Back in the mid-80s when, as a junior doctor, I went to work in the US, I caused a mini-panic amongst the nurses by refusing, at least for a short while, to sign “MD” after my orders. An order in this context being a written order to the nurses to do the myriad of small and big things that comprising the nurse-delivered medical care of a patient. The reason for my reluctance to sign myself MD was that, in England, an MD was a person who had undertaken clinical research, written a thesis, and had subsequently been awarded a medical doctorate. By contrast, MD written after a person’s name in the US simply means that that the person is medically qualified.
I tried to explain that instead of writing MD I should instead be writing BM BCh Oxfd, the equivalent qualifications for an Oxford trained doctor, but to no avail. Without the MD after my name the nurses weren’t happy to carry out my orders. They even started to look a little concerned in case I wasn’t really an MD. Which of course I wasn’t. Something important was clearly being lost in translation and it didn’t take long before I’d given in and began to sign myself Deborah Kirklin MD. Order was returned and orders were acted on.
Which is just one of many reasons why I was pleased to publish a paper about the hit US drama House MD and the counter-intuitive appeal of its anti-hero.
In his paper, Medical paternalism in House M.D., Mark Wicclair ponders the conundrum that lies at the very heart of the immense popularity of this off-beat TV drama: why, at a time when respecting autonomy is undoubtedly top-dog when it comes to the principles underpinning Western medical care, do so many people seem to love House? Wicclair offers some interesting insights. Perhaps you’ve some of your own. You can let us know either by posting a response here or by posting an e-response to his paper.