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  #1  
Old 08-05-2009, 11:02 AM
AuntPam AuntPam is offline
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Does HIPAA require doctor's offices to call you by your first name?

Nothing frosts my cookies like having some twenty-five-year-old twinkie open the door to the inner sanctum and call out "AuntPam? The doctor will see you now."

I was raised to believe that the appropriate form of address in professional situations is always--at least initially--"Mr. Smith" (or in my case "Ms. Smith.") After saying firmly yet politely, "We haven't been introduced; please call me Ms. Smith," I've been told all too frequently "Oh ,we can't do that--HIPAA (the act that protects patients' medical privacy) says we can't use last names."

I see--there are zillions of people named "John" but only a few named "Smith." Wait, there's something wrong with that analysis.......

I've pointed out that:
1) I have a really common last name, so no chance it will "identify" me.
2) HIPAA prohibits the release of specific medical information together with information sufficient to identify a person, and "the doctor will see you now" does not release any medical information at all. For all anyone knows, I could be a pharmaceutical salesperson, or there to check up on a relative, or an old school pal of the doc, just passin' through. What is against the law is hollering "Oh, AuntPam 'Smith'? We just got the results of your biopsy! Positive, I'm sorry to say. Wanna come in now?"
3) Nobody, so far, can cite any actual regulation or even "best practice" that requires this little bit of condescending presumptiousness.

So--do any Dopers--especially any health-care employees--have a reliable cite to some organizational posting or regulation that requires admissions clerks to do this??

Because it annoys about a third of the patient population mightily. Why not just do the polite thing? (I'll make an exception for situations where a child is being summoned, though they rarely go to the doctor's office alone.)

And by the way, after I get to know the personnel at a doctor's office, I'm quite likely to say "Oh, just call me AuntPam. Heck, you've seen me naked."
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  #2  
Old 08-05-2009, 11:11 AM
Ferret Herder Ferret Herder is online now
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They're lying, misinformed, or misinterpreting the statutes - or maybe just going to extremes. Physician's offices are allowed to have sign-in sheets at their check-in desks and to call out names. (Warning, PDF) Covered Entities, Incidental Uses, from Health & Human Services, relevant paragraph:

Quote:
Q: May physicians offices use patient sign-in sheets or call out the names of their patients in their waiting rooms?
A: Yes. Covered entities, such as physician’s offices, may use patient sign-in sheets or call out patient names in waiting rooms, so long as the information disclosed is appropriately limited. The HIPAA Privacy Rule explicitly permits the incidental disclosures that may result from this practice, for example, when other patients in a waiting room hear the identity of the person whose name is called, or see other patient names on a sign-in sheet. However, these incidental disclosures are permitted only when the covered entity has implemented reasonable safeguards and the minimum necessary standard, where appropriate. For example, the sign-in sheet may not display medical information that is not necessary for the purpose of signing in (e.g., the medical problem for which the patient is seeing the physician). See 45 CFR 164.502(a)(1)(iii).
I work in a large medical center, and have typically heard full name being used to call a patient back; I tend to use "Mr./Ms. Lastname" because I work only with research patients and know who will be there to see me.
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  #3  
Old 08-05-2009, 11:17 AM
Kimmy_Gibbler Kimmy_Gibbler is offline
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Originally Posted by AuntPam View Post
So--do any Dopers--especially any health-care employees--have a reliable cite to some organizational posting or regulation that requires admissions clerks to do this??
No, as you suspect, they are trying to bamboozle you with phony-baloney cites to HIPAA. However, you are directing your complaint to the wrong person, next time, tell the M.D. that nobody really minds being addressed as "Ms. AuntiePam" but quite a few don't care to be addressed as "Pam" by strangers.

Also, throw in a phony-baloney cite of your own: "Is this a new thing your office is doing to make people feel ease? I wonder if it will spread, none of the other doctor's offices I've been in have adopted it yet."
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  #4  
Old 08-05-2009, 12:10 PM
DSYoungEsq DSYoungEsq is offline
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Originally Posted by Kimmy_Gibbler View Post
No, as you suspect, they are trying to bamboozle you with phony-baloney cites to HIPAA. However, you are directing your complaint to the wrong person, next time, tell the M.D. that nobody really minds being addressed as "Ms. AuntiePam" but quite a few don't care to be addressed as "Pam" by strangers.

Also, throw in a phony-baloney cite of your own: "Is this a new thing your office is doing to make people feel ease? I wonder if it will spread, none of the other doctor's offices I've been in have adopted it yet."
Or you could be honest and simply ask the manager of the office (which is RARELY the M.D.) to consult the relevant HIPPA regulations, starting with the one quoted by Ferret Herder.
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  #5  
Old 08-05-2009, 12:15 PM
Anaamika Anaamika is offline
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I hate it, too. I'm glad you started this thread. Nearly everyone butchers my first name, and I am tired of hearing it mispronounced at me. I happen to think it's a beautiful name!
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  #6  
Old 08-05-2009, 12:29 PM
Ferret Herder Ferret Herder is online now
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I can definitely understand misgivings about this practice. When I'm a patient I tend to ask the doctor/medical staff person to call me by my first name, since my last name is tough to pronounce, but on the job I seriously respect a patient's right to be addressed as they wish, so typically I stick with Mr./Ms. Lastname until corrected.

I do recall one time where I was a patient and told a doctor (the ER doc who was taking care of my broken wrist) to "Just call me (first name)" after giving my last name's pronunciation, and his response was to smile and say, "Well then you can call me (his first name)!" That's the only time I've heard that from a doctor.
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  #7  
Old 08-05-2009, 12:43 PM
dracoi dracoi is offline
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Is a preference for using last name a regional thing? I see that some of the posters who prefer it are on the East Coast.

I grew up in CA and now live in WA, and my response to a client who wanted me to call them Mr. Smith would be "Don't let the door hit you on the way out." But nobody here expects it. Half the messages I get from prospective clients don't even include a last name and I have to ask for it.
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  #8  
Old 08-05-2009, 01:02 PM
Skammer Skammer is offline
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The thing I don't like about being called by my first name is I don't use my first name - I go by my middle name. Fortunately, my first name is somewhat unusual, because if it was "John" I would probably sit there like an idiot. But when they call "Raguel"* I think, "Oh, that's funny, that's my... oh they mean me."

*My name is not Raguel.
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  #9  
Old 08-05-2009, 01:22 PM
Anaamika Anaamika is offline
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Originally Posted by dracoi View Post
Is a preference for using last name a regional thing? I see that some of the posters who prefer it are on the East Coast.
I don't go by my first name either. I use a nick. I give my first name only to specific people. And as I said, they completely butcher the first name, and only slightly butcher the last name.
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  #10  
Old 08-05-2009, 01:33 PM
Kimmy_Gibbler Kimmy_Gibbler is offline
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Originally Posted by DSYoungEsq View Post
Or you could be honest and simply ask the manager of the office (which is RARELY the M.D.) to consult the relevant HIPPA regulations, starting with the one quoted by Ferret Herder.
I'm not so sure a HIPAA-citing contest between the patient and the office manager is the way to go. I'm also not sure why you would bring it up with the office manager instead of your very own M.D. on the topic of client servicing at her own practice. It might work, but my way is much better.
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  #11  
Old 08-05-2009, 02:13 PM
Ferret Herder Ferret Herder is online now
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Originally Posted by dracoi View Post
Is a preference for using last name a regional thing? I see that some of the posters who prefer it are on the East Coast.

I grew up in CA and now live in WA, and my response to a client who wanted me to call them Mr. Smith would be "Don't let the door hit you on the way out." But nobody here expects it. Half the messages I get from prospective clients don't even include a last name and I have to ask for it.
I'm assuming you aren't in the medical field (and may be wrong); it seems to be different there. When you have a doctor who's almost certainly insisting on being addressed as "Dr. Lastname" but might call patients decades older than him/her, who might be complete strangers before that appointment, by their first name, it can create resentment. Many patients prefer to be addressed by title and last name as a result, though some don't care either way.
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  #12  
Old 08-05-2009, 02:43 PM
Troy McClure SF Troy McClure SF is offline
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Quote:
Originally Posted by AuntPam
Because it annoys about a third of the patient population mightily.
Cite?

That said, working in a clinic, I don't even see how HIPAA would be involved in getting one person walk from one room to another.

Quote:
Originally Posted by AuntPam View Post
Nothing frosts my cookies like having some twenty-five-year-old twinkie open the door to the inner sanctum and call out "AuntPam? The doctor will see you now."
If you treat them like a "twinkie" just because you disapprove of their age- however that works- they might not be particularly interested in how you like your cookies. I sure wouldn't.
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  #13  
Old 08-05-2009, 02:48 PM
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When I worked in a doctor's office, privacy was the source of a great deal of paranoia. As soon as you signed in, your name was blacked out. You were called back by your first name and any papers that didn't go out the door with you were entered into electronic records and then immediately destroyed.

"That's a possible HIPAA violation" in our office was code for "we are pants-wettingly terrified about getting sued and will take irritatingly extreme measures to make sure it doesn't happen."
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  #14  
Old 08-05-2009, 03:36 PM
alphaboi867 alphaboi867 is offline
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Originally Posted by Ferret Herder View Post
...When you have a doctor who's almost certainly insisting on being addressed as "Dr. Lastname" but might call patients decades older than him/her, who might be complete strangers before that appointment, by their first name, it can create resentment...
Why should it matter if the patient's older than him? He's a service provider and the patient is his customer; he should address all his adult patients by title if he expects them to do likewise. Anything else is patronizing. After I shattered my kneecap (age 20) I had to see an orthopaedist for awhile. At my first checkup used my first name so I used his. As soon I as said both the nurse's and the med student's jaws dropped. He actually got offended and said that he "didn't give me permission to use his first name". I pointed out that I didn't either. For rest of my visits be called me "Mr" through gritted teeth. Naturally my mother (a nurse's aid) was horrified beyond belief when I told her. I think he was in his 50s.
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  #15  
Old 08-05-2009, 03:48 PM
Ferret Herder Ferret Herder is online now
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Originally Posted by alphaboi867 View Post
Why should it matter if the patient's older than him? He's a service provider and the patient is his customer; he should address all his adult patients by title if he expects them to do likewise. Anything else is patronizing. After I shattered my kneecap (age 20) I had to see an orthopaedist for awhile. At my first checkup used my first name so I used his. As soon I as said both the nurse's and the med student's jaws dropped. He actually got offended and said that he "didn't give me permission to use his first name". I pointed out that I didn't either. For rest of my visits be called me "Mr" through gritted teeth. Naturally my mother (a nurse's aid) was horrified beyond belief when I told her. I think he was in his 50s.
No, you're right, that doesn't matter. I was just singling it out as the situation typically most likely to cause irritation, to indicate to dracoi why he may want to boot out any client insisting on being addressed with their title but why the situation may be different in other fields.
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  #16  
Old 08-05-2009, 03:55 PM
dracoi dracoi is offline
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Originally Posted by Ferret Herder View Post
I'm assuming you aren't in the medical field (and may be wrong); it seems to be different there. When you have a doctor who's almost certainly insisting on being addressed as "Dr. Lastname" but might call patients decades older than him/her, who might be complete strangers before that appointment, by their first name, it can create resentment. Many patients prefer to be addressed by title and last name as a result, though some don't care either way.
That makes sense. But then, I only refer to my doctor as "Dr. Lastname" when I'm talking to the receptionist to make an appointment. When I come in, it's "Hi, Firstname."

(As far as my field, I'm in accounting. I do know - from talking with others in the field - that some clients are fairly particular about being called Mr./Ms. My philosophy is that I don't wear a tie and I don't call you Mr. - if you don't like, it I'm not the accountant for you anyway.)
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  #17  
Old 08-05-2009, 04:22 PM
tumbleddown tumbleddown is offline
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If they were really concerned about patient privacy, then every patient would be given a number (like at a deli or bakery) when they signed in, and the nurse or PA would come out and say "62!" and the patient with #62 would boogie back for their 6 minutes with the doctor.

I have a feeling that it's a practice that arose out of ease.

I also note that when I've been hospitalized (three different hospitals) everyone who came in, phlebotomists, technicians, med students, residents, attendings and especially nurses (and sometimes even the cleaners who were there to empty the trash) always always always greeted me when they came in, and did so as "Hello Ms. Down." Never as "Hello, Tumbled."
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  #18  
Old 08-05-2009, 04:35 PM
Shot From Guns Shot From Guns is offline
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Originally Posted by alphaboi867 View Post
After I shattered my kneecap (age 20) I had to see an orthopaedist for awhile. At my first checkup used my first name so I used his. As soon I as said both the nurse's and the med student's jaws dropped. He actually got offended and said that he "didn't give me permission to use his first name". I pointed out that I didn't either.
IIRC, this is Miss Manners's official solution to the problem. If they're going to insist on calling you by your first name without being invited to do so, you go right ahead and do the same.
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  #19  
Old 08-05-2009, 04:48 PM
Hirka T'Bawa Hirka T'Bawa is offline
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At the pharmacy I work at, if we have to call you over the PA system, we will always use first name, last initial. So, if I was to call myself I would say "Hirka T. please return to the pharmacy" (Though, why I would call myself to the pharmacy when I was already back there....)



Now if that is just because it's over the PA system, or because corporate is just worried about being sued, I don't know. But that's the way its been since I started working in pharmacy.
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  #20  
Old 08-06-2009, 12:25 PM
AuntPam AuntPam is offline
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I thought I'd let this run for while before responding. Thanks for all the input, especially the cite to the HIPAA Q&A from Ferret Herder. Excellent stuff--I've saved it and printed it out and will send it along to both admins and doctors.

Just to clear up some mis-impressions:

I don't really have anything against people being twenty-five years old. A long time ago, I was twenty-five years old. What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am. I was taught that you always address a significantly older person as Mr. or Mrs. or Miss or Ms.--until asked by them to use a first name. Just an ordinary matter of courtesy.

(This reminds me of a story about Harrods (the English department store) attempting to implement "American" sales techniques. The staff was trained to conclude transactions with that popular American phrase "Have a nice day!"

On the first morning of the new regime, with marketing consultants lurking nearby to observe how it all worked, a dear old British matron tottered in to buy a new teapot in the china department. After it had been wrapped and paid for, the sales clerk chirped brightly "Have a nice day!"

The outraged matron drew herself up, glared at the clerk, and snapped, "Don't be impertinent!"

Program cancelled forthwith.)

So, Dracoi, maybe you you should check out some etiquette websites: I believe you'll find you've been operating under a mis-apprehension. It's rarely appropriate to call strangers, especially older ones, by their first names. And when politely asked to use a formal title, maybe you'd like to respond with "Oops, sorry!" rather than assuming that it is they who are being rude to you. You've got it backwards.

I confess I don't have a firm cite for "about a third" of the public finding this practice obnoxious--but note the number of people responding to this thread who DO. Many years ago, I ran an informal survey at my place of work (an e-mail to about twenty co-workers). That's an insufficient sample size, but it broke down that at least a third of the folks who got my e-mail were genuinely annoyed by hospital/doctor's office "fake friendliness"--as in "How are we today, Firstname? Are we ready for our bed bath?"

Sheesh.

To be fair, some others just shrugged it off as "That's the way they (medical personnel) are, no big deal. Don't like it, but don't really notice." And some did think it was friendlier.

It just seems to me that it would be way easier for these entities to choose to be politely formal. The patient can always opt for informal chumminess. But it is the patient's call, not theirs, when that starts.

I call my own GP "Doctor Ed." But I give him guitar-playing tips while he's checking my vital signs--I've been seeing him for years. I started out calling him Dr. Lastname, and he started out calling me Ms. Otherlastname.
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  #21  
Old 08-06-2009, 06:22 PM
alphaboi867 alphaboi867 is offline
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Quote:
Originally Posted by AuntPam View Post
...What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am. I was taught that you always address a significantly older person as Mr. or Mrs. or Miss or Ms.--until asked by them to use a first name. Just an ordinary matter of courtesy...
You have a point, but do you address stangers several decades younger than you by their given names without asking? Doing that, but expecting them to use a title in return is very condescending. I've never been bothered by nurses addressing me by my given name, but every single nurse (hell every non-doctor healthcare worker) I've met has introduced themselves by their first name. Even my physical therapist (who had a doctoral degree). It's only doctors who insist on the use of their title & surname. Their egos are huge. It's not the use of given names I object to, it's using a given name, but still expecting people use your title in return (then getting indignant when they don't). The fact that patients are also customers and not supplicants makes this even more annoying. My doctor didn't just use my given name without asking, he lectured me me when I did it too him.
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  #22  
Old 08-06-2009, 06:28 PM
Omniscient Omniscient is offline
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Originally Posted by AuntPam View Post
What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am.
Holy crap.

You are being orders of magnitude more offensive than the girl using your first name. Get a grip.

Last edited by Omniscient; 08-06-2009 at 06:29 PM..
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  #23  
Old 08-06-2009, 06:56 PM
Ruken Ruken is offline
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Seeing as the GQ has been answered:

Bolding mine
Quote:
Originally Posted by AuntPam View Post
Nothing frosts my cookies like having some twenty-five-year-old twinkie open the door to the inner sanctum and call out "AuntPam? The doctor will see you now."
Quote:
3) Nobody, so far, can cite any actual regulation or even "best practice" that requires this little bit of condescending presumptiousness.
Quote:
(I'll make an exception for situations where a child is being summoned, though they rarely go to the doctor's office alone.)
Quote:
What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am.
Like Omniscient said.
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  #24  
Old 08-06-2009, 06:57 PM
mhendo mhendo is online now
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Originally Posted by AuntPam View Post
What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am. I was taught that you always address a significantly older person as Mr. or Mrs. or Miss or Ms.--until asked by them to use a first name. Just an ordinary matter of courtesy.
I just don't get this attitude at all.

If i'm introduced to someone in a social setting, and that person is 20 years younger than me, i'm happy for them to call me by my first name. If the person is 20 years older than me, i'm damn sure going to use their first name.

In your case, it's not about age; it's about the setting. In the doctor's office, you're not at a social gathering; you have a professional relationship with the doctor and the staff. In those cases, i think it's a good idea for them to address you as Ms. Smith unless and until you tell them to call you by your first name.

But this should be the same whether you're a 20-year-old patient or a 60-year-old patient.
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  #25  
Old 08-06-2009, 09:11 PM
missred missred is offline
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After going through ongoing medical treatment for the past eight months, I'd like to chime in with another perspective.

Some of the minor indignities inflicted upon patients during the course of treatment (and usually these are necessary) sometimes leave us feeling somewhat vulnerable (strip from the waist down and put your feet in the stirrups, anyone? ). One of the things that help remind me (personally) of my own worth, is to be addressed in a respectful manner of my choosing.

Living in the south, most of the medical professionals that I deal with address me as MissRed or MsLastname. Not a problem. I usually address them as whatever name they introduce themselves with (although if they are significantly older than me, there is a Mr. or Ms. in front of a first name out of habit). My PCP and I are Dr. Will and MissRed. Lends a bit of respect all around.

Oh, and IMO, the whole not using your title and last name was either office policy or CYA on the part of the person erroneously citing HIPAA.

Last edited by missred; 08-06-2009 at 09:14 PM..
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  #26  
Old 08-06-2009, 09:11 PM
LouisB LouisB is offline
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My father once had a tantrum because he was called by his first name by a receptionist at a doctor's office. IIRC he was in his late eighties at the time and he launched into a tirade about the ill mannered youth who had not been invited to use his given name and so forth. My sister had taken him to that doctor and she told me the story. He also left the office, saying he would find a doctor whose staff would treat him with the respect due a man of his age. My father was an absolute asshole and that is not an exaggeration.

As for me, I'm about as easy going as it gets----I want the staff in a doctor's office to be my friends, especially if they are required to stick needles into me or do other unpleasant things. I'm especially nice to the staff in my dentists office as well as the dentist himself.
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Old 08-06-2009, 09:37 PM
Omniscient Omniscient is offline
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My father was an absolute asshole and that is not an exaggeration.
Perhaps this line can be instructive.
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Old 08-06-2009, 09:40 PM
Kimmy_Gibbler Kimmy_Gibbler is offline
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Originally Posted by Omniscient View Post
Perhaps this line can be instructive.
We should take etiquette advice from someone who casually tosses around the "asshole" epithet just because someone expresses a rather conventional preference for being addressed formally by patient service staff at their doctor's office? I'm not so convinced.
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  #29  
Old 08-06-2009, 09:48 PM
Omniscient Omniscient is offline
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If the preference is for formality in all cases, that's one thing. But that's not the case here. This is ageism and arrogance, and a fairly nasty case of it.
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  #30  
Old 08-06-2009, 10:32 PM
JimOfAllTrades JimOfAllTrades is offline
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And to add a gripe about Doctor's offices, they are all panicky about HIPAA, but then call you up the front desk to "check in". You have to give them all your personal data, phone number, address, insurance company, etc., and then even the reason for your visit. Any one sitting within ten feet could hear it all.

I've been in about 6 different doctor's offices in the last few months, and with one exception, they all did this interview style check in right in the waiting room, in easily hearable range of any number of people.

Why isn't this a HIPAA violation?
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  #31  
Old 08-06-2009, 11:39 PM
Hirka T'Bawa Hirka T'Bawa is offline
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Why isn't this a HIPAA violation?
The way I understand HIPAA, there are two reasons it wouldn't be a violation. First and foremost, because they didn't release any personal information, you released the information yourself. HIPAA only covers the healthcare workers, it doesn't cover the patient themselves. You can tell everyone your own information without any trouble.

The second reason could be that they aren't responsible if someone overhears them talking as long as they took "reasonable" precautions to prevent it. In the pharmacy environment that is basically a line on the ground, and talking quietly.
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  #32  
Old 08-07-2009, 01:47 AM
LouisB LouisB is offline
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Perhaps this line can be instructive.
As in Like father, Like son?
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  #33  
Old 08-07-2009, 11:20 AM
Oglomott Oglomott is offline
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People who call you by your first name are not trying to offend you, so why would you take it that way?

Can't recall it right now, but I think there is a term for people who take offense where no offense is intended.
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  #34  
Old 08-07-2009, 11:25 AM
Shot From Guns Shot From Guns is offline
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Originally Posted by Kimmy_Gibbler View Post
We should take etiquette advice from someone who casually tosses around the "asshole" epithet just because someone expresses a rather conventional preference for being addressed formally by patient service staff at their doctor's office?
He didn't calmly request that he be addressed as Mr. Surname--"he launched into a tirade." The correct response to what one percieves as rudeness is politeness, not more rudeness. The man himself was breaking a major rule of the etiquette he allegedly so cherished.
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Old 08-07-2009, 12:47 PM
aruvqan aruvqan is offline
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My PCP is hispanic, and started out with everybody in the office being fairly formal and addressing me as MrsAru, but over the past 2 years of frequent visits we have gotten to be on first a name basis. My OB/GYN oncologist and his staff are new, and started out formally, but have gotten to also be on a first name basis as well over the past 4 months. If it does turn out to be cancer, we may be having a lot more contact that I would hope...

I think I prefer to be friendly with my medical staffers, I do my best to be polite and compliant as some of my procedures are rather unpleasant, and I find that I prefer to think of them as friends, who are not deliberately hurting me. Maybe it is just my area in Connecticut, or the luck of the draw, but all my medicos seem to be formal at the outset...
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  #36  
Old 08-07-2009, 01:56 PM
Kimmy_Gibbler Kimmy_Gibbler is offline
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Originally Posted by aruvqan View Post
... I do my best to be polite and compliant as some of my procedures are rather unpleasant, and I find that I prefer to think of them as friends, who are not deliberately hurting me. Maybe it is just my area in Connecticut, or the luck of the draw, but all my medicos seem to be formal at the outset...
Although they do not come to the same conclusion as you, I think you have hit upon why familiarity really displeases some patients. As you mention, some of the necessary procedures are physically and psychologically painful (including, importantly, embarrassment). Embarrassment, which is a social reaction, is mitigated by interposing social distance, accomplished by insisting on formality.
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  #37  
Old 08-07-2009, 01:57 PM
LouisB LouisB is offline
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Originally Posted by Shot From Guns View Post
He didn't calmly request that he be addressed as Mr. Surname--"he launched into a tirade." The correct response to what one percieves as rudeness is politeness, not more rudeness. The man himself was breaking a major rule of the etiquette he allegedly so cherished.
I accurately described my father in my first post but I'll add that the man was arrogant beyond belief. In any situation, he was right and the rest of the world was wrong. There is/was no excuse for his behavior.
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  #38  
Old 08-07-2009, 03:46 PM
Omniscient Omniscient is offline
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As in Like father, Like son?
No, as in your example draws parallels to the OP.
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  #39  
Old 08-07-2009, 03:58 PM
aruvqan aruvqan is offline
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Originally Posted by Kimmy_Gibbler View Post
Although they do not come to the same conclusion as you, I think you have hit upon why familiarity really displeases some patients. As you mention, some of the necessary procedures are physically and psychologically painful (including, importantly, embarrassment). Embarrassment, which is a social reaction, is mitigated by interposing social distance, accomplished by insisting on formality.
There is the major difference ... I spent a fair amount of time in traction and a body cast .... when you have to have someone else wipe your ass, your nose, turn the pages in the books you are reading, feed you and anything else you need to have done you lose the sense of embarrasment pretty damned quick I used to joke that I could take a dump in a bucket in Grand Central Station at rush hour .... though one good thing came out of it all, I can sleep anywhere no matter how loud or bright or busy it is. I used to amaze people being able to fall asleep on the floor of an airport concourse using a sea bag as a pillow and half a poncho/shelter as a blanket. I also fell asleep on a gooney bird belonging to the Confederate air Force when my Dad and I were visiting Texas on business. Nothing like an airplane with an internal weather system =)
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Old 08-07-2009, 04:51 PM
Troy McClure SF Troy McClure SF is offline
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A long time ago, I was twenty-five years old. What I object to is the condescension inherent in being addressed by my first name by someone several decades younger than I am.
A few issues I see:

1a) People have wildly different ideas of how employees of a given establishment should treat them, and you can't please 'em all. I hate being asked if I need help or how my day's going 40 times every time I go to Safeway (and hated being told to do it when I worked at Cala), but some people apparently do need their ass kissed by every CS worker they come across. Not for me but I'm not going to get pissed when they do it*.

1a) Just because you get offended by something that's not offensive doesn't mean we should, or that they should plan for it.

2) Just because someone is older doesn't mean they deserve extra respect. Old people supposedly are wiser, but as the world shows over and over again, you can grow old and stay pretty stupid*.

*-Not saying either of these specifically applies to you, but I think these seems to be more where your opinions are coming from.
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  #41  
Old 08-07-2009, 06:40 PM
LouisB LouisB is offline
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No, as in your example draws parallels to the OP.
I'm very glad you responded the way you did; I've made a life long effort to avoid exhibiting any of his behaviors personally. Unfortunately, I do or did have a very bad temper and a short fuse. It took me years to get that under control but it still breaks out at times.
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  #42  
Old 08-07-2009, 08:02 PM
aruvqan aruvqan is offline
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I'm very glad you responded the way you did; I've made a life long effort to avoid exhibiting any of his behaviors personally. Unfortunately, I do or did have a very bad temper and a short fuse. It took me years to get that under control but it still breaks out at times.
I inherited my dad's temper also .... when I was about 9 years old, he taught me the trick of tracing the words fuck you on the roof of my mouth with the tip of my tongue to keep my temper ... sort of a combination of private passive agressive behavior on the inside that keeps a neutral expression on the outside =)
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  #43  
Old 08-08-2009, 01:23 PM
chaoticbear chaoticbear is offline
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Are the people who prefer to be "Mr./Mrs./Ms." referring to business situations (as in, doing business with the doctor's office? In a social situation, I absolutely would never use a last name and a title, unless being facetious. In a business situation, (I work in a pharmacy), every single customer, even if they are 16, is "Sir/Ma'am", and "Mr./Mrs. Smith". My coworkers are all "Sir/Ma'am", even if they are younger than I am, which is funny, because some people don't like it ("I'm not old enough to be a 'Ma'am'!")

I'm actually not sure where I picked THAT up, because my parents were never big "Sir/Ma'am" people, and when I worked at McDonald's, every one I worked with, even the 14-year-old kids, were "Sir" and "Ma'am," even when I was their manager and talking to them, although I don't remember a particular formative experience leading to it.

I couldn't care less what people use for me, whether "Mr. Bear" or "Chaotic" or "Sir" or even "Ma'am" (I wear a lot of skirts and occasionally eye makeup as well).

--chaoticbear, age 22, apparently too damn polite for his own good.*

* - this is actually debatable.
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  #44  
Old 08-08-2009, 10:00 PM
StaudtCJ StaudtCJ is offline
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I think it's rude to be called by my first name by a stranger, unless I give them permission (and I usually do, as soon as I'm *gasp* introduced). I'm not even that old. I just severely dislike the intimacy indicated by a complete stranger calling me by my first name. I've never met Nurse01*. I don't know Nurse01. I will call her Ma'am, Miss, or Nurse. Since she has my name in front of her, I expect to be called Ma'am (since marital status is also in front of her), FirstName LastName, or Mrs. MyLastName. If we subsequently converse, I will likely say "Please, call me Firstname, Nancy." She is no longer a stranger, she is an acquaintance. This is not an age thing, although children assuming they can call me FirstName is annoying (because of the failure in parenting involved, not because of a failure on the child's part). On the other hand, someone assuming that because he** is a doctor he can call me by FirstName, since I'm somehow beneath him, will be informed that I am *also* Dr. Lastname, and if he is going to be condescending, then I will also insist on Dr. Lastname, just like he does. Otherwise, we can get along.

My favorite service provider asks me what I'd prefer to be called, and will usually be gifted with my FirstName as a result.

*I am assuming the Nurse is female, based on the probability in the U.S. of the Nurse being female.
**I use he since it is the gender neutral English term, not in reference to actual gender.

Last edited by StaudtCJ; 08-08-2009 at 10:02 PM..
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  #45  
Old 08-09-2009, 12:24 AM
LouisB LouisB is offline
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Originally Posted by aruvqan View Post
There is the major difference ... I spent a fair amount of time in traction and a body cast .... when you have to have someone else wipe your ass, your nose, turn the pages in the books you are reading, feed you and anything else you need to have done you lose the sense of embarrasment pretty damned quick I used to joke that I could take a dump in a bucket in Grand Central Station at rush hour .... though one good thing came out of it all, I can sleep anywhere no matter how loud or bright or busy it is. I used to amaze people being able to fall asleep on the floor of an airport concourse using a sea bag as a pillow and half a poncho/shelter as a blanket. I also fell asleep on a gooney bird belonging to the Confederate air Force when my Dad and I were visiting Texas on business. Nothing like an airplane with an internal weather system =)
Did you see this thing at the Lancaster, Texas Confederate Air Force museum? If so, you were visiting my home town. If not, never mind.
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  #46  
Old 08-09-2009, 02:51 PM
AuntPam AuntPam is offline
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Well, Troy and Omniscient, if you've followed this thread you've seen that others are also annoyed by being firstnamed by strangers. It ain't just me. If people are offended by soemthing, it's offensive--regardless of how it was meant.

And you've seen that some folks in customer service positions agree that the use of "Mr./Mrs./Ms." and "ma'am" and "sir" are the right way to go. Again, it ain't just me. You do have some supporters here, though, I notice.

In fact, I DO call medical office personnel by their last names--the info is usually right there on an ID tag. Regardless of their apparent age. Sometimes it takes two or three tries before they ask "Why are you calling me Ms. Jones?"

"Because this is a professional encounter, and that's how people address each other in professional situations."

"OH! so do you want to be called Mrs. LastName?"

"Yes, please. Until we get to know one another."

I mentioned the apparent age of a medical receptionist/aide in my OP as a secondary aspect of the problem and am genuinely surprised at how angry that part of my OP is making some posters. (Possibly I am just a fuddy-duddy. Hey, you kids, get off of my lawn!!) Seriously though, do you routinely address people more than three decades older than you by their first names the very first time you meet them? Did you do this when you were in your teens? In your twenties? In your thirties? I'm just shy of being able to collect on my Social Security myself, and I absolutely address folks from my mother's generation as Mr. and Mrs. until asked to use a first name.

I don't think I understand what "ageism" means in this context. To the extent that I see age discrimination in ordinary life, it's when younger people assume that older people are stupid or confused or clueless. Usually over some technology issue. As used above, it seems to be a complaint that it's not fair for the young to have to be polite.

Finally, you might want to review what Kimmy-Gibbler had to say :

Quote:
As you mention, some of the necessary procedures are physically and psychologically painful (including, importantly, embarrassment). Embarrassment, which is a social reaction, is mitigated by interposing social distance, accomplished by insisting on formality.
Best insight in the thread, as far as I'm concerned.
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  #47  
Old 08-09-2009, 03:20 PM
mhendo mhendo is online now
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Seriously though, do you routinely address people more than three decades older than you by their first names the very first time you meet them? Did you do this when you were in your teens? In your twenties? In your thirties?
Yes to all that except the teens part, if the meeting was in a social situation. As soon as i left high school, i was living away from my parents and paying my own rent. I figured that if i could do that, i was an adult and should be allowed to address other adults in the same way that they addressed me.
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  #48  
Old 08-09-2009, 11:23 PM
Ducktail Ducktail is offline
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I'm probably younger than most people posting in this thread, and definitely younger than the OP, but I've worked in a medical office, and I would never dream of calling patients--especially those significantly older than myself--by anything other than "Ms." or "Mr." + Lastname. On the other hand, I didn't work reception--I was on the phone with them all day, so privacy wasn't an issue, and I can't attest to the HIPAA issue. I myself prefer medical personnel to address me formally.

Since it's relevant, I also address older folks as 'sir' and 'ma'am' in professional or academic situations, if I don't know them well, or if the generational gap seems to require it (i.e. older neighbors or family members of my grandparents' generation or older). This was how I was taught to do when I was young, and I've never met anyone who took offense, or at least not enough to mention it to me.

Last edited by Ducktail; 08-09-2009 at 11:24 PM..
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  #49  
Old 08-10-2009, 02:20 AM
jackdavinci jackdavinci is offline
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While this is probably hard to apply to the doctor's assistant example, the way I handle the addressing issue in general is to pay attention to how a person introduces themselves to me (this is especially useful for emails) and use that exact phrasing in addressing them. I will then use an identical format to introduce myself. I do care how people address me, but I look to the attitude with which I am addressed and not the specific linguistic form that it takes.

My personal pet peeve is websites that include title as a *required* field. What if I don't want a title? Make it optional!

At my old job I was in charge of processing job applications for post-docs in the genetics field, and also the go to person for vendors. I was always amused by the various correspondence sent to me, including one addressed to "The Esteemed Professor Davinci". (I do not have a PhD nor were there any teaching positions at my employer). PhD positions tend to attract a lot of foreign applicants and I was also amused by what the format of certain applications reveals about job ettiquette in other countries. For example, one applicant went into detail about his marital status and familial structure, and things such as moral standing.

When I was young I used to get a big kick out of being called sir but now it makes me feel old lol. I was also befuddled as a kid by my older relatives who addressed things to me as "Master Davinci".

I generally find most ettiquette to be arbitrary and antiquated, when it goes beyond basic attitude and intentions into formal traditions. But I'll be flexible and try to fit into whatever situation I'm in - I don't have a problem wearing a yarmukle at a Jewish wedding or saying grace with a religious Christian family, etc. I'll only abstain if the particular custom is mean spirited. The main exception is hats. For some reason, where other arbitrary things don't really bother me, I'm greatly offput when people ask me to take off my hat. I recognize that it's a tradition in some parts, but it seems rude to me to ask someone to remove clothing. Whenever someone asks me to take off my hat I have to resist the urge to ask them to remove their pants.

Last edited by jackdavinci; 08-10-2009 at 02:22 AM..
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  #50  
Old 08-10-2009, 02:38 AM
Mona Lisa Simpson Mona Lisa Simpson is offline
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Originally Posted by Skammer View Post
The thing I don't like about being called by my first name is I don't use my first name - I go by my middle name. Fortunately, my first name is somewhat unusual, because if it was "John" I would probably sit there like an idiot. But when they call "Raguel"* I think, "Oh, that's funny, that's my... oh they mean me."

*My name is not Raguel.
I am also a Firstname, Juliefoolie Lastname, and especially in a doctors office (and especially in ER when Im writhing in pain for some reason)I don't always catch when they call out "Firstname." I especially don't catch when they call out "Firsty" or even more obscure arrangement like Fi-na or something...No matter h ow many times we go through it... Please highlight Juliefoolie on my chart that's the name I use... (and I have been going to this clinic on and off for oh... 35 years or so) I get the "we have to go by what's on your health card.

Except that back in the early 90's I had a health card that only had Juliefoolie Lastname on it. When I moved back to Ontario in 2003 they would only let me get a photo one with the full name.

Grrr. Call me Ms Lastname, if you can't call me by my preferred name.
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