call you.

RuralRN said...

I call my personal MD by her title and last name and she calls me Ms. patient. I do not know her too well yet...we will see..in the ED I call the Doc by his title and Lastname in earshot of the patient but at the desk it is Doc Firstname or just Firstname. If we started calling them "Doctor" all the time they would think we were unhappy with them as a rule.

healthpsych said...

I address all my doctors as 'Dr. Whatever' but they all call me by my first name. I don't mind that because when someone calls me 'Mrs. Whatever', I usually look around to see who they're talking to!

A couple will occasionally sign off things with a first name only but I wouldn't feel comfortable using it with them directly. I think using the professional title helps maintain the necessary boundaries.

In therapy, it's a little different but I always let my patients lead in that respect.

winecat said...

I call my doctor by her first name for the simple reason that when I became her patient I asked what she preferred. She said only my mother calls me Dr. LastName.

Anonymous said...

I used to work in an ob/gyn clinic as a receptionist. I called all of them Dr.ob/gyn even if they insisted it was o.k. to call them by their first names. One of the docs kept insisting that I call him by his first name, until I finally explained that he was my BOSS and not my FRIEND. He finally got it.

Anonymous said...

I have always used Dr. Lastname and been called by my first name. Then I got seriously ill and started seeing a specialist much more often than you would see a doctor for nearly anything else in a very collaborative relationship. After a couple years of seeing her more frequently than most people in my life I started calling her by her first name. But this is kind of a weird situation; this is a doctor I haven't gone more than 5 days without contact with in the last 6 months.

Then I moved and started seeing a doctor who has a last name with 14 letters, including every single vowel, most more than once. He uses Dr. First Name with all patients and office staff.

Interesting post. I've thought a lot about it because professionally I work with doctors and call all of them Dr. Last Name and until I got into the unusual situation would never have used a first name.

Bitsy said...

As a new doctor, I am still struggling with this one. I sometimes feel like when I introduce myself as "Dr. XYZ" that I am coming off as pretentious, especially since I am almost always (significantly) younger than the patients. I struggle even more with how to answer pages and how I introduce myself to nurses. Again, I feel silly having these people who are older than me call me Dr XZY when I call them by their first name. By the way, in this hospital and every other one I've ever trained in (both in the north and the south) the nurses ALWAYS identified themselved by their first name. I have never heard anyone refer to anyone as "Nurse XYZ." To make matters more confusing, I used to work as a physician assistant, and I always introduced myself and was called by patients and staff by my first name. If anyone called me "PA Name" I'd laugh. That just sounds silly.

Kungfukitten said...

My primary care is actually a P.A. but I call her Dr. Soandso because in my mind she's my doctor - she's the one writing my prescriptions and coordinating my care. I wouldn't dream of calling her by her first name and the Ms. title doesn't seem to give her the same authority or respect.

Dr. Wannabe said...

All the doctors I've ever met have called me by my first name, and I call all my doctors by their last name, except my PA dermatologist, but she also introduced herself by her first name. Even when I was shadowing a dr who introduced himself by his first name I still call dr. lastname, as does everyone else in the office. I think they call me by my first name because I'm only 20, but shouldn't I be reaching that age where I'm called by my last name? I don't care though. I would tell them to call me by my first name anyway.

Dr. Wannabe said...

Oh, but my PCP is called by his first name by most of his patients. I don't go for that though.

Sara said...

Interesting post. I generally introduce myself as Student Doctor Lastname, but ask patients what they prefer to be called. They almost invariably answer with their first name. I tend to mostly avoid using patients' names entirely though, unless I'm dealing with kids, in which case I feel like first names are entirely appropriate.

The exception to this is when I'm working in a team with another student, doing OMT clinic. She introduces herself as "Firstname, a medical student." So then I bow to peer pressure and I become the same. We are Firstname1 and Firstname 2, medical students. Then again, the attending for OMT has a rather informal relationship with many of her patients, so I guess we're following her lead, though now that I think about it, she's still Doctor Lastname to them. Weird.

Well thanks for giving me so much to mull over.

Teendoc said...

Hell no! No patient of mine calls me by my first name! This is a major sticking point of mine. And it isn't that I have a poker up my ass. It has more to do with maintaining courtesy and decorum in a frequently discourteous world.

Also, my patients are adolescents. I am so not into this new trend of kids calling adults by their first names. Not happening here. As my late mother the doctor used to say, "We didn't pitch marbles together!" Unless we did, we are not on a first name basis.

And as for the whole being addressed as Dr. Mylastname versus Mrs. Hislastname, I just blogged about this recently in my blog. Many thoughts about this as well.

MJ said...

Another question: Do you accord a title to everyone who isn't your friend? For example, do you call your bank manager Mr./Ms. Lastname?

I've always called every boss I've ever had by a first name and I didn't want to be their friends either. It seems weird to me to accord this courtesy to a doctor and not to others in the world. I'm also not sure that boundaries are primarily defined by a title. I don't feel any disrespect for my doctor by calling her by her first name. If I didn't respect/trust her medical skills I'd find another doctor. I also don't want to be her friend, although she seems like a thoroughly nice person.

Ariella said...

I'm 25 and still call adults by Mr./Mrs./Dr. until instructed to call them by their first name. I don't do this because I think of myself as a kid; I do it because it is the polite thing to do. I was raised with an exceedingly manners-conscious mother and have an even MORE manners-conscious step-mother now. All of that has lead to me to be what my friends affectionately refer to as "Miss Manners."

Frankly, I abhor it when people do not send thank-you notes, refer to me by Mrs. Husband's name (I kept my own name), assume they can call me "Ariella" when I haven't instructed them to do so, and have poor phone manners. Of course, I always instruct people to call me "Ariella," so that pet peeve is only present when I get phone calls from solicitors.

As for my doctors, I always call them Dr. So-and-so. I've known my family practitioner since I was a wee thing and STILL call him Doctor, even though he's a family friend and eats dinner at our house. I cannot get past calling him "Ed." Moreover, I also find it impossible to call my teachers or professors anything but Mr/Mrs/Dr or Professor. Anything else seems disrespectful.

So, in sum: I am neurotic and overly cautious, but prefer to be that way rather than being seen as rude.

Susan said...

all of my docs call me susan. i don't mind it. i call them dr. lastname. there IS a power imbalance, they have the knowlegdge and i do not. plus, i just don't care.

our vet and vet's staff all call me mrs. lastname. I HATE IT. even at doggy day care they call me mrs. lastname.

it makes me feel like an old stuffy lady that thinks her own stuff don't stink.

Meira said...

Hmm . . . now that I think about it, I suddenly can't recall anyone addressing me by name or vice versa. Except my Ped -- but she and I knew each other socially before she became my ped.

However, I'm going to see a new primary care person today, I'll let you know if it's interesting.

Carolie said...

BLESS you! I absolutely hate it when I used to call my doctor "Dr. Man" and he called me by my first name. It's already a tough relationship, with more than a little parent/child vibe...and I can't tell you how much I appreciate the respect of being called Ms. LastName!

My current doc is "Dr. SmartWoman" when we are in her office, and I am Mrs. HusbandName. When we go out for coffee, we use one another's first names. Weird? Yes. But it helps distinctly separate our two worlds.

I'm actually grateful I'm on a small military base, because I think otherwise, we could not even have the much-liked, but for-obvious-reasons SURFACE friendship we do have.

Good manners are NEVER old fashioned. Unless I am introduce to someone as FirstName only (or in an obviously casual social setting), I try very hard to use titles and honorifics. It's lovely to be asked, especially after developing a friendship, to "Oh, do call me Hortensia!" instead of being told, in frosty tones "I would prefer you addressed me as Mrs. Honorbound!"

Kelly said...

Sometimes the Dr. thing seems standoffish, esp. when you call the nurses by their first names and especially when you see as much of your doctor as I see my RE these days.

Funny anecdote -- my OB was Dr. Lastname always, until the first time she came into our room to check on me after my daughter was born. She knocked and opened the door a crack, and was like "Hi, Guys, it's Stephanie." Like now that she'd had her arm all the way up my vagina, we were on a first name basis or something. It struck me as funny.

Basically I just care that my doctors are respectful and know how to listen.

Leah said...

My OB = Dr. LastName.
My son's PED = usually Dr. LastName, but sometimes FirstName. She's a younger gal and is rather informal but always respectful and professional.
My daughter's PED = is ALWAYS Dr. First-Letter_Last Name...but he's an old fogey and his last name is very long.
My FP is a PA and I always have trouble there - he's a great PA and in my mind my Dr...so I know technically he's not Dr. LastName but really a Mr. LastName. So I usually call him Mr./Dr. LastName and feel awkward no matter which title I use.

As for what they call me - almost always FirstName. Only techs or nurses call me Mrs. LastName. I don't care what they call me.

As for Mr/Miss FirstName - my southern mama trained me on it and I encourage it in my children...although most adults they know insist on FirstName. I like this cultural nuance, myself.

Linda said...

I call my own doctors "Dr. OB" and "Dr. Dentist" and "Dr. EyeDoctor" etc.

However, as an RN, I call almost all the doctors that I work with by their first names. There are a few old farts that I call Dr. Doctor, but the intensivists who are a permanent part of the critical care team I address by first name. I don't see them calling me "Nurse LastName" and our unit is pretty casual and cohesive~we function as a team. I've been there for years and I would feel weird calling the docs by their last names when we share pictures of our kids, food at potlucks, and general camaraderie.

However, in front of patients and when I speak to patients about them, I call them Dr. Intensivist.

Audrey said...

Interesting post. I did my medical training in the South, and all my attendings were Dr. Attending (for sure!) and patients were Mr./Mrs. No questions.

In my current hospital in the Pacific NW, things are SO much more casual. No RN refers to me by Dr., unless it's in front of a patient/family. Still, since I look "younger than my stated age," by quite a bit, I do ALWAYS introduce myself to families as Dr , mostly so it's clear what role I have on the team. With "older" families, I sometimes will say Dr. First and Last Name, so that then they have a choice as to what to call me. I've never had a family at this hospital want to be Mr/Mrs (no matter what the age--they always correct me if I try to be more formal!), but it seems weird to me for them to be Jane and John but me to be Dr. and so I don't mind at all if they choose to call me by my first name.

For myself, my own OB (about my age) was always FirstName. For our pediatrician (a generation up)we avoid using her name in her presence--I think she'd prefer FirstName, but, given my conservative Southern background, I still want to call her Dr. LastName. I wonder how much regional variation there is, or if my experience is a reflexion of the specific institutions at which I've worked.

B.E.C.K. said...

Our former pediatrician was the son of the Dr. Sears who wrote a bunch of books. He always had us call him "Dr. Jim." For doctors with adult patients, however, it's a different story. I tend to call doctors "Dr. Lastname," and prefer to be called "Ms. Lastname." Most doctors want to call me by my first name, though. I don't have a difficult last name; I think they're trying to be chummy, but I find it condescending.

Erin said...

We've always called doctors by "Dr. LastName", but then again, I grew up in the north calling all adults (whether close friends of my parents/friends or not) by "Mr/Mrs/Dr LastName". Here in the south, I've sort-of grown used to having P call most adults "Mr or Ms FirstName", but only if we know them well. If they're not friends, we call them by their last name.

I'm fine with being called "Miss Erin" by P's friends and their parents (when the kids are present), though it still sounds strange to me. But if we're in a professional setting, I'm "Dr. LastName", not "Mrs. LastName". Actually, that's a topic I plan on blogging about in a few days--I'll have to link over here.

Orange said...

I'm thinking of changing my pseudonym to Ms. LastName.

Dude! I don't really think you have a stick up your ass. But you asked me if you were thus instrumented, and it entertained me to answer in the affirmative.

My doctor called today and said, "FirstName, hi, it's HerFirstName HerLastName." So I get either first name or first and last names from her when she's identifying herself, and not "Dr. LastName." (Inflected, no doubt, by her practicing with her dad, who shares the last name.)

Anonymous said...

I have had MDs that I've called Firstname, ones that we both used lastnames, and ones that introduced themselves as "Dr. Lastname", while trying to get away with "Firstname" for me. I cheerfully correct them with, "I'm Dr. Lastname, thanks." That backs the familiarity right off. I like that you want to respect that titled formality.

Usually, I try and avoid the whole damn name thing, and only refer to them as Dr. Lastname when calling for an appointment.

And then there was the time where I greeted my orthopedic surgeon with a loopy, cheerful "FIRSTNAME!!! How ya doin'?" after my pre-op Versed. . .hee. Gotta love the Versed.

thumbscre.ws said...

Hear, hear for courtesy and decorum, increasingly rare traits in this world.

I'd never, ever call a doctor by their first name. Hell, I won't even call my parent's FRIENDS of many decades by their first names... they're always "Mr. or Ms. FirstName".

Interestingly enough, the usage of first vs. last name is somewhat fluid in the the legal field. I tend to let my attorneys and/or their secretaries be my guide. "Old guard" attorneys (over sixty, three-piece suits even in July) automatically get a "Mr". Female attorneys are referred to by first name (or, if I can help it, never by any introductory phrase), due to the always sticky subject area of Miss/Ms./Mrs. being all the more inflammatory in an arena where women are outnumbered and often compelled to act as though they've got something to prove (you can be just as obnoxious as your male colleagues? Congrats!).

thumbscre.ws said...

Further note of interest: all of this is blown to hell when dealing with mental health professionals, of course. I call my shrink by her nickname, and she calls me by mine. Her abundant use of said nickname ("And how do you feel about that, Jul? Jul, I can really see you struggling with this, Jul") actually led to me more or less abandoning my given name and just going with "Jul" even in a professional setting (although it is somewhat amusing when attorneys call me that).

S said...

This made me realize that doctors are the ONLY people I call by a title. It also made me realize that the nurses at my RE clinic are all called by their first names (I don't even have any idea what their last names are), while all the doctors are honorifically addressed. They all call me by my first name. So presumptuous.

I think I automatically call them Dr. Whatever because I'm hoping that they are higher beings who can work some magic, even when they're younger than I am.

bj said...

I have a tough time with this one. My doctor (who delivered both my children), but who I don't see very frequently) is of the same SES as me, lived in a nearby neighborhood, and has kids about 5 years older than mine. She's a little bit older than me. But, we're kind of acquaintenances outside of our medical relationship. I think we've resolved the situation by mostly not calling each other anything. I wouldn't feel comfortable calling her by her first name in a treatment setting. I don't actually care if she calls me by my first name, and would be a bit uncomfortable with my last name (which usually has Dr. in front of it's used, but that would be confusing in a treatment setting, since I"m not an MD).

bj

Surgeon in my dreams said...

I'm poor and to hear him tell it my doctor is poor. He calls me by my fist name I call him doctor.

CaerLiveSound said...

Rule of thumb: call everyone by a title UNTIL they either A) instruct you otherwise or B) take it upon themselves to call you by your first name.

It's like my broker friend who never takes off his suit jacket until the client offers "Why don't you take off that jacket? It's so hot in here." To which he will reply, "Thank you, I believe I will," as if he didn't notice the sweltering heat.

And my therapist and I were NEVER on a first name basis. It set the tone.

Jen said...

I see a Family Nurse Practitioner and everyone at the practice thinks it is hilarious that I call her Nurse LastName. But, I feel like she spent the time in school and is a professional and she should be called Nurse LastName rather than FirstName. She calls me by my nickname, but that is because I've asked her to. Does that make sense? Growing up in an academic family I was always taught to call people by their titles unless they instructed me otherwise. I still do that with emails to professors and administrators where I work even if I know them, it's just good manners.

Pendullum said...

My kid's doctor I talk with her on a first name basis...I tend to help her along more than the other way around...As I am older, my kid is much older and I think I was one of her earliest clients...
I've just needed her to document the regular stuff...
I talked her through a few things and since I was not an anxious first time mom it worked well...

But my doctor I just call her Doctor... as she is older and I trust her a bit more when it comes to my health...
Strange... and I have never thought of it before...

Old MD Girl said...

I think my doctor calls me by my first name, but I've never really noticed her calling me by name at all..... that must mean I don't mind whatever she uses. I think it would be weird to be addressed as Ms. Anything yet, and I'm almost 30! I guess that just means I've been a student FOREVER.

Anonymous said...

My kids' pediatrician is my best friend's dad but I call him Dr. Lastname in the office and in front of my kids. NP's and PA's I call by their first names because that's what they are called when I make the appt. -- I probably don't use their names when I'm seeing them though. My husband is a dentist and when staff and patients call the house, they ask for Dr. Lastname. What I don't like is when the staff refers to him as "Doctor" like it's his first name -- "is Doctor there?". That doesn't happen any more, it was more the older women that worked for him when he first started practicing 20 years ago. I always thought that was weird.

Liz

christie said...

I call my Drs. Dr. LastName unless told otherwise. I call the Drs. I work with Dr. LastName also, except for a few that have told me to call them Dr. J, Dr. A, etc. As a physician assistant it gets weirder to me. I always introduce myself as Christie LastName, I'm the physician assistant, blah blah blah. Most of my patients call me Christie, a very few call me PA Christie, none call me Ms/PA LastName, and a fairly large chunk call me Dr. Christie (the first few times they do this I point out that I'm not a Dr. just to make sure they know then give up on it). I'm fine being Christie, I prefer to be Christie actually. Most of my patients I call Mr. or Ms. FirstName, I think it's a southern thing. A few of the older one's I call Mr./Ms. LastName, and anyone that introduces themselves to me as Mr./Ms. LastName gets to keep that title until they tell me otherwise. For the most part, when a patient is new to me, I usually ask if they'd rather be Stacy or Ms. Johnson (ah, assuming her name is Stacy Johnson of course) and the vast majority say Stacy...then I end up with Ms. Stacy. But again, we're in the south, a fairly small town, a fairly small clinic, and pretty close knit.

Anonymous said...

My old PCP always called me by my nickname and I called him Dr Lastname. he was a friend of that family that I went to for that reason. That was fine with me. He sadly left town. My new PCP calls me Ms Lastname which struck me as odd at first but I do like it since I do not know her outside of the office. I've worked in various doctors offices for 10+ yrs. The doctors I work for are always Dr Lastname. The PA/NPs have asked to be called Firstname. My GYN is a NP and although I don't think I've called her anything does go by her first name as well.
In the last office I worked at, the doctors were very close to my age and I had a friend who worked there and she always referred to the lady doctor as First Name. That always bothered me even though we did have a small office and all were close.
I don't know if it matters or not but I am in the South

Anonymous said...

I call her Dr Lastname always (though when she misdiagnosed my ovarian cyst pain as wind...then it torted causing me to lose both ovary and tube with a dose of blood poisoning thrown in as a bonus...I referred to her as Dr Donkey). It's a little more complicated now that I teach her son at high school. I'm always Mrs Lastname at work but when she emails me about the little man she signs off with her first name and I with mine.

Funny to read about your cheeky old men patients!

Fiona

ozma said...

I became very friendly with my last doctor and we were on a first name basis. We're the same age, we're both kind of funky, informal people. We would have serious talks about life and politics and babies and travel and stuff in the examination room--of course, she had to run off after a bit but we really liked talking to each other. She took some kind of postdoc thing and isn't my doctor anymore. Last time I saw her we hugged and she gave me a prescription for a year's supply of anti-depressants in case I wanted to take them. (They help me with mood issues but because of my sleep problems, I sometimes really need them.) Initially, because she was a new doctor, she said she wasn't 100% sure what to give me but if I wanted to do my own research, I could. I did, I showed her the articles and she said they seemed reputable and then prescribed what I thought was the best one based on the research I did. She also gave me her email and we emailed back and forth a little bit.

Does this totally horrify you? I gravitate to informal doctors--it's basically the style I use with my own students. I never found anyone who I clicked with so strongly besides her but all the doctors I've had are very informal and open and first-name and all that. What's more important than the first-name thing is that they tolerate my curiosity and don't pretend to have utter certainty about every issue. For some reason, I find this makes me feel safer. Maybe because I believe I have more control? I don't know. I'm sure you have patients like me who need to know everything. I hope we aren't too much of a pain in the ass.

I picked my new doctor at random and she's also very human and down to earth and not very formal but I can't remember how she introduced herself. Actually, come to think of it, she's extremely beautiful as well but in a sort 'smart girl' way--sort of like how I imagine you to be! She's also rushed and busy--I admire doctors as much for the volume of humanity they deal with much as for their skill and intelligence. Damn, two hours of meeting with students and I really feel desperate to escape. How do you people do it?

I admit to preferring the informal doctors and I try not to be biased against male doctors or assume women are automatically more approachable. (My friend, a male doc, complains about this bias.) The male gynecologist is the only one who always has open appointments! But he is also informal and first-name basis and has that 'communicative' style. I'm sure some women docs are more formal and that seems cool too. Different kinds of patients probably need different kinds of interaction.

bihari said...

Oh, I'm with you all the way. I always call my patients by their last names if they're over seventeen or so, for the same reasons you do. I particularly avoid calling older patients by their first names, which seems insulting.

However, being an NP I do introduce MYSELF by my first name, because yeah, what are the other options? Not-A-Doctor Bihari? Nurse Bihari? Midlevel-Provider Bihari? Ms. Bihari? Not.

Beckums said...

I have had the same GP since I was 16 (am now 30) Her last name has changed four times in that time so I call her Dr, FirstName. It is easier than trying to remember what her current last name is at the moment.

Anonymous said...

As a Ph.D. psychologist (and I'll be irked if you tell me I'm not a *real* doctor) I find most of my patients prefer to call me by my first name. Perhaps this is because I am youngish and like to take a collaborative rather than authoritative stance. However, I call them initially by their first name in the waiting room, as using both names is potentially a HIPPA violation and I work for a company that worries about such things. I then introduce myself as "Firstname Lastname, and I'm a Clinical Psychologist," then let them choose where to go from there. It's rare I need to use their names again once they are in my office.

Amanda

Meredith said...

I've always been interested in why doctors of all people get to have their own honorific, because as a young feminist it irked me to no end to see my father the surgeon always addressed as Dr. Hislastname while my mother the Ph.D. wasn't even called Dr. Hislastname by her college students. Then I went to medical school in a country where there are not only no honorifics, but everybody calls each other by their first names. If you can't picture being a medical student and calling your attending John, imagine what it's like to meet the president of the country at an official function and only be able to say, "Pleased to meet you, Martha" - which I did. But I quickly got very comfortable with the lack of status designators there, where doctors and nurses and patients and housekeepers were all accorded the same level of respect in how they're addressed.

When I returned to the U.S. I was uncomfortable with being called Dr. Mylastname and felt that my only response was to move to the same level of formality and always call patients Ms. or Mr. Theirlastname unless they asked me not to. Now that I've started a geriatrics fellowship this only seems more glaring: I couldn't possibly use an 87-year-old's first name, and despite the fact that I look like an even younger whippersnapper than I am and introduce myself as "Firstname Mylastname, one of the new doctors here", they all call me Dr. Mylastname, as they are of the generation that couldn't conceive of doing otherwise. The attendings in their 30's and 40's address these elderly patients by their first names without asking permission, and I've been thinking that the fact that some of the patients are demented makes them feel they can infantilize them like this. But after reading this entry I'm wondering if they're not just following the general rule in this culture of Dr. Lastname and Patient.

With other hospital employees I use their first names and ask them to call me by mine, because I can't stand the thought that the secretaries or nurses think that I think I'm better than them, or that they think I'm better than them. With attendings, however, I definitely still think they're better then me, even now I'm a fellow and have been instructed that I should suddenly switch to calling them Paul and Nancy; I think mentally I'm still stuck in elementary-school mode and since they are my teachers the transition is hard. Personally I think it was all much easier in a culture where this honorific issue didn't exist; but since it does, I have to insist on an equal level of respect. Both doctors and patients using last names seems to be the only option allowing that; and since most non-MD staff get called by their first names only, I feel that doctors can use them too in our work relationships.

Orange said...

My doctor and I played phone tag. When she called back, I was greeted by "This is Firstname."

But you know what? When I ran into her shopping at the Gap, or outside my neighborhood Starbucks, I sure didn't call her Firstname!

Orange said...

...but we had almost sent our kids to the same co-op nursery school, where it would've been weird to use her honorific.

profgoyle said...

I call all of my doctors, including my dentist and chiropractor, Dr. LastName. I call my PA--a woman I like and trust and respect considerably more than any of the doctors I've gone to in my HMO--by her first name, but only after I asked her what I should call her and she said, "FirstName." And I only asked her that because she likes to deal in e-mail, and it's much harder in e-mail to avoid names than it is in person. (She signed her messages to me with both her first and last name and title--I'm assuming it was a pre-programmed signature.) I successfully avoided calling the therapist I saw for a year any name at all. She had an MSW, and clearly those degrees occupy a difficult middle space for me. Dr. is inaccurate. Ms./Mr. doesn't feel right.

I hold a Ph.D. and work as a professor. All of my doctors and medical people call me by my first name. Many of them mispronounce my first name. Not one has ever called me Dr. LastName. I am not unaware of the discrepancy here. I would probably ask them to call me by my first name if they did call me Dr. LastName (most of my students call me by my first name, but that's the culture of my university). But still. It would be nice if they paid attention to titles that are not their own.

My ob/gyn refers to my partner as my "honey." Shudder. This is one reason I choose my PA over her.

And ozma, I couldn't agree more about prefering doctors "who don't pretend to have utter certainty about every issue." There's so much we don't know. It strikes me as pure hubris to think that we can know everything. And it's the doctors who have been most assured who have been to ones to misdiagnose me. (My doctor-diagnosed "virus" that I needed to just wait out? A kidney infection that included a ten-day fever and took three rounds of hard-core antibiotics to kick. And the correct diagnosis came from my PA's self-proclaimed "hunch" and "sense" based on her experience of other patients and small details in my story, despite my absent excruciating back pain.) I appreciate people who have the confidence and wisdom to say, "I'm not sure. Let's see what more we can do to know more."

Anonymous said...

I call all my doctors "Dr. Whatever." All my doctors call me by my first name. It bothers me a little, but I think it has more to do with certain doctors' attitudes than with the name thing. I don't actually want them to call me Ms. Me. No one calls me "Ms." anything. I go by my first name.

My pediatrician, I have no problem calling him Dr. C. I adore him, get along great with him, really respect and admire him. And he never ever ever has condescended to me, so I don't mind the name disparity thing. I also think that if we ran into each other at a party, and hung out together (which I could imagine happening) then maybe in that context, I would call him Dan.

My (former) RE, on the other hand, I hated the "Dr." thing. But he was condescending to me. He would lean on my leg like it was a piece of furniture while doing an ultrasound. And we once had an extremely upsetting conversation while I was wearing no pants. I know he is busy, and I know he had patients waiting to come in for their ultrasounds. But I had no pants on, just a tiny little paper thing. Respect me enough to tell me you will call me later to discuss it, or make an appt., or anything. It was so humiliating. So maybe it bothered me to call him Dr. Dork because he was a dork.

One of my friends automatically calls all her doctors by their first names. Doesn't occur to her not to. Weird.

DoctorMama said...

I'm kind of shocked at how many people are being called Firstname (while being expected to call their doctors Dr. Lastname).

I'm actually against the practice of asking patients what they want to be called, because I think that most people feel like they're being snotty if they say "Ms. Lastname," even if that's what they prefer. I let them correct me if they really don't want me to use their last name.

Jo said...

Interesting question ... and my first post to your blog (which I recently discovered). I always call my doctors by their last name, and they almost universally have called me by my first name (I think because, as you mentioned, I've preferred it and asked them to do so). Now, I'm usually not one who buys into all the hierarchy crap, and by no means do I feel they are my superiors. On the contrary, I feel we are largely peers -- they know more about medicine than I do, and I know more about finance they they do (as I work in that field), but with most of my doctors we are pretty close in age, contemporaries, what have you. And my PCP is a mother to young children as well, so we share that bond and that is part of our conversation. But I guess my bottom line is this: calling them Dr. Whoever is a sign of respect. Not an establishment of hierarchy or pecking order or power dynamics, simply a sign of respect. But I am also of that generation that called all adults Mr. or Mrs. (unless they were family or close friends, of course).

But as to the relationship I have with my doctors? Don't think it would be any different if I used their first name, except that I might feel a bit hesitant or uncomfortable every time I used their name. As you said, while I may like my doctors and feel friendly toward them, I'm not there for their friendship. I'm there for medical advice.

Anonymous said...

My Doctor and i are on a first name basis when we are together in her office. If she leaves me a message, or test results she is Dr. X. This is a perfect combo for me. She will give me her pager number if I am going through something big and she seems to know when this applies. I tell her everything and she has no problem telling me what she thinks but she isn't judgmental. I have heard her speak to older patients and refer to them in the Mrs/Mr.

Anonymous said...

Definitely go by Doctor. When I finish this stupid degree already (I'm ABD tomorrow, for an EdD though so it's not really a doctor anyway), I intend to have EVERYone I know call me Doctor. Just for the sake of having EARNED that title. Not even just a respect thing, which it definitely is for your case. "Doctor, please look at this rash on my bum" sounds a lot better than, "Hey you, check out this gross rash." :-) I intend to be Dr. Mom, Dr. Aunt, Dr. Sister, Dr. everything!

Anonymous said...

I've got a very different situation, because I work in breast imaging and my pcp (a women's health specialist) sends her patients to us all the time. So much so that we talk probably three-five times a week. The only time she refers to herself as Dr. Lastname on the phone is when she's calling me about my own health, and that's strictly so I know to close the door to my office, and then she's firstname again. Meanwhile the attendings in Radiology are split, our section chief is Dr. Lastname, but the rest of the doctors are firstname only. However this was only with their permission to address them as familiars.

Becky said...

Before I read all the comments, I was sure about what I felt about the whole Dr. LastName and Ms. LastName thing. Now, I am not so sure.
At home, my husband and I talk about the FD and the dentist and the vet by first names but use the title and last name when calling to make appointments, etc.
My mother was a nurse and daughter of nurse and battled the old "Doctor as God" mindset and I guess I inherited some of the skepticism and that carries over in the terms of address. Part of it too is the degree of treatment. If I am laying out my intimate fears (is it Lupus - it wasn't) or dealing with the psychological and emotional erosion of infertility - I want the sense of support and involvement that comes with being on a first name basis with my doctor. I am asking for help with something much more fundamental than filing a police report over a stolen item. Even with the emotional detactment that protects a doctor's sanity, I need to feel that for the time in that office, I am the primary focus of attention and the respect is about that, not whether I am called by my first or last name. So far, with my new doctors, they are first name in my head only. Too shy to just use it without permission and awkward to ask.

Mimi said...

I love my kid's pediatrician and I would never call her by her first name. I do discuss all kinds of things with her, joke with her, and even ask her things about her hair or jewelry. Mostly I compliment her. I have known my dentist for nine years and see him all over town, I would never call him by his first name either. It just doesn't seem right somehow.

Mimi

Anonymous said...

I don't call her anything really.. When I call to book an appointment I use her 'Doctor Lastname'. However in the examination room she calls me by my first name and has for the past 9 years. Which I prefer over Mrs. "xxxxxx".

Anonymous said...

Late entry, but I think about this topic alot. I am a gynecologist and geneticist- so I see kids, parents, and women in a vulnerable position. I tend to introduce myself as "I'm Dr. Last Name, my first name is First Name" and let people choose. Since starting to work with kids, I call folks by their first name unless they specifically reply to my introduction with "I'm First Name Last Name"

Anonymous said...

No matter what your doctor calls you, you should respond with "Dr. X". Like someone else said, they have the knowledge, I don't and they deserve respect.

Of course, if they called me "Mrs." I'd have a cow and explain to them the difference between the man-attaching address and the correct "Ms."

Laura said...

Regarding the last statement regarding calling DR.X because "they have the knowledge I don't"
My car mechanic has more knowledge than I do on how to fix my car, what do I call him? The man who built my house and the person who cut's my hair? Should we call them by their titles? Does calling everyone who has a doctorate a Dr. elevate them above everyone else? I really do wonder? my patients call me Dr. my friends call me Laura