Why do I have to call anyone "Doctor"?

[DoctorJ]

I really don’t feel so strongly about this that I want to argue about it.

While I appreciate the effort to tell the patient that the “doctor” is a medical student, you are assuming that your patient knows that medical students are not in fact doctors.

Perhaps. My experience is that it usually goes the other way; people don’t think it’s right to call me “Doctor” because I’m still a resident.

Here’s an interesting question–one of the first third-year med students I worked with was returning to med school after getting a Ph. D. in pharmacology. Would you have been upset if I had referred to him as “Doctor”? I would not have treated him any differently; I still would have disclaimed any reference to him as “Doctor” by explaining that he is a med student.

I appreciate the justification that it is for the good of the medical student, but guess what? The hospital is not there for the good of the medical student. His or her needs come a distant second to the patient.

Yes, but I don’t feel that occasionally referring to a medical student as “Doctor” does appreciable harm to the patient’s needs, just as you see it has having no appreciable benefit to the student’s training. That’s why I really don’t feel very strongly about this.

The balance between patient care needs and a student or resident’s training needs is a whole other topic. When the veteran critical care attending lets the intern who has never done one put in your subclavian line, he is putting the intern’s training needs ahead of the patient’s needs, but that intern has to do his first one sometime.

And, if I, as a patient, don’t want to be seen by a medical student, which is an entirely understandable feeling, that’s my call, not yours.

True, though I think that when you come to a teaching hospital, your admission paperwork includes a statement that some of the work done may be done by students or doctors in training, and that if this is unacceptable, you’re welcome to go to another hospital.

It’s refering to the job that person’s doing? Oh C’mon! I suppose you call the nurses “doctor” too? You know, cause they’re doctoring. And the orderlies?

No, because nurses and orderlies are doing very distinctly different jobs. We’re all parts of a machine, and the medical student is doing the doctor’s part.

To me, it is like referring to a third-year law student as “Counselor”, which (correct me if I’m wrong) is not a title that comes with the J.D., but is more of a job description. Or it is like referring to a guy in his last few weeks at the police academy as “Officer”. It just happens that our job description and the academic title that often comes with it are the same word.

Again, I don’t know what the current status of this debate is, because I remember this came up a few years ago. I’d actually appreciate an update.

It’s about where it has always been–some believe that students should be able to insist on it, some believe it is always inappropriate. Some, like me, feel it is OK to do it informally and with minimal room for confusion. Others address them as “Student Doctor”. There is no consensus, and it isn’t something so important to us that we feel the need for one.

[Fiveyearlurker]

I’m not even going to attempt to code my response!

Anyway, in regards to calling a PhD “doctor” in front of patients. I’m actually against that for both reasons that we’ve discussed in this thread; the use of an honorific as well as deceiving the patient, who expects “doctor” in this context means “medical doctor”. So, no, I think that would be wrong for two reasons.

Just because I sign off on being allowed to be treated by medical students at a teaching hospital does not mean that I’ve signed off my right to knowing when that is occuring. I have no problem with being part of a medical student’s education, but I want to know the level of training that the person I’m getting medical advice from, at least to the point of knowing if they are actually a doctor; you have to remember that my primary goal in going to a hospital is to get better, not to be a lesson plan. If I can be both, fine, but I am not going to base my treatment on the advice of a third year medical student. That’s my right to make that decision, and not yours to take away from me by not telling me that this “doctor” is actually impersonating a doctor.

I appreciate the discussion of it eventually having to be the doctor’s first time. Things you don’t want to think about on the business end of a scalpel. But, at least in that example, you’re talking about an intern. A doctor. Not a medical student. Medical students are not interns. Medical students are not doctors.

[Purple_Scottie]

When meeting patients or their families, I always introduce myself as “Clipperfirstname Clipperlastname, a resident working in [clinic/ED/etc] today.” I address the patient using either Mr. or Ms. – if I know that they hold a doctorate or other degree I’ll use the appropriate title. I feel silly introducing myself as “Dr. Clipper” because I would have never introduced myself as Ms. Clipper prior to receiving the MD. The exception that I’ll make to this custom is when I’m working with children and adolescents – then I do introduce myself as Dr. Clipper.

[Fiveyearlurker]

@clipper

When meeting patients or their families, I always introduce myself as “Clipperfirstname Clipperlastname, a resident working in [clinic/ED/etc] today.” I address the patient using either Mr. or Ms. – if I know that they hold a doctorate or other degree I’ll use the appropriate title. I feel silly introducing myself as “Dr. Clipper” because I would have never introduced myself as Ms. Clipper prior to receiving the MD. The exception that I’ll make to this custom is when I’m working with children and adolescents – then I do introduce myself as Dr. Clipper.

I absolutely can not argue with that. I think that is perfect.

[Gymnopithys]

What about people who are not Dr. and are called Dr. ?
I have written in scientific journals and receive letters or emails addressed to Dr. Gymnopithys. It makes me very confused, and let them know at once while wondering how much lower I am going down in their esteem !

[pseudotriton_ruber_ruber]

When my then-four year old got a splinter, I tried persuading her that it needed to be removed with a tweezer immediately, but she was unwilling. “A doctor has to do that,” she insisted.

“But, honey, I AM a doctor,” I said (I’ve got a Ph. D. in literature).

“Not the right kind of doctor,” she said, still hiding her finger from me.

Eventually, I talked her into letting me perform the operation, but that was the last time I tried fuzzing that particular ethical line.

Do you agree I was behaving unethically in my initial gambit?

[Ronald_C.Semone]

In support of Still Gassy’s comment that “…the Ph.D. has more historical claim to the title [Dr.] than the physician”, I once heard it argued that that Ph.D. degree and title should be much more prestigious than an MD degree and title since the former implies that the holder is a thoroughly educated person and the latter only that the holder has gotten training in a trade. Food for thought.

[Tenar]

@Still Gassy

Emily Post should look up the etymology of “doctor.” The Ph.D. has more historical claim to the title than the physician.

To this (and the above post by Ronald C. Semone): I do not doubt that you are correct. However, usage does change over time. (BTW-- I am neither a PhD nor an MD, just an occasional patient.)

For anyone who cares to know, and apropos of nothing: In 13 years of working in the NY State court system, I have NEVER had a Judge ask me to call him or her by their first name in ANY context. (I can understand this in the courtroom, where decorum must be maintained, but not at the company picnic.)

[Othersider]

I was wondering this yesterday, while writing a letter to the local judge to ask for an extension on defensive driving paperwork - what is a good way to address a (professional) letter to people with honorifics? When we speak to them, we call them “your honor”, “your eminence”, etc…and when we refer to them in third person, it’s “his excellency”, “his holiness”, etc. Maintaining the same level of formality, what is a good way to address a letter to “his (or her) honor”?

[brossa]

Another MD chiming in…

I introduce my self as “Dr. Lastname” when meeting a patient for the first time, and I address the patient as “Mr/Ms/Dr. Lastname” unless the patient asks me to do otherwise. This establishes a certain formality to the ensuing conversation/examination which I feel is entirely appropriate. I routinely perform procedures or do examinations on patients that would be considered battery or assault in other circumstances (e.g. a rectal exam). My use of the title establishes that the following encounter is a medical ‘transaction’ and that I will conduct myself professionally, and that I expect the patient to do the same. This is not a friendly chat with my friend who just dropped by - someone is paying me for the use of my expertise. Frankly, if a patient insisted on calling me by my first name before we had a long-established clinical relationship, it would set off alarm bells.

I do not introduce myself as ‘Dr. Lastname’ in nonclinical situations, and if asked what my profession is I say ‘physician’. I do not have ‘M.D.’ on my checks, credit cards, etc., because I find that pretentious. I refer to medical students as ‘student doctors’ to prevent confusion. In general, when speaking to other hospital employees, I will use their title and last name (Nurse or Ms. Smith) in public. I do not have enough contact with the ward nurses to be on a first-name basis with them, but I am on a mutual first-name basis with many ICU nurses and OR nurses. I don’t find that it demeans me to acqnowledge the achievements or dignity of strangers- sort of saluting the rank, not the man.

[Taber]

@light strand

I’d be willing to my physician “Doctor” if he called me “Ms.”

I bet that’s one physician who deeply regrets not calling you “Ms.”