Physician Dr. Anne Marie Valinoti, writing in the New York Times, explored the subject of exam room etiquette between doctor and patient, and specifically how they address each other.
“Since my early career, I have always been addressed as ‘Dr. Valinoti’. Freshly minted MDs, some as young as 25, get a title of respect – while seasoned nurses in the hospital are just Betty, Kaye or Nancy.
“I remembered the absurdity of this situation when, as a young intern, I was addressing critical care nurses with decades of experience by their first names, while they deferentially called me ‘Doctor.’ These were women who had started their careers when I was still playing with Barbie dolls, yet where were their professional titles?
“Like most things in medical training, I got used to it, and it became second nature.
“One thing I am still getting used to, though, is when patients call me by my first name. There seems to be a void in this area of etiquette: How does one address one’s physician?
“It is almost always an older patient who will use my first name, in a friendly, offhand way. And, I have observed, these patients are usually men.
“It might seem natural if I have had a longterm relationship with these people, caring for them over the years, but often these patients seem to make a decision at the outset to be on a first-name basis with me. I wonder about these people. Are they trying to be chummy? Is it a power thing, making them feel less vulnerable while they sit half naked on the exam table? Do they just call everyone by their first names?”
When I was a little girl, such questions would rarely need to be asked, because few patients would have even dreamed of calling their doctor by their first name. In fact, I can’t even remember Dr. Zaritsky’s first name – and he was our family doctor for decades.
A physician back then was to be addressed only as “Doctor” (or possibly, “Your Holiness”). The only exception to this rule might have been if the doctor were part of the patient’s social circle, fairly common in smaller communities, but even then the doc’s first name would likely be elevated to “Dr. Bill”.
Two years ago, the journal Archives of Internal Medicine reported a study of patients’ own preferences of exam room etiquette vs. the actual reality as captured on videotape during the study. Researchers from Northwest University’s school of medicine interviewed patients and found that:
- just over 78% of patients wanted doctors to shake their hands, while about 18% did not (this study was done prior to the H1N1 flu pandemic scare and subsequent warnings to limit public handshakes)
- slightly more than half of patients preferred that their first names be used during interactions (“Hello, Carolyn”)
- about 17% preferred that the doctor use the patient’s last name (“Hello, Mrs. Thomas”)
- just over 56% of patients wanted doctors to introduce themselves by using just first and last names (“I’m Anne Marie Valinoti”); 32.5% wanted doctors to use just their last name (“I’m Dr. Valinoti”); and only about 7% wanted doctors to use just their first name (“I’m Anne Marie”)
When researchers videotaped new patient visits with doctors, they found that:
- doctors and patients shook hands about 83% of the time
- in 50.4% of visits, doctors did not mention patients’ names at all
- doctors used their own first and last names when introducing themselves in 58.5% of the meetings
- doctors did not introduce themselves at all to new patients in about 11% of the visits (This number, by the way, should be ZERO unless the doctor has a recognized personality disorder, in which case, he/she should not be practicing medicine).
Dr. Valinoti reminds us of another recent study reported in the British Medical Journal on just this subject that also looked at a patient’s age as a determining factor.
“Interestingly, most patients surveyed, particularly those younger than 65, preferred that their physicians call them by their first name.”
But most people surveyed preferred not to address their physicians by their first names.
Read the rest of Dr. Valinoti’s essay from the New York Times.
What do you call your doctor? And what does your doctor call you?