Does HIPAA require doctor's offices to call you by your first name?

Factual Questions
1

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.”

2

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:

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.

3

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.”

4

Or you could be honest :rolleyes: 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.

5

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!

6

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.

7

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.

8

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.

9

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.

10

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.

11

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.

12

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.

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.

13

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.”

14

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. :eek: 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.

15

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.

16

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.)

17

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.”

18

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.

19

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.

20

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.