Friday, 12 December 2008

Hi! My name is... My name is... My name is...

DrJDR posed me this question in a comment to a post that I made earlier in the week

I wonder what you think about the whole 'first names' question? That is, should
you (the doctor) introduce yourself by your first name - such as 'My name is
James, I'm a forensic psychiatrist'? I remember being told off in an exam for
doing this kind of thing, and since then I've always been very careful not to
use my first name and stick to surname - ie 'my name is Dr Blunt' (well it isn't
really, of course). I think that this does set the professional boundaries very
clearly which I think is important for patients. I used to constantly cringe
when hearing young nursing staff / assistants breezily addressing sick old men
and women on their first meeting by using their first names. I always thought
this inappropriate, and personally I would not like to be called by my first
name by someone I had never met. Professionalism in medicine as a whole is
something which has really suffered, and which I think we need to keep going.
Patients expect us to act in a professional manner, and when we do this gives
them confidence in us.

To be honest, I have no hard and fast rules about which title I use to introduce myself. I’ve used “Michael,” “Dr Anderson” and even “Dr Michael Anderson” depending on what seems most appropriate at the time. I have to say that my “default” when introducing myself to an adult or late adolescent is “Dr Anderson,” but I do vary it – yesterday's post for an example.

When addressing patients, I tend to use their full names to start with and then I’ll use their surnames for the rest of the conversation, unless they tell me otherwise. So, generally, it goes something this:

“Good afternoon, is it Amy King?”
“Yes, it is.”
“Pleased to meet you, my name is Dr Anderson, I’ll be the anaesthetic doctor for your operation later on today. Is it Miss or Mrs King?”
“Mrs, but please call me Amy”

Patients are frequently extremely anxious when I see them pre-operatively and you’re right, that professionalism and good communication are incredibly important.

With children, especially young children, I do tend to use first names more, but again, this is no hard and fast rule, and I'll often use surnames with children as well. It depends on the child.

At the end of the day, part of my aim is to try and make the person I'm talking to feel as comfortable as I can using whichever names I feel fits the situation best. It seems to work pretty well for me, but no doubt there's occasions where I've got it wrong and no doubt, I'll get it wrong in the future, after all, every person is different.

I do call patients “dear” or “my dear” occasionally, (yes, I know we’re not supposed to) but again, I’ll do this only when I feel it’s appropriate and certainly not until I’d built up a relationship with the person that I’m speaking to.


Claire said...

I am not from the medical profession but can comment from a patient's point of view. (I work in the private sector and I actually strive to get on to first name terms with business clients/contacts as human beings respond well to being liked and noticed). However I'd imagine that most patients feel vunerable and therefore defensive. Kindly medical staff may use 'friendly' language however a defensive patient may feel patronised.
I guess the attitude to be formal when addressing patients (and vice versa actually) lends authority to the medical staff, drawing a clear line under their position.
Having said that every patient and every day and every proceedure is different and I would imagine that you use your own judgment about how to make patients feel most at ease.

madsadgirl said...

I think that you use a very common sense approach to this perennially difficult problem. I prefer to be addressed as Mrs first and when I am comfortable with a person will normally tell them to use the diminutive of my Christian name. I do not take kindly to people who just assume that they can use it without having been told they may first of all. Anyone who uses my Christian name will normally get a bit of a blast because I do not use the name in full; my parents being the only ones who did, but then parents are like that.

Anonymous said...

I used to judge new psych SHO's on how they introduced themselves. I was looking for whether they offered to shake my hand and what they address themselves as - my preference was for a first and surname "hello I'm John Smith". It just seems more polite. I did once meet one who just introduced herself by only her first name, that was a little too informal! She would sometimes phone with follow up info after an appointment "Hi it's Jane..." which I found very weird. I would never refer to any doctor as anything other than "Dr Surname".

Conversely I hate to be called Miss X. The only people that call me that are trying to sell me something. Use my first name.

Some people are just hard to please, and I can see it must be difficult to work out what's most appropriate.

The Angry Medic said...

Ooh, now this is a post that everyone can relate to. I'm just a tiny insignificant medical student at the bottom of the food ladder, so I feel appropriate using my first name (cos, uhm, I can't exactly add 'Dr' to the front of it. Yet!) but I always ALWAYS use the patient's surname and 'sir' and 'maam' unless they tell me it's okay too. I don't get the whole first-name thing either.

But I agree with madsadgirl - you've got a very common-sense approach to the whole thing.

I'm adding you to my blogroll. Hope you don't mind the heading I've given you :)

Elaine said...

I live in a block of retirement flats with security entry. One of the postmen (the one who makes the parcel deliveries) rings the bell and says "hello, dear, I've got a parcel for you!"

I find it rather funny.

But I wouldn't expect it from a doctor.

Anonymous said...

On the flip side I would prefer that patients referred to me as Dr or Miss Smith at least until I had seen them a few times then I wouldn't mind being called Jane. What I really didn't like was when I was a house officer and (usually male patients in casualty) used to call out 'Hey Doc'. I disliked that much more than someone saying Jane but in a polite manner. I suppose it is more to do with intention of respect than the actual name used.

DrJDR said...

Thanks for your response - I'm honoured to make it to the front page! It's interesting to hear other views on the subject. I really am a forensic psychiatrist, and as such sit on the boundaries between law and medicine. It is interesting to see how the legal profession operates, and it is one in which there is a great deal more formality in general and particularly between client and representative. I think Claire's point about the risk of being seen to be patronising is an important one. I've met few people who object being addressed using their title. Using 'Sir' and 'Madam' is fraught with more difficulty - one surgeon once told me to avoid these on the basis that the only people who call you 'Sir' are policemen, and the only people referred to as 'Madam' are prostitutes! One final thought I suppose is what we think about our title - 'Dr'. My wife has a PhD and as such is keen to remind me that my use of 'Dr' is simply a courtesy title. I do remember a mad rush from my friends to change credit cards etc to 'Dr' when they qualified, but I have always felt uncomfortable about this. In fact, I only really use 'Dr X' when I'm at work and in all other circumstances remain as 'Mr X'. This feels right to me - I've found few if any circumstances where being a Dr is any help in normal life, and I feel that by using it you are sending a message that you should be treated better because you are important. This doesn't sit right with me, but conversely at work I insist on Dr X for professionalism, as per my previous comment.

Hospital Lab Tech said...

I think that demonstrating appropriate professionalism has nothing to do with the title (or lack of) you choose to be known by. I'm not a doctor, but have professional dealings with countless clinicians on a daily basis - and my respect for them (or once again, lack of) has nothing to do with how they introduce themselves and has everything to do with their manner. That's exactly the same for anyone else I encounter in my life regardless of the type of relationship I have (or am expected to have) with them.

As other commenters have said, it's generally a judgement call. I guess it may be better to call your patients by their title and surname until a professional relationship has been established but introduce yourself however you feel comfortable.

Personally, I don't like being called Mrs X - it sounds too mumsy to my ears and I just don't feel old enough for that yet!! Even worse though are people who shorten my name when they don't even know me. That drives me bananas.

Johannah said...

I think you're right, you need to adjust to every situation and every patient. Elderly patients in particular might be more comfortable being called by their second name. But if a patient feels that you are not on the same level as them, they might find it difficult to disclose embarrassing or difficult information. If calling them "dear" is going to make them more relaxed then it should be used without a doubt!