Should Patients Call You by Your First Name?

One Doctor's Naming Journey

Then there are physicians, such as Roger Suss, MD, a lecturer in the department of family medicine at the University of Manitoba in Winnipeg, Canada, who change their views over time as to what they should be called by the patient (or vice versa). When he was fresh to the practice of family medicine, he recalls being a little hesitant as to what he should call himself. Because his name is pronounced like "Dr Seuss," the famous children's book author, it seemed almost humorous for him to be introducing himself that way. He then decided upon using his full name—Roger Suss.

The results were interesting. Some would choose Dr Suss, which to him suggested a preference for a "traditional" doctor/patient relationship. Others would use Roger, suggesting a desire for a less hierarchical relationship on a more equal footing. However, he realized that at least to some patients, his reluctance to openly refer to himself as the doctor may have suggested to them that he wasn't quite ready for the job.

"I've come to realize that some people like a more egalitarian relationship with their doctor, and some like a more hierarchical relationship," he says. "As a young man, I projected my value of egalitarianism onto others."

"I continue to introduce myself as Dr Suss. I view it as a danger sign if my patients want to call me by my first name, but I don't confront it," he explains.

As for patients, he generally greets them by their full name when he introduces himself. If they're significantly older, he calls them by title (Mr, Ms, etc.) but otherwise shifts into using their first name unless there's a reason not to. On the occasion when there's tension in the relationship, he'll switch to using the title.

Peer-to-Peer Etiquette

Another issue in the first name/title situation are coworkers—namely those who help you care for patients, such as nurses, other physicians, and residents.

For some reason, nurses have by and large been appropriated to "first name only" status. In old black-and-white movies, nurses dressed in starched white uniforms and even stiffer caps are usually called "Nurse Kaplan" or at least "Miss Ramirez." Somewhere along the line, title/last name has been replaced with a first name, and in many hospital settings, a nurse's name tag only has a first name ("Maria, RN").

Dr Valinoti notes a bit of injustice in this situation. "Freshly minted MDs, some as young as 25, get a title of respect while seasoned nurses in the hospital are Betty, Kaye, or Nancy."

During her intern days, she recalls the "absurdity of this situation" when addressing critical care nurses who had decades of experience by their first names while they deferentially referred to her as "Doctor."

"These were women who had started their careers when I was still playing with Barbie dolls, yet where were their professional titles?" Dr Valinoti says.

However, depending on the hospital unit, clinic, or practice, the rules of name etiquette can vary tremendously. In many settings, everyone's on a first-name basis. In others, things are more formal. Sometimes, first names will be used exclusively when staff are alone, but then they'll revert to the more formal titles in front of patients. In the military, nurses can outrank doctors, so there's never a question of what name to use.

Dr Suss feels that physicians should call one another by first name in most settings. "My residents get used to calling me Dr Suss and often feel uncomfortable when they graduate and I insist they call me by my first name," he says. "The symmetry reflects the fact that we have become equals in responsibility. I no longer give them feedback on their practice, except occasionally as a peer."

He also encourages his staff to call him by his first name. "In front of patients, I prefer that they call me by title, but I'm prepared to call them by title if desired," he says. "The question is tied to one's interpretation of hierarchy. I consider other staff to be equals in that we both work for the hospital; no one asks me about hiring or firing them, they don't report to me, I don't set their schedules or discipline them if there are problems...but not everyone sees it that way."

Is 'Doctor' Becoming Too Stuffy?

Dr Harrigan uses his first name with all staff, whether they're nurses, pharmacists, other attending physicians, or residents. "I always use my first name," he says. "It seems utterly ridiculous to me that we go around calling each other 'Doctor.' How pretentious."

He notes that many of his residents often call him by title, largely owing to custom, protocol, and his age—57. "But after a while, I get them to call me 'Rich,'" he adds.

But on the opposite side, Sean P. Dent, a board-certified acute care nurse practitioner, notes, "I can relate to using first names. It breaks down barriers and can ease the unspoken tension that can develop among healthcare team members. It 'levels the playing field,' in a manner of speaking."

Ultimately, however, and by default, the physician should be referred to as 'Doctor' unless they prefer otherwise. "At the end of the day," Dent says, "the physician has earned the title and it should be their decision, and their decision alone, that determines how they're addressed."

Medscape Business of Medicine © 2015 

Cite this: Roxanne Nelson. Should Patients Call You by Your First Name? - Medscape - Dec 09, 2015.