On Stage Off Stage.
Dr. Cranquis recently broached a very interesting topic that warranted discussion: that of personal address. Is it Dr. Smith? Or do I call him James like everyone else? What should I be called? It is never really discussed and it is something you feel out as the year goes on. However, there are some unspoken rules that always apply.
Imagine the hospital setting as a theatre, with both the stage - in front of the patient - and back stage - with your team. As long as the stage is set, and the patient or their family is involved, we play our roles, our characters in the hospital: Doctors are addressed as doctors; nurses are called by their first name etc. Back stage however is where the distinctions begin to blur.
Generally speaking, it is always a safe bet to address physicians as Dr. So-and-so until they give you permission to address them by their first name. The same can be said about resident doctors, who generally prefer their first name address backstage; often times they will make it clear when you first meet.
Nurses on the other hand always go by their first name for safety purposes and that makes it easy. They do not typically give out their last name in case patients become attached. Even if you do know their last name, avoid calling them Ms. or Mrs. So-and-so in front of a patient.
For yourself, you can choose to be addressed any way you so choose as long as it fits your role. I typically will go by my first name off stage, and go by the title medical student on stage. Just make it clear you are not a doctor as that revelation after the fact can break your patient’s trust in you and your team.
The more challenging issue comes with seniors whom you knew before medicine or when work must be done off stage. What then? In the former case, the importance is to preserve your roles on stage in front of the patient. Everything else should be played by ear. In the latter case, when orders must be given and plans are being set in motion, regardless of how equalized the playing field was before off stage, “John the resident would like to order these tests,” becomes “Dr. Doe would like to order these tests.”
Remember that in order for us to do our jobs well in the medical system, the role we take on stage and off stage must be clear. There can be no ambiguity when work must be achieved. In the intervening times, the address becomes a grey area where no clear rules are given. Unfortunately, some of these moments you will need to take one at a time.
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I LOVE the metaphor Medical State uses to explain the etiquette of title in healthcare. Thanks for the reply!
(Future idea for discussion by Medical State: thoughts on the expansion of the Doctor title to include mid-level practitioners?)