{"id":27525,"date":"2013-07-05T14:51:34","date_gmt":"2013-07-05T13:51:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=27525"},"modified":"2013-07-05T14:51:34","modified_gmt":"2013-07-05T13:51:34","slug":"ashley-graham-kennedy-do-medical-titles-harm-the-physician-patient-relationship","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/07\/05\/ashley-graham-kennedy-do-medical-titles-harm-the-physician-patient-relationship\/","title":{"rendered":"Ashley Graham Kennedy: Do medical titles harm the physician patient relationship?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/07\/05\/ashley-graham-kennedy-do-medical-titles-harm-the-physician-patient-relationship\/ashley_graham_kennedy\/\" rel=\"attachment wp-att-27594\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-27594\" alt=\"ashley_graham_kennedy\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2013\/07\/ashley_graham_kennedy.jpg\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2013\/07\/ashley_graham_kennedy.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2013\/07\/ashley_graham_kennedy-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a>It was 4 am in the emergency department (ER). An 83 year old woman had come into the ER after experiencing an episode of disorientation and shortness of breath earlier in the evening. The resident physician and I entered her room and he introduced himself to the patient. \u201cHello Ms Stanley, I\u2019m Dr James.* I will be taking care of you this evening.\u201d \u201cWell isn\u2019t that nice? I\u2019m <em>Dr<\/em> Stanley.\u201d \u201cWhat kind of doctor are you?\u201d the resident asked. \u201cI\u2019m a social psychologist,\u201d she replied.<!--more--><\/p>\n<p>This elderly woman\u2019s message to her physician was clear: \u201cTreat me with respect. I am your equal.\u201d However, this is exactly what the use of the title \u201cDr\u201d does not do\u2014it does not foster respect of the patient on the part of the physician. When a physician introduces himself to a patient as \u201cDr\u201d he, whether knowingly or not, sends a message to the patient that she is not his equal.<\/p>\n<p>Titles carry the power to shape relationships. Most of us learn this at a young age. Many of us were taught, as children, to address authority figures\u2014such as our teachers\u2014by their titles, and never by their first names. Think back for a moment and you will probably realise that using those titles shaped the relationships you had with the individuals to whom you afforded them. And this, no doubt, was often a good thing. Addressing an individual by a title can be a way of showing respect to that person. Introducing oneself with a title can also be a way for a person to set himself apart from others.<\/p>\n<p>The practice of medicine has changed radically in the past fifty years or so, and doctors no longer \u201ccall the shots,\u201d in the way that they used to. With the rise of patient centered practice, and the widespread recognition and acceptance of patient rights and autonomy, the physician-patient relationship, thankfully, looks less and less like the one that the title \u201cDr\u201d suggests. The physician-patient relationship is no longer that of a paternalistic provider to a patient. It is time that we, as a society, drop the \u201cDr\u201d title, as a sign of recognition that the physician-patient relationship has changed.<\/p>\n<p>More than one physician has suggested to me that the title \u201cDr\u201d is required for identification purposes, especially in busy clinics, where there are many people\u2014nurses, techs, physician assistants, security guards, administrators, and janitors\u2014running around. Some have argued that without the use of a title, that patients might not be able to identify their physicians. But I doubt that\u2019s the case. Introductions, surely, could do the job just fine.<\/p>\n<p>The more time I spend with physicians the deeper my respect grows for their profession. The work of a physician demands that she be at once hard-working, compassionate, brilliant, and kind. It isn\u2019t easy work, by any means. And although I object to the title of \u201cDr,\u201d this is not in any way an attack on physicians, among whom I count family members, mentors, colleagues, and friends.<\/p>\n<p>An introduction is the beginning of a relationship, and it\u2019s important to start out on the right foot. No doubt this patient would likely have appreciated a simple, \u201cHello, I\u2019m Tom James. I am an ER physician and I will be taking care of you this evening.\u201d She likely would have responded, \u201cWell, isn\u2019t that nice? I\u2019m Ella Stanley. I\u2019m a social psychologist,\u201d knowing that she had been addressed as an equal.<\/p>\n<p>* The names in this blog have been changed.<\/p>\n<p><em>I declare that I have read and understood the BMJ Group policy on declaration of interests and I have no relevant interests to declare.<\/em><\/p>\n<p><em><strong>Ashley Graham Kennedy<\/strong>, PhD is a philosopher at the University of South Carolina and a visiting researcher at Columbia University Medical Center. She conducts research on clinical reasoning and diagnostic methods and teaches courses in medical ethics to pre-medical and medical students. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>It was 4 am in the emergency department (ER). An 83 year old woman had come into the ER after experiencing an episode of disorientation and shortness of breath earlier [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/07\/05\/ashley-graham-kennedy-do-medical-titles-harm-the-physician-patient-relationship\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223,1357],"tags":[],"class_list":["post-27525","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","category-us-health-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Ashley Graham Kennedy: Do medical titles harm the physician patient relationship? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/07\/05\/ashley-graham-kennedy-do-medical-titles-harm-the-physician-patient-relationship\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ashley Graham Kennedy: Do medical titles harm the physician patient relationship? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"It was 4 am in the emergency department (ER). 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