Titles (courtesy Dr. Andy McLean)
It’s university Commencement season: the time of year when people earn not just diplomas, but “titles.”
Certainly, the most common title heard in the UND School of Medicine & Health Sciences is “Dr.” Interestingly, across the pond, once membership is gained into the Royal College of Surgeons in England, those physicians typically eschew the title “Dr.” and embrace the honorary title of Ms., Mrs., Miss, or Mr. (Some have proposed the option of using “Mx.”)
When we introduce ourselves as “Dr.” in our clinical roles, we let our patients know that we have a particular level of training (and hopefully expertise). We do the same with others—colleagues, trainees, the public at large…. If my experience is any indication, when we first become “Dr.,” we like to try out the sound, using it as often as we can. I think this is due in part not only to our sense of pride, but also as a way of dampening the imposter phenomenon, bolstering our identity along the way. I have found, though, that the longer you are in practice, and the more confident you are in your competence, the less you will feel compelled to use the title “Dr.” outside of the usual parameters.
As being a patient is a vulnerable situation, and the doctor-patient relationship can feel hierarchical/asymmetrical, it is important, when addressing a patient with your title, that you ask them how they wish to be addressed. We strive for interactions that are relational, not transactional. Such respect fosters patient engagement, which numerous studies have shown improve treatment outcomes and patient satisfaction. We can be thoughtful in balancing the relationship by reminding ourselves of Dr. Don Berwick’s statement, “We are guests in our patients’ lives.”
There are, however, times when use of the term “Dr.” is particularly important, as in the need for therapeutic or institutional boundary setting. (New providers learn this as soon as there appears to be “over-familiarity,” or a challenge to their station).
And, speaking of institutions, many of you will have noticed those in institutional leadership referring to themselves in the third person, for example “the President.” This can make sense insofar as a leader speaking in this way is reminding listeners that theirs is an institutional position, durable beyond the individual, highlighting the importance of the office rather than the individual.
Lastly, if you are frequently finding yourself having to say, “Because I’m the doctor,” people are coming along because they have to, not because they want to. If you find yourself consistently relying on your title (i.e., your “position power”), rather than your skills in communication/leadership (i.e., “people power”) to get things accomplished, you might want to re-evaluate your approach.
Reminder, if you would like to share inspirational quotes, stories, or ideas which might be helpful to others, please feel free to email Dr. Melissa Naslund at melissa.naslund@UND.edu.
