To wonder why we always call doctors by their last name

[Loveandpeace56]

In any other profession this wouldn’t be the case. Even teachers do often refer to themselves by their first names but with a doctor this would never happen.

Dr is their title like Mr or Mrs. Most teachers do not use their first names, only in FE and HE.

It’s odd, isn’t it?

I call my GP ‘doctor’, but I call my dentist ‘Raj’ and my vet ‘Alice’. Perhaps it’s because at the vets or the dentist I’m a paying customer, but at the Doctors, I’m just a patient.

I view all three as my peers in terms of education and professional status, but the power balance of the interaction is fundamentally different.

@Nowaynothappening

Dr is their title like Mr or Mrs. Most teachers do not use their first names, only in FE and HE.

There are many more professions besides doctors and teachers - most use informal forms of address.

@AgeLikeWine I think you have hit the nail on the head!

Some doctors use their first names especially if long/foreign which are difficult for older people to hear/remember

I'm Dr Firstname only helpfully it's Dr long/foreign Firstname and simple English surname. Am I doing this wrong?

Anyway we are all on first name terms and the doctor bit helps them distinguish whether they are talking to one of the doctors or one of the nurses.

😂I can’t imagine having the social confidence to address a dentist by their first name (or a solicitor, as someone mentioned in a previous thread)!

You misunderstand me RosesandHellebores

I do not want or need to be in the powerful position in the interaction I just am. I'd rather not be but it is what it is.

I explained to you that as a patient I feel the same. Being a patient, being unwell, is inherently a powerless position.

You can't actually change that by paying the person. Quite literally they have the power of life and death over you in some interactions.

Doesn't matter how well educated rich or powerful you are in every part of your life. If you are in pain and I've got the morphine then I am in the powerful position. If you are lying prone with your pants round your ankles and I've got my finger up your bum is it seriously an interaction of equals??
If you won't admit that then you just won't admit reality.

Bad Drs take advantage of that
I am a good Dr so I do not
People often beg me to see them privately in fact because I am excellent at what I do but it's not my ethics.

I also have both a PhD and a medical degree so either way, even by your own rules, I have earned the right to be addressed as Dr.

But that isn't the reason I insist on it
It's for your own protection if you are the patient and not my ego. My ego is not fragile enough to need that kind of propping up.

And just thinking about it, I paid my vet £99 on Monday. She's called Tracey. Calls the cat Midnight and me Mrs Hellebores. The whole practice are always so polite and caring. Sometimes they say "oh don't worry Midnight's mummy". If the children were ill it was always "you mum?" Not even are you Imogen's mum? So heavy handed!

It's interesting how professionals who need you to pay them are so polite. My dentist's a gem and a gentleman too.

The Dr does have the power in a Dr patient relationship.

The doctor does not and should not 'have the power'. They have experience & qualifications, yes. But they don't know everything and aren't infallible. This is why there's rafts of GMC guidance on respect for patients, confidentiality, consent, capacity etc. Patients have every right to question the doctor, seek second opinions and as much information as they like.

Doctors 'having all the power' takes us near back to the dark ages when women would be sectioned for arguing with their husbands. Because the doctor 'had the power'.

DouglasRossIsTheBoss providing I have the ability to consent or otherwise, I retain the power. When I can't hopefully my nearest and dearest will have the power, via POA, not the Dr who respectfully imo is there to facilitate choices or decisions rather than take them.

I am sure you are a decent person from all you have written but you will never be more than the equal of another human. Neither shall I but I do have the power of choice and it is irksome when some employees speak to me and others as though they are something on the shoe and it happens too often within the NHS. Admittedly more from admin staff and very sadly nurses (don't set me off about midwives) than drs if I'm honest.

I used to work with somebody who had a military title and insisted that I call him by that when addressing him, not Major Tom just Major. He'd then call me by my first name and so would object when I called him by his first name. It doesn't work like that. I wasn't in the military so I wasn't prepared to do it and called him Tom.

@theDudesmummy

Consultant surgeons are Mr/Mrs/Ms etc. All other consultants, including physicians and psychiatrists, are Dr.

There seems to be a lot of confusion about this. Being called Miss/Miss/Mr isn't related to whether someone is a consultant surgeon or not. The change of title comes when they pass their surgical exams and become MRCS qualified (or as was, FRCS). So they can be Miss/Miss/Mr for some time before becoming a consultant.

Once again slowly for those who don't understand

All that regulation and the GMC etc is there precisely because of the potential for the power inherent in the relationship to be abused.

Do you lot really feel in a powerful commanding position when in labour or having a colonoscopy? I know I didn't in either of those situations

It isn't even vaguely comparable to taking your cat to the vet it's inherently vulnerable being a patient so Drs have to take extra care not to exploit that power.

But denying that that is the power dynamic doesn't help anyone.
It's not something Drs want or they create it just is.

Hospital doctors are often dr First Name, at least below consultant level.

I realised because of this thread that I didn't actually know my GP's first name, so I looked up the practice. Now I know why the two senior partners are always called Dr Surname! One is a Kirsten and the other is a Kristen! The confusion would be fairly amazing if they used their forenames.

As a mature student at university, I called the tutors (who were mostly younger than me) by their forenames if we were doing one-to-one tuition or having lunch or a drink in the pub together, but Dr Surname in seminars and lectures because they preferred it when there were a lot of us around them.

@melisande99 it depends on the situation, I asked and he says he tends to introduce himself first time as Dr first name last name, and ask what they would like to be referred to as ... this tends to lead to what they end up calling him they tend to be related. Sometimes he will just introduce himself as hi I'm first name, your dr.
He basically just wants his patients to be comfortable, many are going through something frightening when then first meet him and he wants to put them at ease.

I'm a shrink. I am speaking about the psychodynamics of patient Dr relationships not the legality (although under the Mental Health Act I sometimes have legal power too)

Yes you can refuse treatment (unless MHA applies) or you lack capacity. You can go against advice and that's always your right to do so and I have no desire at all to stop you. It's your life. That's not what I'm talking about.

I'm talking about how it feels to most patients and it is an experience that everyone can speak to that they feel vulnerable and not in charge in many many medical situations. That is because this particular area of expertise is related to choices that can be life and death or very serious. It's not the same as your mortgage or even your child's education. You are trusting Drs with your life.

As a Dr you are not a good Dr if you do not realise the power you have and acknowledge that patients are quite likely to be scared and in awe of you. You need to go out of your way to redress that for most patients and how can you do that if your deny it exists?

"Those who don't understand" - "do you lot"! I do understand duckie and no more shall I address you with the respect you appear to think you deserve now as am lumped into "you lot" which afaiac sums up NHS attitudes very accurately. You do realise I suppose that some of us lot actually fund the NHS?

When I had my colonoscopy I was paying the consultant and the anaesthetist and the Dr in recovery and the nurse back in the room. So yes although vulnerable I did have the power because if any of them had put a foot (or perhaps finger) wrong, I wouldn't have paid them.

In Labour with DS1 he nearly died on the NHS. I never let you lot have that level of power or control again.

As you were. Money = choice = power. Even NHS services are free only at the point of delivery.

@ikltownofboothlehem

The Dr does have the power in a Dr patient relationship.

The doctor does not and should not 'have the power'. They have experience & qualifications, yes. But they don't know everything and aren't infallible. This is why there's rafts of GMC guidance on respect for patients, confidentiality, consent, capacity etc. Patients have every right to question the doctor, seek second opinions and as much information as they like.

Doctors 'having all the power' takes us near back to the dark ages when women would be sectioned for arguing with their husbands. Because the doctor 'had the power'.

This in spades!

I don't call anyone I deal with professionally by their Christian name (unless I know them).

I would also expect them to address me as MrsR. In a formal situation that's what happens.

pigsDOfly they don't call them Dr Mary or Dr John which is acceptable they just call them Mary or John but the GP's never introduce themselves as Mary or John but as Dr Mary surname or Dr John surname.

Taxpayers fund the NHS
Drs are taxpayers as much as anyone else.
I could argue that I fund my own job. I always find that one a non sensical circular argument

I feel sorry for you RosesandHellebores that you have clearly had such a bad experience that the need to be in control is so very strong for you.

You were no more in control when having that colonoscopy though than I was having mine. We were both pretty powerless as patients in that scenario and very much in the hands of the people doing it who we were obliged to trust.

Yes you could have refused to pay or sued them if something went wrong but at that moment the power was in the hands of the person with the scope up your bum.

I'll give up arguing now because clearly people don't agree with the point I'm trying to make but

I am NOT saying that being a Dr makes me inherently more worthy of respect or that I want to boss people around

I AM saying that it is a well acknowledged psychological aspect of medical consultations that the power dynamic is skewed and that good Drs will be aware of that and try to correct it.

The link to the point of the thread is that use of formal language on both sides is a mechanism to boundary a psychologically dangerous interaction and make it safer for both parties.

Well I can't disagree that that the "power" imbalance is improved when the Dr addresses me as their equal.

Shame I only needed a dr's finger up my bum due to a significant rectocele and damaged anal sphincter caused by medical incompetence in the first place - ie a botched birth because a twit of a midwife couldn't tell the baby was posterior and the heart beat dropping was because he had the cord wrapped round his neck and not due to a faulty belt. The cord was cut inside because he was too far out for an ecs and had to be born swiftly. Fortunately after a night in scbu he was fine!

My failing was that I was told he was posterior at 36 weeks by a Dr. I read up and decided I would ask about a carsarean at the next set at 37 weeks but Labour started at 36.3! Sadly I didn't have the courage to raise it once I was on the mat ward but never ever again. I am sure "the lot" like me keep you busy and unnecessarily so if there was greater competence at the birth stage.

" I wasn't in the military so I wasn't prepared to do it and called him Tom."

Good for you. Why should a civilian use military titles? I'm not a monarchist so I don't care about HRHs, Sirs, Lords, MBEs, etc. I can't see how I'd ever get into trouble for not using except at work maybe, it's not illegal to call every man Mr X and every woman Ms Y.

I think that it is is basic manners that if you want to be called Mr X you should be using other people’s titles and that if you’re using other people’s first names then you should expect to be called by your first name. Anything else just smacks of ‘but I want to show you how IMPORTANT I am!’

I agree. “Hello Jane, I’m Dr Bassingthwaite”, makes me feel belittled. I’m happy to be called Jane, if I can call you Eve (or Steve). Otherwise, I prefer Ms Cattenberg.