When you're called "doc" by mistake?

[sdnetrocks]

Now say I was a clinical psychologist - so, a PhD - who was routinely called "Dr. Smith" by her clients and office staff, and went to a hospital to do an evaluation. I wouldn't expect to get "the doctor will be in shortly" because that does kind of imply an MD/DO type doctor. But if the attending doc referred to me as "Ms. Smith" all day, I'd think I'd be pretty grumpy by the end of it.

I imagine the attendings would just address you by first name, as they typically address each other... I agree, though, that this is a bit of a gray area.

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[saiyagirl]

I don't think there's anything wrong with being called "doctor."
I like to consider the two basic definitions of the word:
1) a person who has earned the highest academic degree in a specified discipline (this does not apply to me until May 2007 but does apply to many who are not in health care)
2) a person skilled or specializing in healing arts

Medical students, interns, residents, and attendings are as a team caring for the health of the patient; I believe all may be considered "doctors." Likewise, I wouldn't argue if someone said, "I have an appointment to see my doctor next week" where the "doctor" is a nurse practitioner. It's about the role as a health provider, not the degree.

In accordance with definition (1), I would not introduce myself as Dr. Me but would have no problem with "student doctor" (except that it does sound pretty dorky).

Doctors are people who have already earned a doctorate degree, period.

In the hospital world, people who have MD's or DO's are referred to as "doctor," and i think this is what most patients expect. (Some places also refer to PhD's as doctor).

I always correct people who call me doctor (and people who call me nurse, for that matter)...at the end of the day, it's just right for people to know the truth. student doctor is very misleading...also sounds ridiculous.

i just say that actually, i'm the med student on the team. i have the rest of my life to be called doctor, so what's the rush?

 

[DOtobe]

I never really corrected attendings when they called me "doctor" when I was a medical student. (Never jumped in and said, "oh, no, I'm a medical student...") But I did when patients called me "doctor" (however, as a female, I was probably called "nurse" more than doctor!)

And regarding the patient who was a doctor, I call all my patients Mr/Ms. I had a patient who apparently used to be an attending at my hospital but had since retired, and I didn't know he was a doctor until after I saw him for a cross-cover issue. He didn't care that I called him "Mr." Likewise, I wouldn't care if any of my patients called me by my first name. A lot of my clinic patients do call me by my first name, as well as families I sometimes talk to on call. One family member I met called me by my first name, and one of the other family members said, "You can't call her that!" like doctors have to be called doctor. I just laughed and told them they could call me whatever they wanted.

 

[miscalculated]

when i was called "doctor" by mistake recently, I found it really awkward, blushed and said "I'm not a doctor, I'm still training to be one."

 

[pillowhead]

when i was called "doctor" by mistake recently, I found it really awkward, blushed and said "I'm not a doctor, I'm still training to be one."

This isn't necessarily directed at anyone in particular, but it seems to me that the people who react this strongly to being called "doctor" are the ones that put so much emphasis on the title like it's some big amazing thing to be a called doctor. I mean, it's really not worth getting all awkward over. It's not like your being called Lord Username or being introduced as the Royal Username of Hospital X. Don't introduce yourself as Dr if you're not one, but generally, if a patient keeps calling you that after you correct them once or twice, who cares? Maybe they want to make you feel good or want to give you some respect--let them!

It just seems that if someone gets this freaked about being called "doctor" now, one's ego might get a little overly inflated when you actually are called doctor on a regular basis.

 

[miscalculated]

When I said "awkward", it was because I felt like a fraud when the patient called me such; that's why I reacted so strongly. I don't see what this has to do with "inflated egos".

 

[Samoa]

As to correcting the attending when they introduce you as a doctor. That is gutsy … I would instead take it as a compliment that the attending sees me as more of a colleague. I personally wouldn’t ever correct an attending b/c I have seen some students go down in flames for doing so. But, hey if you escaped without a bad eval then good for you.

The rest of my demeanor makes it clear I'm not "correcting" the attending so much as correcting the patient's impression of my status. Sometimes I don't do it right then, but I always do at some point if it's a patient I'm taking care of. Believe me, I would never overtly correct an attending in front of other people. At most, I would ask a question about whatever was said, commenting that I was under the impression <insert correct answer> was correct.

Usually the answer I get falls clearly into one of two types: 1) the attending has done far more reading and thinking about this issue than anyone who's previously taught me, and truly has a better grasp of the finer points of the subject. Or, 2) the attending has done far less reading and thinking about it, and perhaps this isn't a strong point of their knowledge base.

When I get a #1 type answer, I'm always very glad I asked in an unassuming manner.

Attendings were med students once, and not every one of them scored 100% on every test. My goal is simply to know whether I need to learn something different than what I've been taught. So I do it in a non-confrontational manner, and I've never gone down in flames for it.

 

[pillowhead]

When I said "awkward", it was because I felt like a fraud when the patient called me such; that's why I reacted so strongly. I don't see what this has to do with "inflated egos".

I think the reason people react so strongly to accidentally being called nurse or doctor is because those positions are perceived as being so low or high on the totem pole respectively. If we could all get over the title that will be after our names some day, I just don't think most people would see being accidentally called dr as such a big deal. If someone called you something completely off the medical hierachy (sp? my spelling has gotten so bad over 3 yrs of med school), I don't think you would react so strongly. It definitely has more to do with just being called something you're not.

(I'm really not directing this specifically to miscalculated, just to the forum in general.)

 

[velo]

I think some react so strongly because we are nervous about the responsibility that comes with the term "doctor." We like to be able to fall back on the fact that we're students, and we can always ask the resident/attending, and all of our orders have to be checked etc--so when a patient refers to us as "doctor" and asks a question, and we get flustered trying to explain that we're not "doctors" yet I think what we're really saying is "I'm not confident in the advice I'm giving you and I'd rather you not hold me accountable for anything I'm about to say."

I think we should take on as much responsibility as our level of training allows us to. If a patient who's having trouble understanding the hierarchy asks a question you know the answer to and calls you "doctor" I say don't fall over yourself explaining how you're not a doctor--confidently educate the patient.

Now I'm not saying to misrepresent yourself. You should introduce yourself as a medical student and make it clear that your level of training differs from that of the residents and attendings. And while I do find the term "student doctor" a little misleading and don't use it personally, I've been refered to as a student doctor and I don't feel as though its a cardinal sin. I think you should also feel comfortable enough to tell a patient, "I don't know, I'd have to look that up/ask an attending/etc" if you don't know the answer to the question they're asking. Just as you should give a confident answer when you do.

Bottomline: If you've explained to the patient your position and role and they still view you as their "doctor" step up and assume the role. Falling all over one's self to explain that they're a student usually means they're not comfortable viewing themselves as a doctor yet--which is perfectly understandable--but it also means that you have a patient who views you as a doctor and has given you a perfect oppertunity to get more comfortable in that role. Med school will be over before you know it. disclaimer: add to this the obvious stuff about not getting in over your head and making sure you only give the patient accurate information and are not afraid to say you'll have to research things/ask attendings/etc

 

[miscalculated]

Pillowhead, I know you're not directing this at me, that's alright. You're right in saying this has more to do with being called something you're not, but that extra thing is what Velo pointed out, that we don't want to take on the responsibility yet.

But what he said at the end was bang on and has given me a totally different slant on it, that we should step up and assume the role given the opportunity. Next time there'll be no blushes!

 

[Samoa]

I think some react so strongly because we are nervous about the responsibility that comes with the term "doctor." We like to be able to fall back on the fact that we're students, and we can always ask the resident/attending, and all of our orders have to be checked etc--so when a patient refers to us as "doctor" and asks a question, and we get flustered trying to explain that we're not "doctors" yet I think what we're really saying is "I'm not confident in the advice I'm giving you and I'd rather you not hold me accountable for anything I'm about to say."

That's not why I do it, at all. I'd be fine if it were my responsibility to decide things, but it's not. I always answer the patient's questions, when I know the answer. But I don't want the patient to be confused if I come in there and say one thing, and then what happens is something else entirely. So even when I know what I've said is correct, I make it clear that the decision is not mine, and there may be things I'm not considering that will change the plan.