Interns calling supervisors by first name

[YungPsy]

Well maybe it’s exactly as you said which I thought was a good point - that it’s possibly partially due to shifting cultural norms. Which can make those few outliers really stand out, and then we fall prey to the base rate fallacy or whatever the appropriate term is

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[GradStudent2020]

As a current PsyD student, reading this post was insightful, and so I want to offer another perspective.

The best supervisors I have worked with did not emphasize their titles. Instead, they recognized that respect was less about their title and more about how they related to trainees (i.e. by being a nice human being in the room) while maintaining good boundaries about the hierarchical role that everyone already knows they hold. Of note: I have had supervisors that I fondly referred to solely by their titles, but they never had to ask or emphasize those titles.

From a trainee standpoint, emphasizing the "Dr." title with interns often communicate that the supervisor likely cares more about the power differential than their supervisee. As interns and externs, we are already extremely aware of the power dynamics and hierarchy that exists in the supervisor- trainees relationship, so when a supervisor emphasizes the need for the "Dr. title" it comes across as power play on the part of the supervisor even if that was not their intent. As such, they are often perceived as impersonal, uncaring and/or unapproachable. The reality is that most interns would call you Dr. XYZ anyway and the ones who do not are probably not being "intentionally" disrespectful OR if they are being intentionally disrespectful, they would do the same exact thing when they call you by your "title."

I believe that respect is not defined by the title a supervisor holds, but by how they carry themselves in that role. You can maintain hierarchy and authority without a title because the nature of your position already secures your authority (i.e. it clarifies power differential). As a trainee who grew up in a culture where respect is highly valued, I often call supervisors by their title until they tell me otherwise, but to be honest, the boundaries and respect I have for them does not come from using their "title." If anything, the level of respect I already feel is diminished when a supervisor emphasizes their "Dr. title " because it comes across as if they have made assumptions about my character (i.e. they have assumed that maintaining hierarchy by emphasizing the Dr. title" is the only way that trainees can be taught to show respect or maintain boundary).

In situations where trainees call supervisors by their first names when not invited to do so, it may be more useful to directly express concerns about that and discuss your preference with that trainee without automatically assuming their motives and intent. This is because much like a therapist-patient relationship, the power differential in the supervisor-supervisee relationship is always present, and related to individual perspectives and/or expectations.

I really appreciate everything you said here. It has definitely been my (anecdotal) experience that supervisors who feel the title is what warrants respect severely lack in the interpersonal department. The ones most insistent were fairly terrible potential mentors that were difficult to learn from. Very focused on the illusion of respect/power rather than the clinical environment.

I’ve been in the field for a little over a decade and have always deferred to Dr. X unless told otherwise. I do that because it seems to be proper/the social norm, not because I hold more professional respect for Dr. X than Mr. X (ex. Therapist).

 

[pediatric_psydoc]

Broadly, I think use of titles seems to be a cultural and generational preference. I just don't see the problem with modeling respect for those with more experience/age in our culture; I think normative American culture tends to shun titles generally, though (with titles representing a class/hierarchy to them, perhaps?), whereas other cultures tend to value showing respect those with more experience or with greater age through titles. It's the same as saying things like "sir" or "ma'am," which have started to phase out of dominant American culture, except regionally (maybe pockets of the US still do this?). My parents and grandparents were raised to say "ma'am" and "sir," but I wasn't, and neither are the generations beyond millennials. I think it's perfectly fine to offer a title of respect to folks, and it's not necessarily a sign of narcissism to ask to be referred to as such.

As I mentioned previously, yes, in some cases, folks with titles can be on a power trip (and so can those who don't ask to be referred to as "Dr."), but I don't think it's a fair assumption to generalize to everyone.

I'm just wondering why it's seen as so extreme by today's trainees for supervisors to use their title with them....is it not fair to offer a small sign of respect to those who are taking the time to train us?

And also as @PsyDr said, addressing a person as “dr” demonstrates recognition of the achievement of 20+ years of education.

 

[msc545]

Sometimes I have felt that I no longer have a first name, as it has become "Dr." in clinic by virtually everyone, including my peers. It seems to be the culture in our facility, and I have reluctantly adopted it. My closest friend at work has always called me "Dr", and I him.

 

[WisNeuro]

This thread is like a forum version of a Rorschach looking at reaction formation/projection. Sometimes a cigar is just a cigar folks

 

[ClinicalABA]

And also as @PsyDr said, addressing a person as “dr” demonstrates recognition of the achievement of 20+ years of education.

Actually, the doctoral degree and the 3 licenses and one board certification (official copies) on the wall behind me are reminder/recognition enough of the 20+ years of education and experience. Any (many a?) fool can call themselves Dr., whereas less fools have the stuff on the wall!

I'll add that even though I feel the need to have others directly refer to me with the title, I always refer to the other psychologists I work with as "Dr." in the presence of clients or interns. I am especially mindful of this in that they are all females and I am a male, and there is some research that males under-use titles like "dr." when referral to female colleagues vs. male colleagues.

Also, in my setting when a co-worker directly refers to me as "doctor," it's typically a goof or because they want something, rather than a term of respect. I prefer they respect me because i do my job well and make their jobs easier, vs. simply because of my educational history.

 

[PsyDr]

To clarify:

In my personal observations, it would seem that many psychologists act in an informal manner with people. Many seem to offer to be addressed by their first name rather quickly. I'm guessing that a lot of this behavior is motivated by a desire to please people, and quickly establish rapport. And I don't think it is necessarily a bad thing.

HOWEVER, if one is in a setting and the physicians are all addressed as Dr. LASTNAME while the psychologists are addressed differently (i.e., referred to as MR/MRS/MS LASTAME or FIRSTNAME or DR. FIRSTNAME), then there will be an obvious hierarchy. This is a bad thing. Keep in mind, that in 2008 the AMA tried to ban any non-physician from calling themselves "Dr." in hospital settings. They ignored the idea that physicians from the UK get a masters degree and do not have a doctorate. It's an attempt to corner a title. I doubt it will be the last time. There are publications as of 2018.

I think maintaining the title is very important, even if it means being slightly less agreeable.

 

[deleted106747]

As I"ve commented in a thread awhile back, women's achievements have been overlooked and minimized historically (including titles that they achieve), so not only to establish a clear boundary/framework, but to instill a sense of respect for women's accomplishments, I hold on to my title where appropriate (without flashing it around everywhere to be pretentious, of course), but to be fair, I haven't supervised since internship, when I didn't have the "Dr." title anyway.

It's all just a matter of personal preference, though. I don't think it's a terrible thing to be on a first-name basis with supervisors, in fact, in my experience, it was first-name basis for most of my supervisors, but I do think interns assuming their supervisors are okay with first names is a bit presumptuous; I'm in favor of observing what the supervisor introduces himself/herself/themselves as upon the first meeting and/or in emails to the supervisee.

Patients - call me Dr.
Students - call me Dr.
Colleagues - call me by my first name when we are in meetings/hanging out, call me Dr. in front of the patients (some find this difficult and just do Dr. all the time which is fine).

Any relationship in which I want there to be a very clear boundary, e.g. that we are not friends, I maintain the Dr. title. I think it sends that message. I also have very much had the experience where people disregard my accomplishments and role and start to speak to me in overly familiar ways. This has always been done by males - male patients, male students. Anecdote is not evidence and I wouldn't be surprised if people run into this issue with female students/patients, I just haven't yet. I have a first name that lends itself to many nicknames, and I find the same dynamic with people out in the world who just shorten it without asking if that's my preference.

Probably cultural, but I'm not a big fan of how casual we get easily in the US. I refer to my patients by Mr. and Ms. too. I never wear jeans to work, either, unless there's some activity going on where I would prefer to be wearing them like CPR training, etc.

 

[WisNeuro]

Probably cultural, but I'm not a big fan of how casual we get easily in the US. I refer to my patients by Mr. and Ms. too. I never wear jeans to work, either, unless there's some activity going on where I would prefer to be wearing them like CPR training, etc.

Eww, are there really psychologists who wear jeans to work? Have some self respect.

 

[deleted106747]

Eww, are there really psychologists who wear jeans to work? Have some self respect.

On casual Fridays mostly. But there I am in my usual dress clothes, all stuffy and ****.

 

[pediatric_psydoc]

Eww, are there really psychologists who wear jeans to work? Have some self respect.

The CMHC down the street has “jeans Friday.” The AMCs at which I have worked, one while a psychologist and the others while a student, haven’t had such a thing.

 

[WisNeuro]

On casual Fridays mostly. But there I am in my usual dress clothes, all stuffy and ****.

You want to participate in casual Fridays, wear a polo shirt or something. Jeans in a professional setting are just...eww.

 

[Therapist4Chnge]

I'm in a practice w a bunch of physicians across a few specialties and it's pretty old school here. It's always Dr at work, with provider to provider being first name when not w patients or staff.

There are no differences when it comes to gender and title, so that's good. Trainees never use first name, though they tend to be medical students who always seem to be "deer in headlights".

I'm not sure if it's a generational thing but the avg is probably 55. Backgrounds are a mix of academics to PP and the rest straight to PP.

 

[Therapist4Chnge]

You want to participate in casual Fridays, wear a polo shirt or something. Jeans in a professional setting are just...eww.

Agreed.

Our staff does casual Fridays, but all providers are always at least biz casual (w suits for court and in-office depos). Scrubs sometimes if a provider is doing a procedure or are in surgery.

I actually talked with a colleague about dress code and conduct earlier in the week, and we agreed that we need to hold ourselves to a higher standard bc that is what the staff expects and we as providers expect.

 

[PsyDr]

Patients - call me Dr.
Students - call me Dr.
Colleagues - call me by my first name when we are in meetings/hanging out, call me Dr. in front of the patients (some find this difficult and just do Dr. all the time which is fine).

Any relationship in which I want there to be a very clear boundary, e.g. that we are not friends, I maintain the Dr. title. I think it sends that message. I also have very much had the experience where people disregard my accomplishments and role and start to speak to me in overly familiar ways. This has always been done by males - male patients, male students. Anecdote is not evidence and I wouldn't be surprised if people run into this issue with female students/patients, I just haven't yet. I have a first name that lends itself to many nicknames, and I find the same dynamic with people out in the world who just shorten it without asking if that's my preference.

Probably cultural, but I'm not a big fan of how casual we get easily in the US. I refer to my patients by Mr. and Ms. too. I never wear jeans to work, either, unless there's some activity going on where I would prefer to be wearing them like CPR training, etc.

I highly agree with the gender aspect. Which is one of the reasons I think all psychologists should maintain the formality of the title.

 

[AcronymAllergy]

Most of the mental health providers here (including multiple psychiatrists) wear jeans when they're allowed on Fridays. I don't, but I also tend to find my work pants to be more comfortable than my jeans. Not sure about the physicians outside mental health; probably more of a mix.

 

[psychetudier]

"Doesn't believe in A grades" supervisor insisted upon "Dr." from day one and at all times. Just some anecdotal stuff there.

 

[WisNeuro]

When I was an undergrad, clinical faculty who insisted everyone call him by his first name was later indicted for sexual assault of a student, as long as we're throwing out anecdotes.

 

[ClinicalABA]

Eww, are there really psychologists who wear jeans to work? Have some self respect.

Had somebody show up recently for a job interview (psychologist position) wearing jeans. We have added a "dress like a professional/grown up" seminar at the beginning of the pre-doctoral year didactics.

 

[PsyDr]

Had somebody show up recently for a job interview (psychologist position) wearing jeans. We have added a "dress like a professional/grown up" seminar at the beginning of the pre-doctoral year didactics.

But do drop crotch sweatpants count as professional dress?

(some of us remember)

 

[ClinicalABA]

But do drop crotch sweatpants count as professional dress?

(some of us remember)

No, but if you show up in Zubaz or Hammer Pants, you’re hired just on principle. I’ll even promise to always call you Dr. regardless of your degree.