Formality with Attendings

[Wolf02]

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Hey Everyone,
I was just wondering how do you address your attendings and PD? Do you call them by their first name or as Dr. ____? case by case?
For example, my new PD signs his emails with only his first name, but it still kind of feel strange to just call him by his first name on the return emails....

Thanks!

 

[ResSwitchThrowAway]

Dr. Lastname, unless they specifically tell you otherwise.

 

[colbgw02]

To me, that is a clear indication that your PD is okay with first names. However, as always, understand context. That is, don't call him Jimmy in the middle of a meeting in front of other residents/attendings. And, of course, it's always better to err on the side of being too formal.

 

[NotAProgDirector]

Crazy idea: ask!

 

[Wolf02]

Crazy idea: ask!

We'll that I was planning on doing anyways, but I was asking the forum first to see if there was an already established societal component that I wasn't privy to yet. Thanks all.

 

[Raryn]

Dr. Lastname unless I know them in a personal context (which is generally only the attendings that were residents/fellows within the last 1-2 years). Even if they say I can call them Jim or whatever, I still usually stick to Dr. Lastname if they're my attending.

 

[norwood]

Put it this way: you're never in the wrong by using Dr. Lastname. The small percentage of docs who'd rather be called by their first name (I'm one, incidentally) will speak up to correct you, but we're so used to it that we can't object.

Reminds me of working with a CRNA who was a veteran...

me: I know you're really used to calling everyone Sir, but please just call me _____
CRNA: Yes, Sir!

 

[gostudy]

My rules:
Never call a physician of any level by first name in front of patients.

Always call physicians I either grew up with or knew as med students, residents, or fellows by first name in casual and social situations. And when I'm an attending always call faculty more junior than me by first name in social and casual situations.

Always call attendings by last name in ALL contexts (unless more junior, see above).

ONLY address attendings by first name in social/casual situations if he or she insists I call them by first name in these contexts.

It's just like going to a party or event. Hard to be overdressed, easy to be underdressed.

Funny thing is though when I'm an attending I won't make a big stink about what people call me (I'm not insecure like that) but I will note who doesn't follow my own self imposed rules above. If some intern calls me by first name because I'm a cool young attending I won't correct them but will make note of their cocksureness.

 

[evilbooyaa]

Attendings = Dr. Lastname only. Residents generally = first name unless maybe first time introducing self to a senior.

Anyone in front of patient = Dr. Whatever.

 

[j4pac]

To me, that is a clear indication that your PD is okay with first names. However, as always, understand context. That is, don't call him Jimmy in the middle of a meeting in front of other residents/attendings. And, of course, it's always better to err on the side of being too formal.

I don't think so.

I'm in the military so I have developed a pretty good sense of what's ok and what's not. Calling your PD by his first name is NOT EVER appropriate unless the PD specifically tells you to call him/her that. And them putting their first name on an email is NOT an indicator that you can call them that. Some people just don't want to address THEMSELVES as "Dr." because it sounds snooty. Also...your PD may be ok with calling him Bob one on one...but unlikely to be ok with it when you are around other residents/med students/nurses.

Same goes with med students vs residents. It is always better to be the safe side and call the resident "Dr. ____". They will very likely say..."call me Joe". That box is checked. Med student to med student and resident to resident...first name basis is ok. If I had a fellow over me...I would call him "Dr. ____" until he told me otherwise.

Another thing...just because your attending is ok with you call him/her by their first name does NOT mean that the other attendings are ok with you referring to them by their first name. Keep the formal identifier rules when you are referring to your superior.

 

[colbgw02]

Okay, well, I'll put it this way:

As staff at a residency program and also someone in the military, I would not sign an email with my first name unless I were okay with the recipient calling me by my first name. And yes, I routinely sign emails to subordinates using my title and surname. I mean, it's okay if they prefer to call me Dr. X (and pretty much all do) when I've indicated otherwise, but this is just the online equivalent of using how someone used to introduce themselves in person. The rule used to be that, upon introduction, if the senior person is "Chris", then it's okay to be Chris provided that the context is appropriate even without explicity stating so.

 

[Winged Scapula]

I've also noted a distinct specialty based difference.

Surgical programs tend to be more conservative with everyone using "Dr"; during fellowship my PD told me to call him by his first name. Just couldn't do it.

EM and FM programs seem to be much more casual with attendings going by first names.

YMMV but I think the advice above to always use "Dr" in front of patients or with people senior to you especially unless told otherwise and you feel comfortable.

 

[dpmd]

I've also noted a distinct specialty based difference.

Surgical programs tend to be more conservative with everyone using "Dr"; during fellowship my PD told me to call him by his first name. Just couldn't do it.

EM and FM programs seem to be much more casual with attendings going by first names.

YMMV but I think the advice above to always use "Dr" in front of patients or with people senior to you especially unless told otherwise and you feel comfortable.

This is true. There is a guy who was my attending for the first two yrs of residency and is a very laid back kind of guy who I have been drunk with and have gone to his ski cabin with him and his family before. He is the reason I have the private practice job I have now and I consider him a friend. However, I am still unable to call him by his first name. I don't always throw the Dr. title in front but basically just use his last name (maybe that is a holdover from my enlisted days). The other surgeons in the community aren't technically my superiors, but they are older than me so the get the last name usage as well.

 

[BoardingDoc]

I've also noted a distinct specialty based difference.

Surgical programs tend to be more conservative with everyone using "Dr"; during fellowship my PD told me to call him by his first name. Just couldn't do it.

EM and FM programs seem to be much more casual with attendings going by first names.

YMMV but I think the advice above to always use "Dr" in front of patients or with people senior to you especially unless told otherwise and you feel comfortable.

There is definitely a culture difference among different specialties. All the surgery residents at my program refer to their attendings as Dr. <name>. I, and most of my EM co-residents call about 90% of our attendings by their first name. The only time I refer to them as Dr. is in front of patients.

 

[lockjaw]

I've also noted a distinct specialty based difference.

Surgical programs tend to be more conservative with everyone using "Dr"; during fellowship my PD told me to call him by his first name. Just couldn't do it.

EM and FM programs seem to be much more casual with attendings going by first names.

Yup, this. I'm in pediatrics, and it feels weird if I address an attending as Dr. Lastname. We go exclusively by our first names here (except in front of patients).

 

[gostudy]

Same goes with med students vs residents. It is always better to be the safe side and call the resident "Dr. ____". They will very likely say..."call me Joe". That box is checked. Med student to med student and resident to resident...first name basis is ok. If I had a fellow over me...I would call him "Dr. ____" until he told me otherwise.

Maybe it's just me, but I always found it pretty obnoxious when a resident (or fellow for that matter) wants to be addressed as "Dr." by people more junior. I've always insisted on calling residents, even while in med school, by their first name.

 

[rokshana]

Maybe it's just me, but I always found it pretty obnoxious when a resident (or fellow for that matter) wants to be addressed as "Dr." by people more junior. I've always insisted on calling residents, even while in med school, by their first name.

no its the whole millennial generation...its defined by the entitlement...

 

[DrPerrla]

Maybe it's just me, but I always found it pretty obnoxious when a resident (or fellow for that matter) wants to be addressed as "Dr." by people more junior. I've always insisted on calling residents, even while in med school, by their first name.

I don't find it obnoxious but as a med student (can almost say was!), I also only addressed attendings as Dr. Lastname. I called all fellows and residents by first name and I have never been in a situation with other med students at my institution where they did anything different. Didn't seem to bother anyone.

no its the whole millennial generation...its defined by the entitlement...

Maybe he shouldn't have said that it's obnoxious if a resident or fellow wants to be addressed as Dr. Lastname, but I honestly don't see what this has to do with being "millennials" and entitlement. This could be an institution based formality, could be geographically based, etc... If you're offended or feel disrespected because some med student(s) don't call you Dr. so and so, I think that's extremely petty of you.

 

[rokshana]

I don't find it obnoxious but as a med student (can almost say was!), I also only addressed attendings as Dr. Lastname. I called all fellows and residents by first name and I have never been in a situation with other med students at my institution where they did anything different. Didn't seem to bother anyone.



Maybe he shouldn't have said that it's obnoxious if a resident or fellow wants to be addressed as Dr. Lastname, but I honestly don't see what this has to do with being "millennials" and entitlement. This could be an institution based formality, could be geographically based, etc... If you're offended or feel disrespected because some med student(s) don't call you Dr. so and so, I think that's extremely petty of you.

no, i don't expect med students or residents to call me dr. last name....i'll introduce myself as rokshana , but to presume the informality as a given is presumptuous of the med student or resident (less the resident but most definitely that of the med student)...and as stated elsewhere...not going to be picky about it...but it is noted...

 

[DrPerrla]

no, i don't expect med students or residents to call me dr. last name....i'll introduce myself as rokshana , but to presume the informality as a given is presumptuous of the med student or resident (less the resident but most definitely that of the med student)...and as stated elsewhere...not going to be picky about it...but it is noted...

I think we're going to have to agree to disagree. You're entitled to your opinion as am I to mine. I don't think it should be "noted" at all and I don't think it's presumptuous of med students or residents to presume informality. Of course you're going to introduce yourself as whatever your first name is, especially since these people aren't your patients. Attendings for the most part introduce themselves by first name as well. Out of respect we all call them Dr. Lastname, not that we don't respect the fellows or residents, but like I said before, I think it just becomes petty. What about med students who already have their PhD? You address your PhD professors as Dr. Lastname so why not them? The attending is the one who is ultimately responsible for everyone's (fellows included) actions regarding their patients, so until you have that responsibility riding on your shoulders I'm not going to automatically call you Dr. Lastname.

 

[rokshana]

I think we're going to have to agree to disagree. You're entitled to your opinion as am I to mine. I don't think it should be "noted" at all and I don't think it's presumptuous of med students or residents to presume informality. Of course you're going to introduce yourself as whatever your first name is, especially since these people aren't your patients. Attendings for the most part introduce themselves by first name as well. Out of respect we all call them Dr. Lastname, not that we don't respect the fellows or residents, but like I said before, I think it just becomes petty. What about med students who already have their PhD? You address your PhD professors as Dr. Lastname so why not them? The attending is the one who is ultimately responsible for everyone's (fellows included) actions regarding their patients, so until you have that responsibility riding on your shoulders I'm not going to automatically call you Dr. Lastname.

you're right, we will have to agree to disagree..but that is also very generational in thinking...silent generation, baby boomers, gen x , and millennial think differently and were trained differently..the informality of millennial generation is at a different level...and the word entitled is often used with this generation...sure there are many that don't act that way, but is is not an uncommon observation.

 

[dpmd]

Rokshana, I have a feeling @jdh71 would agree with your interpretation. I do find it interesting that in addition to being comfortable with informality with those above them (but only slightly above them I guess in their minds) they take it a step further and are annoyed by those that prefer to maintain the heirarchy.

 

[gostudy]

no its the whole millennial generation...its defined by the entitlement...

I don't see it as a "millennial" or "entitlement" thing at all. I always call attendings/faculty (again, that I didn't previously know as a med student, resident, or fellow) by last name even if they are just one year into being an attending. That's a sign of respect in my book. The only way I call an attending by first name is if they insist I do.

It's not the military, so if we went to college and med school together and you happen to finish residency before me and become an attending I'm not going to call you by "Dr. Lastname" in non-patient care contexts. If you insist I do, we're probably not friends anymore. In the same way, 100% of all the residents I've known who have insisted on being called "Dr." while a resident have been obnoxious and uptight. Anecdotal, but my experience.

Plus, when I'm an attending I won't pitch a fit if some n00b calls me by my first name because I'm confident enough in my educational background, skill, and expertise that I don't need someone calling me "Dr." to make me feel better.* And for the most part if I have enough respect in my department, I won't even need to correct the n00b, other people would do it for me.

*The one caveat being if the n00b does this in patient care contexts I'd correct him immediately because that is disrespectful.

 

[jdh71]

Rokshana, I have a feeling @jdh71 would agree with your interpretation. I do find it interesting that in addition to being comfortable with informality with those above them (but only slightly above them I guess in their minds) they take it a step further and are annoyed by those that prefer to maintain the heirarchy.

You mean how useless millennials are?

God help us. All.

 

[jdh71]

To be honest though. I often feel a bit silly about the whole "doctor jdh" thing and I like my students and residents to call me by first name. (Or "big sexy papa" - however that one got me sensitivity training so no more of that!)

We should always use "doctor" around patients because. Well. That actually what patients want. For instance: "I was talking Steve and Steve thinks we should we need an special heart study in the case to look for the arrhythmia source". Vs. "I was doctoring to dr green and dr green thinks we should . . ."

 

[dpmd]

To be honest though. I often feel a bit silly about the whole "doctor jdh" thing and I like my students and residents to call me by first name. (Or "big sexy papa" - however that one got me sensitivity training so no more of that!)

We should always use "doctor" around patients because. Well. That actually what patients want. For instance: "I was talking Steve and Steve thinks we should we need an special heart study in the case to look for the arrhythmia source". Vs. "I was doctoring to dr green and dr green thinks we should . . ."

Yeah, I don't insist on being called doctor and mostly tell people to use my first name (and refer to myself by just my last name with no doctor so those uncomfortable with first names have an option less formal than dr last name). However, if a student/resident/allied professional I haven't met just strolls up to me at the nurses station or something (so clinical context but not directly in front of patients) I am going to think it is weird and maybe disrespectful, perhaps just not polite (I wouldn't call my patients by their first names when first meeting them, you wait for someone to tell you you can be informal).

 

[maxxor]

As a resident, I don't even know my attendings first names. They are just (last-name) in my head. Reminds me of high school sports... "Greenberg said to do x. Patel said to do y."

 

[Wilf]

Maybe it's just me, but I always found it pretty obnoxious when a resident (or fellow for that matter) wants to be addressed as "Dr." by people more junior. I've always insisted on calling residents, even while in med school, by their first name.

But the Dr. in front of the name is there because of the MD degree. So an attending is no more of a doctor than a resident or someone who completed medical school but never did residency (such as Dr. Jarvik.)

 

[gostudy]

But the Dr. in front of the name is there because of the MD degree. So an attending is no more of a doctor than a resident or someone who completed medical school but never did residency (such as Dr. Jarvik.)

Being called "Dr." as a resident is not technically wrong. We are MDs/DOs after all as you say. It's a cultural thing though. The general academic medical culture is that residents do not go by Dr. Lastname in non-patient care contexts. I don't think it's weird for a med student to call a resident or fellow "Dr." either on initial meeting or all the time. However, I do think it strange for residents and fellows to insist that med students call them "Dr."

 

[mvenus929]

Same goes with med students vs residents. It is always better to be the safe side and call the resident "Dr. ____". They will very likely say..."call me Joe". That box is checked. Med student to med student and resident to resident...first name basis is ok. If I had a fellow over me...I would call him "Dr. ____" until he told me otherwise.

We snicker at the med students when they call us 'Dr.' Outside of direct patient care. It is seen as unnecessary formality.

There is definitely a culture difference among different specialties. All the surgery residents at my program refer to their attendings as Dr. <name>. I, and most of my EM co-residents call about 90% of our attendings by their first name. The only time I refer to them as Dr. is in front of patients.

I have noticed that EM tends to be more lax about titles than other specialties. I know a good portion of the EM faculty at our hospital by their first name or nickname (partly because they list their names on the patient tracking board), but the surgery people, including the residents, almost always introduce them self by title, rather than name.

 

[Goro]

Eh, cut 'em some slack. I had a non-trad, older student once who had a daughter the same age as my sone in pre-schools. They played together and it turned out that they lived on the next block. Despite my best attempts at being a fellow parent and neighbor, she ( the mom) just could NOT bring herself to call me by my first name...it was always "Dr Goro".

I think it's a parent:child thing rather than mentor:mentee. Can you call your parents by their first names???



We snicker at the med students when they call us 'Dr.' Outside of direct patient care. It is seen as unnecessary formality.

 

[22031 Alum]

While a resident, attendings were Dr. Lastname unless they specifically told me to use their first name (many did, especially younger attendings). I always used first names for any residents or fellows who stayed on as attendings, though. Now, I'm at a much more formal program. I briefly entertained thoughts of having the residents call me by my first name, but that was quickly squashed. I can't even get them to stop calling me ma'am.

 

[mercaptovizadeh]

In my experience it's usually been first name basis with residents and fellows. I've never seen a fellow or resident who introduced themselves by their Dr. Surname title.

Attendings I address as Dr. Surname unless they specifically ask and tell me to call them by first name, which probably 20% do.

In front of patients, I always try to (don't always succeed) go by Dr. Surname for anyone (including co-interns).

 

[dpmd]

In real life i hardly refer to people by their names when talking to them so the whole title or not thing doesn't really matter i guess (although some of that is because i might not remember their names as i am speaking to them).

 

[username456789]

Our entire department (residents and attendings) are on a first name basis. You would sound very silly in our program if you referred to anyone as "Doctor _____."

That said, medical students call the attending "Doctor", although we generally insist they refer to the residents by first name.

 

[DrPerrla]

Like I've said before, I think it's a much more cultural (as in culture of the program/medical school/health system) than it is a generational or "millenial" thing and subsequent posts/recent posts continue to support this. I'll be a resident in a few months and if a med student calls me Dr. Lastname, my inclination is too feel like they're trying to kiss up. I don't need my ego petted. Really I think this is all so silly. In patient settings everyone with an MD is Dr. Lastname. Otherwise, Attending = Dr. Lastname unless heavily insisted, everyone else, first name. BOOM, problem solved.

 

[thepoopologist]

What about an attending who was a 4th year resident when you were an intern? Currently I call them by their first name unless they're around nurses, medical students, or acting in an official capacity. Then I go with Dr. Lastname.

 

[dienekes88]

I generally stick to Dr. Last Name. A couple attendings have asked me to call them by their first name. Even then... it doesn't feel right. With some of the big deal older attendings... even the other faculty and the chairman will call them Dr. Last Name even though they all sign their e-mails with their first name.

I've slipped up a few times with the anesthesiologists. They mostly seem chill, and I'm pretty friendly with them, though.

A different standard is to go by the name you learned when you first met them. Usually med students call residents and fellows by their first name. By that metric, if as an intern you met a 4th year resident as "first name," then you might consider calling them by their first name as an attending... you might want to test the waters prior to getting to familiar with them.

 

[Psai]

What about NPs that introduce themselves as dr. whatever? I just can't do it.

 

[Wilf]

What about NPs that introduce themselves as dr. whatever? I just can't do it.

I have never called a nurse practitioner Dr. and never will.

 

[Arcan57]

I'll agree that there are certain people I just can't address by their first name, even having trained in EM. There is an even smaller subset of doctors that I can't even discuss with a third party by first name because it just doesn't feel right. Outside of patient care, I introduce myself to everyone in the hospital (docs, nurses, environmental services, etc.) as firstname (+/- lastname) but find that 99% of time I am still referred to as Dr. Lastname. I think that forcing people to be less formal than they feel comfortable with is also somewhat rude.

 

[mvenus929]

Eh, cut 'em some slack. I had a non-trad, older student once who had a daughter the same age as my sone in pre-schools. They played together and it turned out that they lived on the next block. Despite my best attempts at being a fellow parent and neighbor, she ( the mom) just could NOT bring herself to call me by my first name...it was always "Dr Goro".

I think it's a parent:child thing rather than mentor:mentee. Can you call your parents by their first names???



We snicker at the med students when they call us 'Dr.' Outside of direct patient care. It is seen as unnecessary formality.

Given that, as interns, we are 2 years, exactly, ahead of the med students in training, having them refer to us by title rather than first name seems unnecessary. I don't personally know any of the attendings fresh out of training, though there are a few who insist that we call them by their first name, and we generally don't unless it's the ED (where the culture is different). So I get it for attendings, especially since if you are new to the system you don't know who is fresh out of residency and who has been in several years, but you always know how far ahead of you the residents are, and it's usually not several years (surgery excluded).

I also go by first names with the nurses, but have a couple who insist on calling me Dr. I don't like it, but I get it.

 

[Doctor Bob]

I tell people to call me Bob... or Dr. Bob if they're feeling very formal. I don't use my lastname much because people always get it wrong. And it's a pretty common last name. But whatever.

I had an attending who would get upset when he heard people call me Dr. Bob. He would tell the nurses and techs that they were only to call me Dr. Lastname. That was problematic because I was telling them to call me Dr. Bob. I even told the attending that my preference was for people to use Dr. Bob. He said it didn't matter; it was disrespectful to me (in his eyes) when people were so informal.

 

[kidthor]

When at work I call all physicians, whether they be attendings or co-residents by Dr. Lastname. This gets rid of any confusion and it maintains some level of hierarchy in a medical world where everyone from techs to IT people wear white coats and then tell you how medicine should be practiced. That being said, I don't really care what people call me. I always introduce myself as Dr. Firstname Lastname so that they can make their own decision on how to address me.

 

[operaman]

I was always taught the 1 level up rule -- first name is assumed to be okay within 1 level of training but anything beyond that and you should be formal until told otherwise.

 

[gostudy]

I was always taught the 1 level up rule -- first name is assumed to be okay within 1 level of training but anything beyond that and you should be formal until told otherwise.

Exactly. More elegant explanation of my rules. This also applies to attendings I meet initially completely outside the context of medicine. If we were on a first name basis when we meet then it stays that way outside of the medical context.

 

[styphon]

Interesting... In my family medicine program we called all of our attendings by Dr LastName and there were no exceptions.

Now that I am an attending, I hang outside of work with the receptionist/nurses and they insist on calling me Doctor, its very odd.

 

[Daiphon]

It's very individually dependent. I prefer my first name or surname alone, no appellation... because I pay more attention to it than "Doctor Daiphon."

Seeing as how I work in the ED, though, which is typically less formal, it isn't much of an issue. Plus, it's important to get my attention (codes, etc).

So, I typically tell my residents & students this: I prefer my given names, but understand if you're uncomfortable using them. However, if you *need* me pronto, then call out with them.

-d

 

[CardiacIntensivist]

As an anesthesiology resident I have on a first name basis with 95% of the attendings form the get-go. I absolutely can NOT bring myself to address the older ones.more established ones by anything except Dr. Lastname. Even if they have told me otherwise