Whilst the title of our latest article may sound farcical, hear us out. Studies are being conducted to show the dynamic between a patient and their Doctor, and how removing the word Doctor, can have trust implications.
The relationship between a doctor and their patient is sacred. Both parties need to trust each other to create a successful working relationship. But some patients are now calling their doctors by their first names instead of using the title doctor, and some providers say the exchange has become too casual.
Dr. Yul Yang, a dermatologist at the Mayo Clinic in Scottsdale, Arizona, prefers to address his patients by Mr. or Ms. – even if they ask him to use their first name – as a way of distinguishing between his role as a professional and a more personal one, such as a friend or confidant.
But his patients often call him Yul instead of Dr. Yang. He finds it “kind of awkward” but he lets it pass. He and his colleagues recently conducted a study to see how many patients call medical providers by their first names. They examined tens of thousands of emails between patients and doctors at their institution. The results, published in JAMA Network Open, highlighted a few surprising trends behind this phenomenon.
According to the results, female doctors were twice as likely as male doctors to be addressed by their first names. The same was true of doctors of osteopathy compared to doctors with an official M.D. in their title.
Male patients are also more likely to use a doctor’s first name compared to female patients. Patients were more likely to use a first name when addressing general practitioners compared to specialists.
Yang and his colleagues didn’t find any differences based on age. However, the study didn’t take race or ethnicity into consideration.
Experts suggest this language could be a sign of disrespect.
The results note “a subtle but important form of unconscious bias” against female physicians, general practitioners, and doctors of osteopathy, wrote Lekshmi Santhosh and Dr. Leah Witt of the University of California, San Francisco, in a commentary for the study.
“Use of formal titles in medicine and many other professions is a linguistic signal of respect and professionalism,” they added.
Yang added that many facilities and providers ignore the issue altogether. At Mayo Clinic, at least “doctors don’t talk about it,” Yang said. But putting an observer in the room changes everything. “Once an observer is in there everyone’s behavior will subtly change,” he said.
This is the largest and most comprehensive study on the issue to date. A study from 2000 showed that around three fourths of doctors said some of their patients call them by their first names some of the time, but little else is available on the subject. Yang and his colleagues went through 29,498 messages from 14,958 patients sent from Oct. 1, 2018, to Sept. 30, 2021.
Experts say this is a relatively new phenomenon. Even just a few years ago it was unheard of for patients to refer to doctors by their first name, says Jonathan Moreno, a professor of history and sociology of science at the University of Pennsylvania.
“My father was a psychiatrist with his own sanitarium in Beacon, New York, where I grew up,” he said. “Patients, their families, staff, townspeople never addressed him as anything but Dr. or referred to him as ‘the doctor.’ I don’t remember my parents ever referring to his colleagues or their own caregivers as anything but doctor, unless they were close friends.”
It may be a sign that the world is becoming increasingly informal – whether doctors like it or not. The 2000 study showed that 61% of doctors were annoyed when their patients addressed them by their first names.
Debra Roter, an emeritus professor of health, behavior, and society at Johns Hopkins’ Bloomberg School of Public Health, says this language can undermine the doctor-patient relationship.
“Doctors might find it is undermining their authority,” Roter said. “There’s a familiarity that first names gives people.”
But she said doctors referring to patients by their first names can be just as damaging.
“It could infantilize the patient or establish the paternalism of the doctor,” she said.
However, she said using a patient’s first name is better than using language that could be seen as derogatory or sexist.
“I had an experience with a new doctor,” Roter said. The doctor entered the exam room where she was waiting and said: “Oh hello dear. Please come up to the table.”
“I was almost like, ‘Do I know you?’” Roter said. “I never went back.”