December 30, 2011

On A First Name Basis: What’s In A Name?

I like the warm-up group exercise where individuals take a few minutes to write and then share in a gathering the story of their first name. How they came to have their first name?  It’s a way to share something in a group that may not have been ever shared with others. It's an opportunity to reflect and hear stories of diversity with minimal risk. Storytelling and dialogue about self-identities, cultural/family traditions and relationships emerge for exploration and development.  My first name is the same as my grandmother’s middle name.  In my family, it was inappropriate to call adults by their first names.  Like many families with southern roots, formal salutations (e.g. Mr., Mrs., Dr.) and last (family or sir) names were used when referring even to close family friends.  It’s now more acceptable to use first names for informal settings even in the exchange between adults and children.  In school, work and beyond you learn through others and norms, how to address those in leadership roles and where formality matters.  In the profession of medicine, the Dr. title indicates creditionals, offers a distinctive meaning of respect, as well as privilege and power for allopathic and osteopathic physicians.

Nurses, pharmacists other professionals along with educators work side-by-side with physicians also have doctoral degrees.  Are they not doctors? Is the M.D., Ph.D. a doctor, doctor?  The New York Times article“When the Nurse Wants to Be Called ‘Doctor’” opened heated debate on this topic revealing the divides among physicians and other health professionals who are committed to collaborative approaches for high-quality, safe and compassionate patient care.  Advanced degrees and specialty training incresease knowledge, compensation and leadership opportunity.  Highly trained individuals charged with treating illlness, the relief of pain and suffering and wellbeing should be able to find acceptable nomenclature to define their roles and work.

In The New York Times Health blog Dr. Danielle Ofri laments the term “health care provider” as a definitivie title for her role as a physician.  The increasing influence of other fields and professions collaborating in medicine is likely to continue the need for revision. For example, new retail clinics are new employing doctors.  Imagine "Yes, we take walk-ins. Go to aisle 6 just past the toothpaste. The ________ will see you now."  The New England Journal of Medicine essay by Dr. Pamela Hartzband and Dr. Jerome Groopman describes the rise of complexity within our health system pointing to another dimension of the struggle for identity and language.  In the business world there’s a push to drop formality and consider first name exchanges to establish common ground.   You have to examine carefully the norms and policy in your setting to understand appropriate strategies in addressing those around you.  Furthermore, pay attention to what others indicate as preference and/or ask directly for the sake of clarity and to avoid offense. You should also make known your own personal and professional preferences known to others.

Do you use formality when addressing attendings, mentors and informality with colleagues?  What’s your take on all this name calling?  Have you ever been called out for inappropriately addressing someone?

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