Dr. Harrigan is an associate professor of emergency medicine at Temple University Hospital and School of Medicine in Philadelphia.
The scenario is a familiar one: You grab a chart, stride across the busy ED, mind on a hundred things, multitasking (I hate that word). You pull back the curtain, walk into the patient's room, and say, “Hi, I'm Dr. Harrigan. What brings you to the hospital today?” Greeting patients is not the most exciting thing we do, but it certainly is something we do all day, every day.
Now, let's try this from another angle. This is not something that happens every day. You are sick. You go to the hospital; maybe you wait for hours in the ED waiting room. You finally get a room, which often is not a room but a physical space defined by a wall and three curtains that don't quite close. You put on a patient gown, and wonder who last wore this rag. If you're a rookie, you mistakenly put it on like a shirt, open in the front. Now you lie on an asphalt stretcher waiting to meet the doctor in your vintage cotton gown with one snap at the neck that is otherwise wide open to the knees. You are about to meet someone who will ask personal questions and examine your body. Tests will be ordered, decisions made, treatment rendered … you are totally at the mercy of this stranger.
We all had this explained to us in medical school. And, to varying degrees, we all understood it; hopefully it made us better doctors if we considered life on the other side of the stethoscope. I'd like to suggest a new wrinkle, however, one I'm sure was not taught to you in medical school.
Figure. Richard Harr...Image Tools
Consider this: Drop the title. When you see your next patient, greet him formally and tell him you are his doctor, but try introducing yourself without your title, just your first and last names. Why? Why not? I have yet to hear a good explanation why our profession warrants a special means of address. Respect? If you feel respected because someone calls you doctor and disrespected because someone fails to, then you have bigger issues to deal with than respect. Convenience? This is only a matter of a couple of extra words. Habit? Okay, but it's like your mom said, some habits are made to be broken. Try breaking this one.
If we introduce ourselves as people, not as doctor-people, then we have helped remove the first barrier to establishing the doctor-patient relationship. It immediately brings you closer to the patient. Your patients give up a lot when they come to the ED, including but not restricted to their time, clothes, comfort, and dignity. Give up your title. This is really not a doctor-patient relationship; it is a person-to-person relationship, and you just happen to be a doctor. The success of the doctor-patient relationship is determined by the same factors that determine person-to-person relationships everywhere.
What will your patient do? My observation is that most patients still call you “Doctor” or “Doc” so for those of you who are worried that you might have to get used to patients merely calling you by your name, I'm sorry to say that most people still reflexively use the title. Be prepared, however: Some will call you by your first name. It's strange: People actually calling you by your name.
‘If you feel disrespected because someone fails to call you doctor, then you have bigger issues to deal with than respect.’
While I'm on the subject, what's up with this? Why do doctors introduce themselves as doctors to other doctors? I've been an attending for 14 years, and this still kills me. For instance, I call for a consult, and when the consultant calls back, I'll say, “Hi, this is Rich Harrigan. I'm the ED attending.” And, to my amazement, more often than not, the voice on the line informs me that this is “Doctor So-and-So.” And this is not specific to attendings; it is a disease that has affected fellows and residents.
On occasion, I'll ask the person why he is not disclosing his first name. Is it a secret? Is he embarrassed about his first name? Perhaps he has simply forgotten it having introduced himself as “Doctor” for so long. Often I have heard something to the effect that, “We've never met,” or “We don't know each other.” Does that make sense to you? That is the purpose of the introduction. We're all in the same club. How well do I have to know you before I get to call you by your first name?
I did my residency with a guy who must have really liked being a doctor. I'll change his name here, but he signed his notes as “Dr. Warren Lorman, MD.” We used to call him “Doctor Doctor.” But he hung in there for three years with the double-title approach to signatures. True story.
I'll close by admitting that some of the people I like and respect the most in our profession don't line up with me on this issue. And although there are plenty of arrogant doctors out there, I've found no correlation between haughtiness and introducing oneself as “Doctor.” So please don't take this personally if you are a doctor who has and always will introduce yourself as such. My aim is to question an old custom that needs to be rethought. Hey, this could be contagious. Who knows? If we embrace this and stop introducing ourselves as “Doctor,” maybe judges everywhere will not insist on being called “Judge.”
Or … maybe not.
© 2006 Lippincott Williams & Wilkins, Inc.