Why do I have to call anyone "Doctor"?

In My Humble Opinion
21

Clearly, you never spend any social time with MD’s and hear about their patients if you think this isn’t a problem in medicine. I really think if Dr.J never again has to hear the phrases, “Now, I’m not telling you how to do your job,” or “Now, I know my body, and…” he will be able to die a happy man.

That’s really neither here nor there, though, as I don’t think that’s at all the reason we should use honorifics in formal, professional settings. We use honorifics because that is (or at least used to be) the default setting for professional settings. That’s why my mom’s coworkers call her Mrs. CatLady in front of students, parents, and in staff meetings, although they typically call her Paula when they’re just shooting the shit. That’s why everyone in our clinic uses honorifics for our clients unless they’re people we already know personally or they tell us otherwise. That’s why my bosses might use a nickname for me in the treatment area, but always call me by my real name in the exam room. That’s why when I took EMT training they taught us to always, always, always call the patient by an honorific (yes, Mr., Mrs., Miss, and Ms. count as honorifics) and last name until told by the patient to do otherwise. That’s why we call judges Your Honor and sometimes call lawyers Counselor. That’s why people address the Commander in Chimp as Mr. President instead of just calling him George.

That’s not to say that the level of formality can’t be reduced in a professional setting. I’ve yet to see a mechanic introduce himself to me as Mr. Gearhead, but rather by first name. We don’t address them by honorifics because they tacitly tell us not to.

But your focus on the medical profession, coupled with your comments about MD’s you’ve worked with and how they irk you, really does make it come across as though you’re not lobbying to drop all honorifics, just Dr. And that makes it come across as an issue that’s a little more personal than you let on.

22

Although I try not to be a jerk about it, I tend to avoid all honorifics both for myself and others. I think it is somehow undemocratic.

But then again, I am strange in other ways too.

23

Doctor patient relationships are different than any other professional relationship. When meeting a doctor, you must quickly communicate things that are very private, and potentially embarressing. The reason it feels ok to do this is that you are talking to a doctor, and it’s just different when you are talking to a doctor–it’s a different set of rules for how you talk to somebody than the rules for talking to anyone else. I can tell “Dr. Smith” who I just met about the shift in odor in my clotted mentrual discharge (I just made that up). I could never, ever tell “Bob” or “Lisa” about that.

Calling them “Dr. Smith” is just a side effect to the fact that I want to think of them as “Dr. Smith.”

24

Tell your father he’s the one being pretentious–the term applied to scholars before it was used by medical professionals:

c.1303, “Church father,” from O.Fr. doctour, from M.L. doctor “religious teacher, adviser, scholar,” from L. doctor “teacher,” from doct- stem of docere “to show, teach,” originally “make to appear right,” causative of decere “be seemly, fitting” (see decent). Familiar form doc first recorded c.1850. Meaning of “holder of highest degree in university” is first found c.1375; that of “medical professional” dates from 1377, though this was not common till late 16c. Verb sense of “alter, disguise, falsify” is first recorded 1774.

Cite: http://www.etymonline.com/index.php?l=d&p=14

In my experience, M.D.'s are the most guilty of expecting people to use the term “doctor” when referring to them; I can’t think of a single Ph.D. outside of a formal function who demanded they be called “doctor.”

Still, if someone earns the degree, he or she is entitled by societal dictate to be called “doctor.” If there is a problem, it’s not with them but with the people who refuse to accept it.

25

Here’s the deal (at least in the U.S.) … When the honorific “Doctor” is used in front of a name, the default assumption is that the person has a doctoral degree in a medical field, be it medicine, dentistry, podiatry, optometry. That does not mean that anyone else with a doctorate can’t be addressed (or insist that he or she be addressed) as Dr. So-and-so, but then comes the qualifier (sometimes expressed verbally) “but not a medical doctor”. This includes PhDs, JDs, and even PharmDs. Since this is the IMHO board, I do think that it’s a reach for social superiority when someone with a non-medical doctorate insists on being addressed as Doctor. The only exception to this might be within an academic setting when a professional relationship between instructor and student is needed. But even in that case, being on a strictly first or last name basis works fine.

26

My father was an English PhD and was called Dr. Crayons a lot, though he never asked anyone to do so. Dunno why.

27

I’m not considering “Mr.” an honorific. I’m not sure if that is supposed to be encompassed under the term honorific. I’m simply opposed to anything elevating someone above Mr. or Mrs. If I’m singling out Dr., it’s just because that’s the only one people come in contact with. I suppose judges go by “the honorable” and whatnot, and yes, I would be opposed to that as well.

28

I don’t want to turn this into whether or not a PhD is allowed to use the term “Doctor” to describe themselves. What I want to know is why anyone does.

So, far, other than Polycarp’s example of clearing up who is in charge in an emergency, which I concede could be an exception (I don’t feel like I can post in Great Debates because I’m too willing to give ground…), it seems to boil down to commanding respect among coworkers.

Here’s the problem: it isn’t COMmanding respect, it’s DEmanding respect, and outside of the military, that isn’t going to work. Commanding respect is a matter of truly being good at what you do, treating your coworkers, regardless of level, well and it takes a while to build this sort of respect. Demanding respect comes from superficial things like either yelling at someone or demeaning someone; the effect is immediate, but I don’t think it’s effective in the long run.

I think if you are a good doctor, and command respect, you don’t have to worry about hierarchichal issues, and won’t have to demand that people call you anything.

I don’t know. My two cents.

29

I don’t mean this as rhetorical, I mean this as a real question: Do you think that your coworkers would not be focused on patient care if they didn’t call you “doctor”? My research associates (the term for those “below” me) call me “Five”, and we’re focused on our science pretty intently. I feel like it allows them to come to me with anything, and what’s more, they often have GREAT scientific ideas. If I were “Dr. Lurker” (a good comic book villian), I’m not sure they would feel as comfortable coming to me and we might all lose out.

Do you think that it might intimidate a nurse to not speak up about perceived problems in patient care if she has to go see “Dr. Smith” instead of “Dave”? Don’t you think that a patient is more likely to tell “Susan” about her rash than “Dr. Jones”?

30

That’s an interesting topic. The idea is that the student is acting in the context of a physician (which has traditionally been denoted by the “Doctor” title), and that his relationship with his patients should have the same dynamic as any other doctor/patient relationship, for the benefit of both the student and the patient. If, as many believe, using the honorific “Doctor” is useful in fostering that dynamic, then it should be employed.

The book we used in med school on medical interviewing says that it’s OK for a medical student to insist that a patient refer to him as “Dr.” whatever, and even gives a little script for how to address it. That, I think, is going too far; I would not let any of my med students insist on it. But I do often refer to them as “Doctor” in front of patients just to foster that dynamic; if patients ask, I’ll usually be rather light about it: “She’s got a year or two left, but it looks like she just might make it, so we don’t split hairs.” Most patients are fine with that; if anyone has a problem with it, I drop it, and encourage the students to do the same. (I can think of maybe once when it has been an issue.)

When we’re not around patients and I’m quizzing them or something, I’ll often exaggerate it, referring to them as “DOCTOR” suchandsuch with widened eyes. We often did this to one another in med school, partially as ego boost and partially as a huge joke. This is, in fact, how I got my user name; it was a med school nickname that built out of that.

31

No offense, but you seem to be hung up on having to call someone something they wish to be called when you would rather call them something else. Isn’t the problem, then, with you and not with them? If it truly makes no difference in terms of their job performance or leadership abilities, why does it bother you so much? It sounds more like a lack of respect on your part than a demand for respect on theirs. Maybe you need to sort through some insecurity issues.

32

I know that in the University of California, we usually called our professors “Doctor so-and-so”, unless they asked us to address them more informally. “Professor” was almost never heard.

The real reason Ph.D.s may be missing out, as it were, is that these days, everyone is missing out, so to speak. Even if you don’t have a Ph.D., how many times does anybody call you Mr or Ms.? It’s not really done much anymore, except in forced situations like that at my local grocery store, where the clerks are supposed to read customers’ names on the receipts and say “Thank you, Mr/Ms X, please come again.”

33

I studied under Dr Elinor Burkett (author of ‘The Baby Boon’ and some other screeds) for a few years during my undergrand. Great woman…great professor…volatile as all hell.

She started each of her classes with something like this…

“Hello everyone. I’m Dr Elinor Burkett. You may call me ‘Elly’. That’s what I go by. However, if you don’t wish to it can be fatal to refer to me as ‘Mrs Burkett’. It’s ‘DOCTOR’ Burkett at that point. Oh, and the females in this class aren’t girls…they’re women. Now let’s begin.”

Elly is a corker.

I’ve also found that the ‘Mr’ thing has applied in England. In the states I can’t remember the last time I referred to someone (other than a formal or negotiating situation) where I didn’t refer to a colleague or boss by his or her first name. But on some travel to England for business senior people (even just one rung up) were always ‘Mr’ or ‘Mrs’ so and so by the staff.

It’s one of the things that put me off pursuing a job there a while back. That and my industries (in England) habit of requiring suits and such whereas in the US I can be a dockers and polo wearing guy.

34

Just one other question, does it really take twice as long to get a Ph.D. in the hard sciences as to get an MD? Even if you factor in the years of internships and residency requirements that the doctors have to meet before they can hang out their shingles?

35

The average in the life sciences a few years ago was 7.8 years to PhD. That’s with no vacations, summer or otherwise, so it’s a real 7.8 years. 4 years for the MD, with some time off in there.

I’m not counting residencies, but I’m also not counting postdocs (which is the PhD equivalent of the MD residency, and is absolutely required to get any position). If we include both of those, it gets more complicated. I think the average PhD ends up postdocing for about 8 years. But, that stat is misleading, because the majority (91% last I saw) never get a tenure track position, and end up quitting academic science for something else. Best case scenario, you aren’t a full fledged PhD professor until age 40 or so, and that is very, very, very rare.

MD residencies obviously vary by time depending on specialty.

36

See, that’s exactly the response I wanted to avoid, and I think I’ve gone to pains to show that it’s not the case. I have the utmost respect for MDs; I would never suggest that it was easy to get there. I hate to pull the “some of my best friends are doctors” thing, but it’s true. Though, the ones I’m friends with tend to be the ones who agree with me on this thing.

I think it DOES cause a problem in job performance and leadership abilities. Have you ever spoken to nurses? Many of them HATE to work around doctors. I think the culture of elevation, of which honorifics is a large part, is part of the problem.

I also think I’ve outlined how it I believe that it affects patient care.

37

Let me elaborate, I wear scrubs and a lab coat every day. I am a research scientist. I can answer a lot of questions about my particular field (diabetes and islet cell transplants) however, I am *not * a medical person. I can barely give persons directions around the campus, including admitting rooms, and various buildings. Since I have a lab in one building, and an office in the medical wing, I am often mistaken for an MD. People ask me medical questions all the time, and I have to tell them I’m not a Dr.

In my facility, even the housekeeping staff wear scrubs. once you’re there for a while you get good at distinguishing the staff by the color of their scrubs. The students wear dark blue, the medical staff wear the hospital distributed strange blue-green, and the nurses buy their own, usually pattered, scrubs. This is why the doctors come into a room and say “I’m Dr. Feelgood, how are you feeling today”.

Personally I wish the nurses would go back to white, and the Dr.s would be the only ones wearing scrubs and/or lab coats.

All of this said. Yes. Under a fair number of circumstances MDs want to be called “Doctor” strictly as an ego stroke, and for some as an excuse to push people around. Moreover, in my opinion, the new Doctors are the worst. I don’t give two hoots how long they’ve been in school, they do not know more than an RN who’s been doing her job (and in some cases, a good part of theirs) for thirty years.

I agree with you in that an honorific is to be used only when a superior/supplicant relationship is required. as such, all doctors I work with (barring the head of the department) I refer to either by their fist name, or their last name only, as in: “Is Goldstein in?”

That said, almost every Dr. I work with has introduced themselves to me by their fist name. I think they introduce themselves to their patients as “Dr.” simply to put them at ease. I mean, when someone is removing you liver, and putting in a new one, I think it relaxes folks to believe that the guy has a lot of schooling. this is clearly conveyed by an introduction of “Good morning Mr. Smith, I’m Dr. Liverremover”.

38

I don’t object to calling a doctor “Dr.” However, I don’t think that only doctors should be entitled to their honorifics.

In particular, I lament the demise of the old Southern honorific “Colonel,” once applied rather indiscriminately to lawyers and various prominent members of the community.

Perhaps we can revive this tradition by bestowing that title upon prominent posters and/or old-timers here on the SDMB.

You may now call me Col. spoke-, thank you very much.

39

A reasoned response, light strand. I agree with most of it. Thanks.

I would still argue that in the rare instance of you or I being mistaken for an MD because we’re wearing lab coats, a brief, “Whoa there dude! I don’t know why your thingie turned green and fell off. I’m a scientist,” will usually suffice. Therefore, it’s probably not necessary in your average doctor’s office where emergencies are rare, if they occur at all.

40

I call doctors by their first names, especially when they use mine. The only doctor we see regularly who calls me Mrs Flora is one who recently returned from the US. I think it’s a cultural difference though as I’ve never had anyone get irritated with me. Most of the doctors we see regularly will identify themselves as Joe Shmoe in email or when they ring me.