Following my previous post on the use of first names, and entirely by coincidence, the folk over at St Emlyns blogged on a very similar subject, but extended the discussion a little to what your patients should call you.  I pulled up short about in discussing this before and I’ve been wondering why since.  

How do I introduce myself to patients and their families?  Well, in some ways the choice is easy, since I have an entirely unpronounceable surname.  So, I tend to say “Hello, my name’s Ian Wacogne, and I’m one of the consultants here”.  Interestingly they then use a variety of forms of address back – many of them use Doctor, fewer use my given name, and a few are brave enough to have a crack at my surname.

You might have noticed that in my previous, I’ve written that I ask our team to refer to me by given name, except in front of the patient.  This is because of a belief I have that the phrase “I’m going to ask the consultant, Dr Wacogne” has a higher therapeutic value than the phrase “I’m going to ask the consultant, Ian”, but as I examine it I realise that this could well be nonsense.  Perhaps what we need is a trial a little like the classic from Barrett and Booth on what patients perceived of paediatricians from their attire – now a little dated since I’ve not seen a paediatrician in a white coat in the UK in a decade.

I remember an eminent paediatrician saying to me, amused, once that a family had asked “What’s your first name, doctor?”, to which the reply had been “Doctor”.

I worked for a geriatrician very many years ago who would say “I’m the consultant in charge of the team,” which I took for some time to be arrogance, until I realised that he was actually clarifying what must have been a bewildering structure for the patient.

My dad – who likes his titles – asked me for quite some time about my title:  “So, now that you’re a consultant, you’re now a Mr again, is that right?”  It took me probably five years for the penny to drop that this was less about his inability to understand the medical hierarchy than about his ability to press my buttons.

It strikes me that part of this is what power the patient and their family wish to invest in the title.  If they wish to feel chummy, close, or informal, then they can use my first name. If they wish to maintain formality then they can use my title.  While it is fun, and important in the structure of a team, to get through the cognitive dissonance of referring to a consultant by title, it’s almost certainly not that helpful to do that in a 20 minute patient consultation.

Perhaps that’s the key; what is it that the patient needs from your behaviours? Which things from your behaviours do the patients and their families get the most?  I suspect that’s a third post in the series…