Lisa Machado looks at the great personal divide between us and our doctors.
Does the honorific uplift or undermine the physician/patient relationship?
Ihave been compiling a list of “rules to live by.”
Top spot goes to social media: Do not ever get pulled into a Twitter or Facebook scrap, I tell myself. You can never win, and it just makes you feel bad. And, to be honest, I am no match for the virtual insults, online rages and digital putdowns from strangers who simply don’t agree with me. So I choose not to engage. Except for the other day. A Twitter post from a doctor caught my eye. She wrote about how one of her patients asked if they could call her by her first name, and she said no. It wasn’t so much the ‘ no’ part that got to me, but the way she framed the discussion. Her post went like this:
My patient: “Can I just call you Kendra?”
Me: “...NO.”
The ensuing tweets were from other doctors agreeing and sharing stories about how they never allow patients to use their first name, and how there needs to be a clear divide between doctors and the people they care for. One even went so far as to post a snarky note instructing patients to “call her by her name. And that’s DOCTOR to you.”
I tried to let it go, but the comments stirred something in me. Mostly annoyance, but also fury. It’s already so hard to be a patient. To be sick and vulnerable, to feel like your body betrayed you, to be frightened and feel powerless against an unexpected disease that’s turned your life upside down, ended your marriage or threatened your ability to function as a parent or partner. Illness can steal away everything you have held dear in your life, and all you can do is watch.
So when the person you depend on most — the one who literally holds your life in their hands and who may symbolize your last hope to make things right, or at least a little less painful — draws a line that tucks you neatly beneath them, pulling some weird hierarchy play to remind you of their expertise, it’s, well, not a great feeling.
And I get it. Doctors go to school forever. Despite what we may think, except for a handful of specialists, the pay isn’t amazing and the hours are long. I am sure most days are thankless, especially during a pandemic. Still, as someone who spends a lot of time in the healthcare system, I need to know that I do count in the relationship with my doctor. It’s not about having to use a title — it’s about never being made to feel less than.
The morning after, I was still simmering. And then I did it. I went against my social media rule and responded, saying something about how demanding to be called “Doctor” doesn’t do much to facilitate a partnership. I also asked if she was interested in being interviewed.
What happened next was gross and awkward, as people weighed in endlessly on why they deserve to be called “Doctor.”
But what I was referring to was less about the title and more about patients as partners. Relationships that are collaborative, respectful and that honour both parties — the doctor as the medical expert and the patient as the expert of their body and their experience, coming together in the spirit of empathetic problem solving. When done right, this is a powerful combination that makes for the best outcomes. Demands that patients use a professional title, and talk of putting patients “in their place” does not. Believe me, we don’t need a reminder of how important you are.
Talking it over with friends later, we concluded that the conversation about how to address a doctor is complicated.
One friend felt that using a title is helpful when meeting a doctor for the first time — it shows professionalism and simply identifies them. But she would be put off if someone foisted their title on her. Another friend said he could understand why a doctor would prefer a title, given the recognition of accomplishment factor and whatnot, but he also acknowledged that a respectful discussion around this should happen first. And another wanted to know why everyone couldn’t simply just get along.
The whole experience reminded me that, for all the work that patient and caregiver advocates have done to level the playing field between themselves and those who provide care, we are still so far behind. It also reminded me why I had the rule about social media in the first place — virtual scraps rarely end in any kind of resolution.
As for the offer of an interview, the offer still stands — in case any of those title-focused-keep- patients- in- their- place doctors happen to be reading.
Done on a first-name basis, of course.