comebacks for condescending/overly familiar patients

[quinsy]

Hello folks,

I need something to think about that's less stressful than the boards. Tell me about what you say to patients who become overly casual or even condescending with you?

I'm used to the "oh, you're so young", and able to shrug that off with a smile. I do also get called "honey", "sweetheart", and "dear", which I can deal with, and sometimes even "kid" or "girl", which I am not very happy about.

So - what do you say when patients ask your name, and when you reply "Dr. Quinsy", they respond with "What's your first name?" - which they then proceed to use for the remainder of the visit, i.e. leaning over the emergency department counter into the physician charting area, "hey, Q, when are they going to decide what to do with me?"

(They never ask me "when are you going to decide what to do with me, Doctor?" it's always some other ill-defined entity who must be taking care of them from behind a Wizard of Oz-like curtain, because, of course, I am too young to be a doctor anyway)

This has become a pet peeve of mine, even when the patient is otherwise very amiable. I never call the patients "hey, Joe" or "hey, Jane" - always Mr, Mrs, Ms, even sir or ma'am. I feel like they're not respecting me, because I've never heard anyone do this to the older docs. Are there some good/slick ways to respond to this kind of behavior that won't come off as scolding or grouchy? "It's Dr. Quinsy to you" seems rude.

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[ilovepath]

Thanks for the reminder, I needed that.

Hello folks,

I need something to think about that's less stressful than the boards. Tell me about what you say to patients who become overly casual or even condescending with you?

I'm used to the "oh, you're so young", and able to shrug that off with a smile. I do also get called "honey", "sweetheart", and "dear", which I can deal with, and sometimes even "kid" or "girl", which I am not very happy about.

So - what do you say when patients ask your name, and when you reply "Dr. Quinsy", they respond with "What's your first name?" - which they then proceed to use for the remainder of the visit, i.e. leaning over the emergency department counter into the physician charting area, "hey, Q, when are they going to decide what to do with me?"

(They never ask me "when are you going to decide what to do with me, Doctor?" it's always some other ill-defined entity who must be taking care of them from behind a Wizard of Oz-like curtain, because, of course, I am too young to be a doctor anyway)

This has become a pet peeve of mine, even when the patient is otherwise very amiable. I never call the patients "hey, Joe" or "hey, Jane" - always Mr, Mrs, Ms, even sir or ma'am. I feel like they're not respecting me, because I've never heard anyone do this to the older docs. Are there some good/slick ways to respond to this kind of behavior that won't come off as scolding or grouchy? "It's Dr. Quinsy to you" seems rude.

 

[PharmaTope]

Hello folks,

I need something to think about that's less stressful than the boards. Tell me about what you say to patients who become overly casual or even condescending with you?

I'm used to the "oh, you're so young", and able to shrug that off with a smile. I do also get called "honey", "sweetheart", and "dear", which I can deal with, and sometimes even "kid" or "girl", which I am not very happy about.

So - what do you say when patients ask your name, and when you reply "Dr. Quinsy", they respond with "What's your first name?" - which they then proceed to use for the remainder of the visit, i.e. leaning over the emergency department counter into the physician charting area, "hey, Q, when are they going to decide what to do with me?"

(They never ask me "when are you going to decide what to do with me, Doctor?" it's always some other ill-defined entity who must be taking care of them from behind a Wizard of Oz-like curtain, because, of course, I am too young to be a doctor anyway)

This has become a pet peeve of mine, even when the patient is otherwise very amiable. I never call the patients "hey, Joe" or "hey, Jane" - always Mr, Mrs, Ms, even sir or ma'am. I feel like they're not respecting me, because I've never heard anyone do this to the older docs. Are there some good/slick ways to respond to this kind of behavior that won't come off as scolding or grouchy? "It's Dr. Quinsy to you" seems rude.

do you really care how rude it seems? how about you dont tell them your first name. how about when they start their game you completely ignore them and treat them like a number. screw it. they are there treating you like a service man to them.

welcome to america, people are not the same.

 

[jdh71]

Hello folks,

I need something to think about that's less stressful than the boards. Tell me about what you say to patients who become overly casual or even condescending with you?

I'm used to the "oh, you're so young", and able to shrug that off with a smile. I do also get called "honey", "sweetheart", and "dear", which I can deal with, and sometimes even "kid" or "girl", which I am not very happy about.

So - what do you say when patients ask your name, and when you reply "Dr. Quinsy", they respond with "What's your first name?" - which they then proceed to use for the remainder of the visit, i.e. leaning over the emergency department counter into the physician charting area, "hey, Q, when are they going to decide what to do with me?"

(They never ask me "when are you going to decide what to do with me, Doctor?" it's always some other ill-defined entity who must be taking care of them from behind a Wizard of Oz-like curtain, because, of course, I am too young to be a doctor anyway)

This has become a pet peeve of mine, even when the patient is otherwise very amiable. I never call the patients "hey, Joe" or "hey, Jane" - always Mr, Mrs, Ms, even sir or ma'am. I feel like they're not respecting me, because I've never heard anyone do this to the older docs. Are there some good/slick ways to respond to this kind of behavior that won't come off as scolding or grouchy? "It's Dr. Quinsy to you" seems rude.

I don't think you need a snappy comeback, I think you need to work through your inferiority issues. Go talk to somebody.

 

[NJWxMan]

It's all Borderline PD BS. Learn to deal with it; everyone has their own method.

 

[WentForitandWon]

Tell them your first name is Doctor and chuckle. then say Doctor First name last name (as if they must not have heard you the first time). being snappy or smart will just piss people off.

 

[PharmaTope]

I don't think you need a snappy comeback, I think you need to work through your inferiority issues. Go talk to somebody.

honestly, there is no working through that, years of therapy and you end up nowhere. you are who you are. simple as that.

just say **** it, they prob some douche anyways. laugh at them, no need to have a dick measuring contest with them.

 

[TreeOfSouls]

Why does that bother you? If the patient is older than you, especially by a lot, of course they will perceive you as being very young... and when you're older, you'll very likely do the same. You getting upset about it almost reinforces their deeper concern, which is that you are not mature enough or knowledgeable enough to be their doctor. You could try to find a way to only ever treat patients your own age or younger to avoid this issue or perhaps focus on exuding confidence and maturity rather than getting mad at your patients. I thought most med school programs trained at least a little on diversity and working with patients of different ages/generations? Quite possibly, what you are taking as an insult (desire to know your first name) might be a scared patient's way of "humanizing" or connecting with you, which is really not an insult at all.

 

[McGillGrad]

I'm not quite sure why some of the comments are unnecessarily abrasive. Nonetheless, I'll give you my take.

Although I am fortunate enough to be a male in medicine, I cringe when I see patients call my female colleagues 'nurse' or 'hun'. It comes with the territory and you will eventually develop a tick skin.

Until then, the best method to deal with those types of patients is to be direct and pointed. Boundaries have to be drawn and maintained.

I am assuming that you are an attending and that position comes with a few perks. One of them is the right to be called Dr. by most everyone in the hospital. If they ask for your first name, then you could simply ignore it and continue with your medically relevant questions. If they insist on continuing, have a witness come with you the next time and document their behaviour and mark them down as an unreliable historian.

You are required to practice good medicine, not be a social butterfly. Ask your questions and treat them. If they are difficult, have a witness and document it.

You are too busy to deal with difficult patients.

 

[WholeLottaGame7]

If they insist on continuing, have a witness come with you the next time and document their behaviour and mark them down as an unreliable historian.

You are too busy to deal with difficult patients.

Disagree with both of these statements. A) If you had someone come with you to document every difficult interaction, you'd have to have someone constantly following you around. B) Just because they're a jerk doesn't mean they're an unreliable historian. C) If you were too busy to deal with difficult patients, you wouldn't be busy at all. It just takes 2 or 3 "difficult patients" on a service to really suck your time down, regardless of how you handle them.

Dealing with difficult patients is an art. It requires a lot of adaptability but also a lot of firmness. And it's something that I don't think anyone has truly mastered.

 

[Entgegen]

Strangely enough, I have the opposite situation as the OP. I'm still a 4th year med student, been told I look young, and I never introduce myself to a patient as "Student Doctor ____" anymore because I think it's too cumbersome. So I just introduce myself with my first name. Then they almost invariably refer to me as "Doc" from then on. Maybe it' because I'm in my (short) white coat. Maybe it's because I'm a guy. Dunno.

 

[McGillGrad]

The OP is not dealing with a regular patient that is being difficult. The OP is describing patients with personality issues who have no boundaries. You see people like that every so often.

On the other hand, if the OP has problems like this with patients often, then that is a whole other matter.

Disagree with both of these statements. A) If you had someone come with you to document every difficult interaction, you'd have to have someone constantly following you around. B) Just because they're a jerk doesn't mean they're an unreliable historian. C) If you were too busy to deal with difficult patients, you wouldn't be busy at all. It just takes 2 or 3 "difficult patients" on a service to really suck your time down, regardless of how you handle them.

Dealing with difficult patients is an art. It requires a lot of adaptability but also a lot of firmness. And it's something that I don't think anyone has truly mastered.

 

[docB]

I completely see where Quinsy is coming from. And the people who were snarky are either ignorant or too self absorbed to see how this does happen to our colleagues. It happens to me frequently and I am not young, young looking or female.

I find that it is usually done by salesman types. You know them. They are the cocky, "everything is open to negotiation," want to shake your hand and squeeze too tight, used car shilling jerks. I think that they try to call doctors by their first name to change the dynamic of the interaction. They feel intimidated by their knowledge deficit and they're trying to cut the doctor down to make themselves feel better.

I think this is inappropriate although it does give me some useful insight into them. For example these are the patients who will start bargaining for narcotics, etc.

It happens to me a lot as I have my first and last names embroidered on my scrubs. So if they want to try this game it's right there for them. I usually don't do or say anything about it once they start.

 

[eforest]

I look very young and get stuff like that a lot. It really doesn't bother me.

Hello folks,

I need something to think about that's less stressful than the boards. Tell me about what you say to patients who become overly casual or even condescending with you?

I'm used to the "oh, you're so young", and able to shrug that off with a smile. I do also get called "honey", "sweetheart", and "dear", which I can deal with, and sometimes even "kid" or "girl", which I am not very happy about.

So - what do you say when patients ask your name, and when you reply "Dr. Quinsy", they respond with "What's your first name?" - which they then proceed to use for the remainder of the visit, i.e. leaning over the emergency department counter into the physician charting area, "hey, Q, when are they going to decide what to do with me?"

(They never ask me "when are you going to decide what to do with me, Doctor?" it's always some other ill-defined entity who must be taking care of them from behind a Wizard of Oz-like curtain, because, of course, I am too young to be a doctor anyway)

This has become a pet peeve of mine, even when the patient is otherwise very amiable. I never call the patients "hey, Joe" or "hey, Jane" - always Mr, Mrs, Ms, even sir or ma'am. I feel like they're not respecting me, because I've never heard anyone do this to the older docs. Are there some good/slick ways to respond to this kind of behavior that won't come off as scolding or grouchy? "It's Dr. Quinsy to you" seems rude.

 

[MrBurns10]

I am assuming that you are an attending and that position comes with a few perks. One of them is the right to be called Dr. by most everyone in the hospital. If they ask for your first name, then you could simply ignore it and continue with your medically relevant questions.

Seriously? I mean no offense to you or anyone else, but I've never understand this mentality. There is absolutely no reason to insist on the title with the people you work with. Nurses and techs, they know you're a doctor...you don't need to remind them of this every time they speak to you. How about trying to form a personal relationship with them, one that starts with being friendly enough to remove the title in front of your name?

As for patients, it's personal preference, but I do think the connection you make with patients and especially their families can be more personal if you make it seem okay for them to call you by your first name. Just my opinion.

 

[McGillGrad]

I understand your point of view and it is your right to be called by your first name. No one has the right to force a title on you.

In the same vein, you have no right to take away someone else's title. Being called Doctor is one of the few remaining benefits of 11-15 years of education and sacrifice.

You are not asking people to call you 'Master' or 'Lord'. You are asking people to address you by your title. You can be friendly and nice while still maintaining a professional relationship.

Patients are not my/your friend. They don't want a friend, they need an expert to advise them of their situation and options. I am not saying that you should stop caring about your patients intensely. I am saying that a professional distance is what is best for a patient, even if that means not being warm and cosy with them.

In my view, other attendings can call you by your first name. Residents and med students will call you by your title. Nurses/techs will depend on how well they know you.

Seriously? I mean no offense to you or anyone else, but I've never understand this mentality. There is absolutely no reason to insist on the title with the people you work with. Nurses and techs, they know you're a doctor...you don't need to remind them of this every time they speak to you. How about trying to form a personal relationship with them, one that starts with being friendly enough to remove the title in front of your name?

As for patients, it's personal preference, but I do think the connection you make with patients and especially their families can be more personal if you make it seem okay for them to call you by your first name. Just my opinion.

 

[nitemagi]

My personal approach is a covert behavioral intervention (conditioning). Sorry to make the analogy, but akin to a clicker for a puppy. Marking good behavior. You don't need to scold bad behavior, just mark good behavior. So with those statements, ignore it, but immediately respond in a friendly and receptive manner when they treat you respectfully. Lather, rinse, repeat. Marked silence, non-responsiveness, or ignoring inappropriate questions and moving on methodologically through an exam subtly sends the message you don't respond to that type of interaction. But responding positively when they do something good reinforces the behavior you want.

Try it out.

But keep in mind like the kid throwing a tantrum, if they're used to getting a response to their provocation (or tantrum, or button pushing), if at first you don't respond they may INCREASE the behavior temporarily. The spike before extinction.

 

[Samoa]

Simply say, "my friends call me Samoa, but my patients call me doctor."

Most people get the message at that point. If not then they probably have some boundary issues, and won't realize I'm crossing one when I get more direct and say, "It's not appropriate to use my first name, when I haven't asked you to do so."

If someone calls me honey or sweetheart, and I get the sense that their intent is either demeaning or sexualizing, I go straight for the second option. But if I don't get that sense, I let it go.

In the case of a psych issue, those patients respond well to a firm assertion of boundaries. The person whose intent is to bully is counting on your being too polite to call them out, and won't push further. Neither one will you actually alienate, strangely enough. You'll only alienate a normal person who didn't truly mean any harm. So if you exercise good judgment, you shouldn't ruffle too many feathers.

 

[jdh71]

Insisting on being called "doctor" is so blowhard ******ed to me. Yeah, you spent some extra time in school and training, can you insist on being called anything you want simply because of that? Seriously so many of you and so many of my colleagues NEED to get (laid) over themselves. You're not a special and unique flower. You're one more bozo on the bus, just like everyone else, and until you wrap you brain around that, you can't be helped.

 

[Samoa]

Insisting on being called "doctor" is so blowhard ******ed to me. Yeah, you spent some extra time in school and training, can you insist on being called anything you want simply because of that? Seriously so many of you and so many of my colleagues NEED to get (laid) over themselves. You're not a special and unique flower. You're one more bozo on the bus, just like everyone else, and until you wrap you brain around that, you can't be helped.

I think it's appropriate for patients to call me doctor. I call my own physician "doctor." And I don't see what's wrong with asking to be respected for the years of education and training that enable me to help someone in a way that they'd never be able to do for themselves.

It's worth respect and it's worth money. The warm fuzzy feeling of service to mankind is a secondary outcome that makes any lack of the former two more palatable.

 

[McGillGrad]

Insisting on being called "doctor" is so blowhard ******ed to me. Yeah, you spent some extra time in school and training, can you insist on being called anything you want simply because of that? Seriously so many of you and so many of my colleagues NEED to get (laid) over themselves. You're not a special and unique flower. You're one more bozo on the bus, just like everyone else, and until you wrap you brain around that, you can't be helped.

Tell us how you really feel...lol

 

[McGillGrad]

I think it's appropriate for patients to call me doctor. I call my own physician "doctor." And I don't see what's wrong with asking to be respected for the years of education and training that enable me to help someone in a way that they'd never be able to do for themselves.

It's worth respect and it's worth money. The warm fuzzy feeling of service to mankind is a secondary outcome that makes any lack of the former two more palatable.

I wouldn't take it personally.

I generally find that out-of-proportion outbursts about a banal subject have more to do with personal issues than the topic at hand. Maybe something to do with authority figures as a child. Who knows, I am just rambling and not referring to anyone in particular.

 

[3dtp]

I don't think this is a very important point. While some place great stock on titles and creds, other do not. Personal preference. You will, in practice develop your reputation in your future practice on what type of physician you want to be and will attract those types of patients.

In my specialty, a strong sense of compassion and empathy is essential to success, as well as expertise. Rule number 1: Be nice to your patients. Draw necessary lines and don't let them be crossed, but be nice about it. Rule number 2: Word gets around in the community, rapidly. Being arrogant or obnoxious with titles (ie snappy comebacks, or demanding to be addressed in a certain manner), will be part of your community/practice reputation.

In medical school, one of the worst fools I ever had for an instructor was the one who began his lecture with a slide that had all of his academic/society/licensing credentials on the title slide. There was more alphabet soup on that screen than there was room to put it. Unfortunately, the remainder of his talk was as vacant as the first slide was full.

So, you can choose to be full of yourself, demand titular addressing by your patients, peers and colleagues, or you can be collegial with your peers, colleagues and patients, yet still maintain the necessary boundaries. And your reputation will be better for it.

I always introduce myself to my new patients by my first name without the honorific, and 99% of my patients call me Dr. 3dtp. And, as I held a PhD and a faculty position long prior to medical school, by rights, should I be called Doctor Doctor 3dtp? Sorry guys, I think a little humbleness will go a very long way in building your patient's trust. After all they came to you for your expertise, and chose you because of it. Building that trust will help far more than a wall of arrogance. Patients who do develop that trust will be more compliant and possibly healthier for it.

 

[Dr.LeoSpaceman]

I too don't know where all the "Get over it." comments are coming from. In some cases, it's a salient point. When the implied meaning of "How old are you?" is "I don't believe you're qualified to be here", it's problematic.

So to answer the OP's question, a snarky/snappy comment is not necessary (or appropriate). It's just going to put the the patient off even more. Be a professional, and be confident in what you are talking about. Show them that you may be young, but you still know your stuff. That's really the only "comeback" necessary.

As for the "I need to be called Doctor" part, I generally don't care what people call me, but I do think it's important for patients to hear you introduce yourself as "Doctor X". They see so many people from students, to nurses, to therapists, I do think that it should be clear who the physicians are (and as such, who are the ones making the actual decisions). Once that's clear, if they want to call me by my first name, I generally don't care.

 

[Janedoedoctor]

I, too understand how the OP feels about such patients. To me, it's not about insisting on being adressed by a title (everbody knows what I am), but it's about keeping a professional distance. These people are not my friiends or co-workers, they're patients and they get treated as such. I always adress patients as Mr/Ms X, even if they are much younger than me (except children, of course).

At my place, nurses, techs and residents/fellows all call each other by their first names when no patients are present. When we're in the room with a patient, every MD gets adressed as 'doctor'. I believe this is the right way to do things.

I can count the number of times I've been asked for my first name on one hand (it's right there on my nametag anyhow), but I've always ignored the question. Outright refusing to give your first name might come across as weird in the sense that you'd be trying to hide your identity. If they push the issue, just state the name but ask them to adress you as doctor.

 

[jdh71]

I think it's appropriate for patients to call me doctor. I call my own physician "doctor." And I don't see what's wrong with asking to be respected for the years of education and training that enable me to help someone in a way that they'd never be able to do for themselves.

It's worth respect and it's worth money. The warm fuzzy feeling of service to mankind is a secondary outcome that makes any lack of the former two more palatable.

Wish into one hand and crap into the other. Get back to me on which one fills up faster. Is it nice to be addressed as "doctor"? Is it even the appropriate address? Sure. However, when you get all butthurt and upset when someone doesn't address you as "doctor", that one's on YOU not the patient. Like the poor, the jackass we will always have among us. Try renting as little space in your mind to them as possible.

 

[shopsteward]

The chaps here may be expressing less difficulty with this situation because they don't get the sexism that is being mixed in with the over-familiarity.

Could the OP hide behind ethics? "My first name is Q, but as I now have a doctor/patient relationship with you I need to keep our relationship formal, Mr X/Ms X."

If there are patients who are addressing the OP informally in the physician charting area of the Emergency Department counter, then either a physical barrier discouraging patients from approaching, or support staff running interference ("the doctors in this area are writing down important medical decisions and can't be disturbed") might help.

 

[Samoa]

Wish into one hand and crap into the other. Get back to me on which one fills up faster. Is it nice to be addressed as "doctor"? Is it even the appropriate address? Sure. However, when you get all butthurt and upset when someone doesn't address you as "doctor", that one's on YOU not the patient. Like the poor, the jackass we will always have among us. Try renting as little space in your mind to them as possible.

And you assume that insisting on respect is the same as getting "butthurt".

I'm comfortable with the boundaries I set, and so far it hasn't kept me from developing effective doctor-patient relationships. Which is, I'm sure you'll agree, the salient point here. Yet my way of handling the situation clearly bothers you. This sounds like your problem rather than mine.

 

[jdh71]

And you assume that insisting on respect is the same as getting "butthurt".

I'm comfortable with the boundaries I set, and so far it hasn't kept me from developing effective doctor-patient relationships. Which is, I'm sure you'll agree, the salient point here. Yet my way of handling the situation clearly bothers you. This sounds like your problem rather than mine.

I'm not particularly "bothered" by the way you handle this situation. I merely think it's stupid and unproductive. There is a difference. You can't "insist" than anyone do anything for you, least of all respect you . . . those are the kind of unrealistic expectations that lead to resentment. You can do what you want. I'm merely pointing out it's not helpful.

 

[ilovepath]

To gain perspective you should seek antecdotal opinion from more senior practicing physicians about how they feel. I recall many of the private practice physicians I rotated under that have been in the field have noticed a dramatic change in the way pt populations interact with their Drs. Although this thread addresses particular attributes of the op, I don't think anyone has been immune to this change over the past few decades.

 

[pgg]

I have old geezers nervously comment on how young I look all the time. Usually I just lift up my scrub cap and we laugh about how I have less hair than they do. No harm, I don't take it personally and it beats the alternative - looking old.

I find that it is usually done by salesman types. You know them. They are the cocky, "everything is open to negotiation," want to shake your hand and squeeze too tight, used car shilling jerks.

That's funny but so correct. It reminds me of something that happened to me a week or two ago (CSB time).

I'm at home, in my garage, door open (sunny day), working on something. Some door-to-door salesman guy walks up the driveway, leans on my garage door frame, and starts telling me how he'd like to vacuum my house for free. Conversation, paraphrased:

me "No thanks."

him "Why not, it's free, you don't have to buy anything and I get $50 for every house I vacuum."

me "My carpet is fine. You're selling something, you'll want me to sign up for some house cleaning service, I'm not interested."

him "You don't have to buy anything. Say that's a nice car, what kind of work do you do?"

me "Not interested. Go away. Stop bothering me."

him "It won't take long and I'll do a great job. How fast have you gone in that?"

me "Get the **** away from me right now you worthless obnoxious sack of ****, I wouldn't let a deadbeat like you inside my house if YOU were offering to pay ME for the privilege of vacuuming."


He slinks off in a huff. Afterwards I was thinking, man I really wish I could talk to some of my patients that way.

 

[Bartelby]

I think sometimes the fix is worse than the problem itself, this seems like one of those times. When patients say mean/snarky things to me I go on as if I did not understand that they were mean/snarky. Surprisingly it generally gets dropped. I think a lot of these people are frustrated or whatever and feel a need to vent, as a professional you don't have time for that and the most efficient way to avoid a pissing contest seems to be ignoring it.

If they start interrupting you in a physician workspace you have to enforce boundaries, but short of disrupting your work I would be hesitant to engage them about their childish behavior.

 

[Bartelby]

me "Get the **** away from me right now you worthless obnoxious sack of ****, I wouldn't let a deadbeat like you inside my house if YOU were offering to pay ME for the privilege of vacuuming."

😱 Damn! The guy seems annoying, but wow.

 

[pgg]

😱 Damn! The guy seems annoying, but wow.

Being polite didn't get him to leave. You can hang up on telemarketers. When someone won't leave your house ... sometimes being unexpectedly and inappropriately rude is effective.

Surprisingly enjoyable too.


Also ... one has to consider that guys like this might be casing places for burglary. A little aggressiveness may be useful in helping them choose another target.

 

[MrBurns10]

I understand your point of view and it is your right to be called by your first name. No one has the right to force a title on you.

In the same vein, you have no right to take away someone else's title. Being called Doctor is one of the few remaining benefits of 11-15 years of education and sacrifice.

You are not asking people to call you 'Master' or 'Lord'. You are asking people to address you by your title. You can be friendly and nice while still maintaining a professional relationship.

Patients are not my/your friend. They don't want a friend, they need an expert to advise them of their situation and options. I am not saying that you should stop caring about your patients intensely. I am saying that a professional distance is what is best for a patient, even if that means not being warm and cosy with them.

In my view, other attendings can call you by your first name. Residents and med students will call you by your title. Nurses/techs will depend on how well they know you.

Sure, I have no right to take away someone else's title and I've never tried. I always address attendings as "Dr" even if they sign emails to me with their first name only until they tell me "Please, call me Bob." Then I will (and usually with difficulty!). But, that doesn't mean I necessarily agree with insisting on the title with colleagues, and one of my favorite things about my residency program when I was interviewing was that the residents were all on first-name bases with attendings. This is the kind of attending I want to be...friendly yet worthy of being respected and listened to when giving orders. The nurses I work with now call me by my first name, except in front of patients, and I do feel like this has promoted a more congenial environment without losing any respect. And a bit off topic...one of my biggest pet peeves is when attendings sign their names "Dr. X" in emails, which I find pretentious and completely unnecessary. At the same time I think it's disrespectful to address an attending as "Dr" unless you've been specifically told not to.

With patients, I usually do introduce myself as "Dr. so and so" so I make sure they know I'm a doctor and because I think it can instill more trust/confidence off the bat. But with families I've found it awkward when I say "Hey, I'm Dr. So and so" and they reply with "Hey, I'm Mike", so I usually make it clear it's okay to call me by my first name as well. I'm just more comfortable that way.

 

[quinsy]

Lol....thanks to those who gave thoughtful and serious responses, and to the rest of you, thanks for the laughs! .... if I were really the arrogant title-asserting jerk that some of you suggested I was I don't think I would have this problem. I always intro myself by first name to colleagues and coworkers. DocB, as usual you are right. They are the salesmen in some cases, trying to be manipulative. And in many cases I am touched by how respectful even elderly patients can be, though I know I look like I am in high school. This is a minority of patients. One of you hit it on the head by referring to these people as seeming like they are subtly trying to imply that you are less qualified because of your gender or appearance, or whatever. Yes, I know I could just ignore it as I have been up til now, but was curious if anyone had thought up good methods to actually address this behavior. 🙂

 

[393656]

JDH71 you should spend less time trying to sound clever and witty in your posts because its just coming across really annoying. If you think you are just another bozo on the bus than I hope I never am your patient. Doctors are pretty rare and thus deserve the respect. It also importantly keeps boundries and develops important accountibility to patients. Too friendly than they may think they can get away with more etc.

Chill on the posts though its getting really irritating.

 

[TreeOfSouls]

It might help with perspective to remember that respect is something earned... not "in general" by being a doctor, but by each patient through providing high quality, professional, competent care. While a few patients might base their respect on your title, chances are that most won't. They don't care how many years of training you've had- they only care about what kind of care they are going to receive from you (competent or not). If you look young, then why should an older patient assume that you know as much as an older physician when, in most things, more experience = more skill/knowledge? Also, by the "years of training" logic, all professors should be highly respected but that's not the reality. We may call them "Dr. So and So" because it's the social norm when we take a class- but actual respect is only there when it's earned. Takes a lot to earn and little to destroy. This is in ALL professions, not just medicine. Long gone are the days of being respected just for a title alone. So, you can butt heads with patients and insist that they call you "doctor"... but, if it's actually respect you want, that's probably going to be irrelevant.

 

[jdh71]

JDH71 you should spend less time trying to sound clever and witty in your posts because its just coming across really annoying. If you think you are just another bozo on the bus than I hope I never am your patient. Doctors are pretty rare and thus deserve the respect. It also importantly keeps boundries and develops important accountibility to patients. Too friendly than they may think they can get away with more etc.

Chill on the posts though its getting really irritating.

Burnett's Law? Nicely played.

You may keep stomping your cute little foot and demanding respect, while I'll keep it real and understand I've got no right to demand anything like that from anyone, least of all expect it. People will do what they will do.

What a patient calls you is irrelevant to the boundaries you set. You're merely looking for an ego protecting intellectualization that allows you to cosign this nonsense. If you need the title "doctor" to set and keep a boundary your problem isn't with me or with any patient.

I post what I want, when I want within the boundaries set by the TOS. You are free to place me on ignore.

Click on name
Drop down menu
??????
Profit!!

Peace, homes.

 

[jdh71]

It might help with perspective to remember that respect is something earned... not "in general" by being a doctor, but by each patient through providing high quality, professional, competent care. While a few patients might base their respect on your title, chances are that most won't. They don't care how many years of training you've had- they only care about what kind of care they are going to receive from you (competent or not). If you look young, then why should an older patient assume that you know as much as an older physician when, in most things, more experience = more skill/knowledge? Also, by the "years of training" logic, all professors should be highly respected but that's not the reality. We may call them "Dr. So and So" because it's the social norm when we take a class- but actual respect is only there when it's earned. Takes a lot to earn and little to destroy. This is in ALL professions, not just medicine. Long gone are the days of being respected just for a title alone. So, you can butt heads with patients and insist that they call you "doctor"... but, if it's actually respect you want, that's probably going to be irrelevant.

Don't tell the truth in here sir/madam!! These folks DEMAND respect!!

 

[393656]

Well if you want to keep being absolutely annoying then have at it. Clearly you are just an annoying type and that is not going to change from me pointing it out. If you sounded less "forced" and did not try to be overly eloquent like almost poetry (bad poetry) you would get a lot more respect.

But if you feel rough and tumble on here then surely you need this outlet. Have fun!

 

[jdh71]

Well if you want to keep being absolutely annoying then have at it. Clearly you are just an annoying type and that is not going to change from me pointing it out. If you sounded less "forced" and did not try to be overly eloquent like almost poetry (bad poetry) you would get a lot more respect.

But if you feel rough and tumble on here then surely you need this outlet. Have fun!

1. I'm not "trying" to do anything.
2. This is the way I am, love me or leave me.
3. I'm not responsible for your negative feelings.

 

[nitemagi]

1. I'm not "trying" to do anything.
2. This is the way I am, love me or leave me.
3. I'm not responsible for your negative feelings.

Fritz Perls woulda loved you.

 

[393656]

wow, even more sad that this is really who you are. Atleast if you were putting on a show there would be hope for you in real life. Oh well!

 

[jdh71]

Fritz Perls woulda loved you.

Maybe

 

[jdh71]

wow, even more sad that this is really who you are. Atleast if you were putting on a show there would be hope for you in real life. Oh well!

I like who I am. And I don't find me to particularly sad at all. I do wonder why would would feel it necessary to make a statement like that though. You might consider what that says about you. Like I said before, I'm not really your problem here.

 

[Samoa]

I like who I am. And I don't find me to particularly sad at all. I do wonder why would would feel it necessary to make a statement like that though. You might consider what that says about you. Like I said before, I'm not really your problem here.

I like you too, jdh. We just disagree on where the line should be, and although we may be comfortable with our own choices, this kind of discussion does help those behind us to figure out their own approach to this very individual issue.

 

[smq123]

wow, even more sad that this is really who you are. Atleast if you were putting on a show there would be hope for you in real life. Oh well!

Can we stay on topic and not fixate on individual posters? If someone's posts irritate you that much, you are free to put them on "ignore."

Muchas gracias.

 

[jdh71]

I like you too, jdh. We just disagree on where the line should be, and although we may be comfortable with our own choices, this kind of discussion does help those behind us to figure out their own approach to this very individual issue.

I do hear what you're saying Samoa. I have dealt with these kinds of patients as well, almost most of us on the front lines have - Psych, FP, IM, and ER (maybe certain parents in peds?). And these people are trying to go get you off your game, wether intentionally or they're just a naturally born jackass like that. I simply don't see how insisting on someone calling you doctor allows for better "practical" boundaries . . . I'm not going to give you opiates/benzos/muscle relaxers, I won't fraudulently fill out paper work for a motorized scooter, I won't lie so you can get handicap parking, I won't lie and say you're disabled, you don't need abx for a cold . . . call me by my first name, call me "kid", call me a "stupid racist mother****er who doesn't understand the how hard it is for a blackman" (and I have actually heard that one) . . . My practical boundaries are set. I don't need you to call me doctor, you won't get your nonsense past me.

 

[Doctor4Life1769]

I do agree with jdh.

You can't demand everyone call you doctor.

You can't demand respect. You can only COMMAND respect through your actions (i.e. hard work) and the way you care for your patients.

Much in the same way a chef can't demand respect. They let their finished product (i.e. meal) do the talking.

You can still do what you need to do, and maintain boundaries, by being a professional when a jerkoff is in your office (or ED, etc.).

I've been called things as benign as "kid" and something as malign as "*******" .... doesn't change anything. You still have to manage them. If they're stable and obviously well, turf them out... but otherwise, you need to be the professional here. Patients have no liability, YOU do.

Going around telling patients to call you doctor every time someone makes a mockery of you or your intelligence does nothing positive for you or the patient, and may make you look pretty lame/needy in front of your colleagues.

If you came into this profession expecting it to be all rosy and peachy, maybe you should have looked harder into the profession before starting.....👍