Where do we fit?

[AcronymAllergy]

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Not clear on this comment. I'm guessing you have a really easy last name and don't work with children.

I believe PSYDR was referring mainly to interactions with other healthcare professionals (and particularly with physicians).

 

[PsySeeker]

To expound upon this, here are some recs from an article I wrote w. a colleague about being a psychologist working in a medical setting. We wrote these 6-7 years ago, but I think they are all still very applicable in today's healthcare arena. (The bolding was added for this thread, and some shortened for brevity).

I'll add: don't accept the name game. It's either both dr surname or both first name. They call you by your first name, you do the same. They call you doctor surname, you do the same. It cannot be dr physician and John Doe psychologist. That type of linguistic stuff just reinforces that psychologists are not "doctors".

Do not do the stupid "dr first name". Get therapy if you cannot handle the power differential.

Excellent point.

It may sound minor, but how patients view you and how other staff view you are really important factors in day to day work. I spend a majority of my week dealing with difficult pts, their families, administrators, and often other providers...so the perception of others is a big part of being able to get things done.

As an aside, this is where hospital privileges and full faculty appointments come into play too. As a FT faculty we have full voting rights and the same responsibilities as our physician colleagues (e.g. serving on dept/hospital committees, teaching in the residency program, participating in review boards, etc), which has really helped ensure equal footing in clinical, administrative, and research settings. Being relegated to adjunct or auxiliary faculty weakens your position in the hierarchy and it has a very clear difference in pay and responsibility. Some faculty activity avoid committees and the like, but I want to ensure a seat at the table instead of not even being a consideration when important decisions are made.

Anyone who allows themselves to be treated like a second class citizen has no one else to blame but themselves. This applies to titles, pay, and overall responsibilities.

I think you guys should considering compiling your knowledge on this topic and making it a sticky. A lot of people read these forums, if we want to move in the direction of being treated as equal professionals we need to start somewhere. Why not display the why and the how prominently on here?

 

[PsyDr]

T4C:

MEDICAL Faculty. None of that Allied Health Professional Faculty bull.


Dr. Eliza: As always we disagree. Dr. Sanjay Gupta has a mildly difficult name to pronounce, but CNN does not call him Dr. G. My last name is easy to pronounce. My various personal physicians names are not, but they do not go by "Dr. Dave". Some of colleagues have difficult to impossible to pronounce names. However, they still go by Dr. Surname. If you choose to go by Dr. Firstname, you are already saying that you are different and not equals with those that use the proper mode of address.

 

[Therapist4Chnge]

MEDICAL Faculty. None of that Allied Health Professional Faculty bull.

Absolutely. Allied Health Professional status has far-reaching limitations in regard to protection and promotion within the medical community. Being FT Medical Faculty requires more continuing ed credits, additional quality assurance procedures (random record review as part of yearly renewing of hospital privileges), and all sorts of fun red tape...but we are far better taken care of than if we were just "staff" or AHP. Most clinicians don't know the difference between all of these titles and designations, but they really should!

 

[erg923]

I think that is a little hardlined in you are doing child therapy or evaluations. I actually do think we should be seen differently than physicians by our patients.

 

[Doctor Eliza]

Dr. Eliza: As always we disagree. Dr. Sanjay Gupta has a mildly difficult name to pronounce, but CNN does not call him Dr. G. My last name is easy to pronounce. My various personal physicians names are not, but they do not go by "Dr. Dave". Some of colleagues have difficult to impossible to pronounce names. However, they still go by Dr. Surname. If you choose to go by Dr. Firstname, you are already saying that you are different and not equals with those that use the proper mode of address.

I'm pretty sure anyone can pronounce Gupta. Come on.

I do know physicians who go by Dr. firstname, especially in pediatrics. But I do not work in a hospital setting, and it seems you were specifically referring to medical settings among colleagues. In my case, it seems pretty appropriate (in fact, I like it) when my kid clients call me Dr. Firstname rather than Dr. Impossibletosaylastname.

My real issue is with the NYT that goes out of its way not to call PhDs "Dr." They quote Harvard professors and refer to them as "Mr." or "Ms." At the very least the could call them "professor." Unacceptable.

 

[PsyDr]

Erg: IMO, I would argue that having the title allows for the maintenance of boundaries in therapy, and that offering to change the sign, which in this case could be considered the title, would be a boundary violation by the therapist. In keeping the title, one can explore the transference and countertransference if one is dynamically inclined. If one if CBT inclined, then the use of the informal mode of address could represent a cognitive distortion of the nature of the relationship, which could be addressed using Functional Analytic Psychotherapy. If one were family systems, one could formulate that this is recruitment. If one were humanistic or whatever, then one could address the feelings that motivate that communication. But if there are no boundaries set by the title and situation, things could get confused, which would be, IMO, a failure by the therapist to address his/her own feelings of the power differential and its relationship to the nature of psychotherapy.


E: that's from the associated press stylebook. NYT wont change until the AP changes the convention.

I am referring to all psychologists. I can understand allowing kids to call you Dr. E, if your name is difficult to pronounce, but if you are doing that to other professionals they are not going to treat you the same as other healthcare providers. This is really day one tactics in court to start the discrediting of an expert. Attorneys use this tactic because it works. Will Ferrel did it in Stepbrothers....


[YOUTUBE]http://www.youtube.com/watch?v=91hSwiTvtyw[/YOUTUBE]

 

[thewesternsky]

PSYDR- Do you allow your graduate or practicum students to use your first name? I'm curious because most graduate programs I've seen operate on a first name basis between graduate students and professors.

As a student therapist, I use "my clinical supervisor, Dr. Smith" when talking to my patients... But typically I'd call him "John" in person after the first few contacts.

(I always wait until the supervisor provides an opening to switch, of course... Usually this occurs in person when they correct me for using "Dr.", or by email when they sign using first name only.)

 

[AcronymAllergy]

PSYDR- Do you allow your graduate or practicum students to use your first name? I'm curious because most graduate programs I've seen operate on a first name basis between graduate students and professors.

As a student therapist, I use "my clinical supervisor, Dr. Smith" when talking to my patients... But typically I'd call him "John" in person after the first few contacts.

(I always wait until the supervisor provides an opening to switch, of course... Usually this occurs in person when they correct me for using "Dr.", or by email when they sign using first name only.)

I'd say this probably varies even from professor to professor...no one addressed my advisor by first name, even though it was never formally stated as a "rule." However, other advisors would frequently request grad students use their first names.

My supervisors on internship and here on postdoc typically have never gone by first name, at least while at work and especially in the company of other professionals. Although the settings have all been AMCs and VA MCs/hospitals, so that could be a large factor as to why.

 

[erg923]

and here on postdoc typically have never gone by first name, at least while at work and especially in the company of other professionals. Although the settings have all been AMCs and VA MCs/hospitals, so that could be a large factor as to why.

Uh, is you whole day like this? http://www.youtube.com/watch?v=9Lge2_H_8IQ

Funny, but kinda stick up the ass if you ask me.

 

[AcronymAllergy]

Uh, is you whole day like this? http://www.youtube.com/watch?v=9Lge2_H_8IQ

Funny, but kinda stick up the ass if you ask me.

Basically, yep.

In all seriousness, though, it's mostly a matter of keeping with hospital "parlance" (and if we don't address each other with professional titles, why would anyone else take the titles seriously?) and also understanding that even though I'm a fellow, I'm still a trainee, and there's still ultimately a series of professional relationships and boundaries to maintain...at least while at work and in the presence of other folks.

I don't really see it as much different from most other work settings. I probably wouldn't default to calling a senior-level boss by her/his first name unless they'd given me the express ok.

 

[erg923]

I have reservations about people having to call me doctor because I am insecure about my image to others. I can get on board within the context of treatment teams and in-front of patients of course...but behind closed doors? Get real. We are all big boys and girls here....

By the way, I think Francis still goes by Jorge to most. 🙂

 

[docma]

The debate about titles is also about cultural competence I think, as well as organizational/advocacy competencies in a political sense. The skill I think is in learning how to be comfortable with using the title when it is appropriate and going without when that is appropriate and there is a learning curve to that, like all clinical skills.

Legend has it that (and it was reality in my experience there) that faculty all used Mr. (and the rarer Mrs...or Ms.!) because the culture assumed everyone had a Ph.D. 😉

 

[Therapist4Chnge]

I had an instance pop up yesterday afternoon that illustrates one of the reasons why this matters. I was asked to be present while a social worker spoke with a very volatile patient about some bad news. The patient has ongoing impulse control and anger problems, and he started to escalate quickly bc he didn't like what he heard from the social worker. We've found the only thing that works (besides 4-pt restraints and/or IM injections) is having an authority figure present and asserting him/herself during the interaction. Anyhow, she started w. "now Mr. (my name) is going to talk to you", which went over like a sack of bricks. When I re-introduced myself I said, "Dr. So and So" and it was like a light switch went off. His affect changed, his voice changed, and he talked to me like a human being. It is amazing how pt interaction changes when titles are used. /anecdotal

 

[paramour]

Why did it take her 6 years to get a masters?

Er, my recent "master's" took 6 years.

 

[JeyRo]

At my VA site, the doctors (me and the MDs) all refer to each other by our first names. Social Work is on a first-name basis with the doctors. OT calls me by my first name. RT and PT seem to habitually use the "Dr." monniker, in contrast. Not sure why.

With the nursing staff, it's variable. Some of the RNs refer to me as "Dr. so-and-so" without fail. Others (typically administrators) default to the first name. All LVNs and NAs doctor me to death, even the ones I know really well and have occasionally prompted them to call me by my first name (e.g., when we're chatting in the breakroom).

Needless to say, when we're in treatment team meetings or meeting with patients, the "Dr." prefix is always used to refer to me. I think everyone gets that it adds to my authority when I'm identified properly.