What’s in a name?

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A guest post from @tweediatrics.

Last week, a discussion surfaced on Twitter regarding the use of “affectionate” names with patients. It started from this, tweeted by an A+E consultant in the UK:

“Colleague disciplined for calling a 90 yr old lady ‘my dear’ & ‘darling’. She had no issues with them. Are we being too PC? #overreaction?”

So how many of us, as paediatricians, have committed the same alleged faux-pas; use of overly-familiar names to imply or foster a closeness with our patients? Is it really a problem if we do, or do the same rules not apply to the young as they do the elderly?

Confession time; I’m a serial offender. The younger the child, the more likely I am to use something other than what’s on their birth certificate.

A scandalously-unscientific poll of paediatricians showed a range of names: darling, sweetie, chap, champ, tiger, cutie, poppet, mate, buddy, kiddo, young man/lady, dude, mister, gorgeous, little man, big man, maggot(!), pickle, sausage and munchkin all made appearances.

So it seems that many of us will use an affectionate name, tailored to the child’s gender and age. Timmy may not mind being a “tiger” aged three, but may have changed his mind by thirteen! I’ve personally never had a negative reaction from either child or parent, although one colleague was once told in no uncertain terms by a child, “I’m NOT your buddy!”

In my mind, this raises another question; what do we call the child’s mother? “Mrs. Jones” seems formal, but may not be correct. First name straight away may be too far the other way. Is it safer just to say “Mum”? Or “Timmy’s mum”? Again, I’ve consulted the Twitter hive-mind of paediatricians and parents.

Opinion was split over “Mum”; many paediatricians saw it as being impersonal or lazy. Parents seemed divided, some not minding “Mum” as it recognises their role (similar to them addressing me as “doctor”), whilst others echoed the doctors’ concerns about it seeming impersonal. Other parents preferred “Mrs. X”, although some pointed out that they don’t share a surname with their child. Most popular seemed to be a first name, but the same message cropped up repeatedly; ask first.

One respondent simply stated:
“In the short term, I don’t care; just fix my child”.

As ever, one-size doesn’t fit all. In choosing how to address children and parents, we may be expressing not just friendliness and openness, but also consciously or subconsciously assigning positions and roles within the consultation. The best course of action seems to be ask your patients, and listen to their answers. If you’ve got an opinion, feel free to carry on the debate on Twitter; I’m @tweediatrics. Thanks poppet.

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