Should doctors and patients call each other by their first names? R-E-S-P-E-C-T (Aretha Franklin)

Recently I visited a medical specialist I have known for twenty five years. Back then I was a new hospital President and he was a junior attending. About ten years later I became his patient. And hadn’t seen him in two years.

When he saw me he said “hello Dr. Metsch” and I responded “hello Dr. Green” then we switched to first names. Even though I retired ten years ago and he is now a senior attending our initial greeting reflected mutual respect.

Mid-career I worked in the President’s Office at Mount Sinai for ten years for four physician CEOs. I always called them Doctor even as my younger colleagues would call them by their first names; they bristled at this informality.

About that time (1988) this was written: “The paper discusses the moral difficulties physicians encounter when determining the level of formality they will use when addressing their patients. It is argued that physicians ought not to use a patient’s first name unless the patient also uses the physician’s first name. In short, physicians and patients should always address each other with the same level of formality. It is argued that this is so even when patients invite physicians to address them informally.” (A)

“Developing a good rapport with a patient is essential, and what transpires during a first meeting can set the stage for the ongoing relationship. But unfortunately, there are no definitive guidelines on how physicians and other providers should be addressed, how patients prefer to be addressed, or how staff should introduce themselves.” (B)

There are certainly various points of view on this.
“If I call a patient by their first name, it would seem only fair and equal that I offer up my first name. I have always addressed my patients by their last names and titles, particularly in San Antonio, Texas, where military titles are extremely important. Familiarity also seems inappropriate in an environment where the patient does not see the same provider at each visit and has to start from scratch. Long gone are the days of a family physician who cared for three generations of the same family. Since a sizeable portion of patients and physicians may be offended by the use of their first name, it seems best that, unless invited to do so, we stick to formal titles.” (C)

“I address my patients (over the age of 18) by their titles and last names unless they have given me permission to do otherwise. When I meet new patients, I address them by their first and last names and then ask them how they would like for me to address them. My expectation is that they will address me as I prefer to be professionally addressed: “Dr. Middleton.”” (D)

Maybe I’m old school but I think all successful patient-doctor relationships are based on mutual respect. If a physician calls a patient by his first name, she should allow the patient to do the same. If a physician wants to be called Doctor, then he should use Mr., Mrs., Ms. or Doctor, Professor, Reverend, Captain or any other appropriate title.

I think formality should prevail initially and over time informality might be mutually OK and here’s a good example:
“I have at least a hundred patients who call me James, Jimmy, Dr. James, Dr. Bowtie, Dr. S, Herr Doctor or Jim. I have no need of an ego-massaging label. The difference is that we have long-standing relationships, and those patients have usually asked permission. We are friends, colleagues, in battle against the dread disease. I gain satisfaction to have built relationships where mutual respect is expressed in this way. Even so, when the proverbial excrement hits the spinning blades, many of those patients revert to “doctor.” That makes emotional sense to me.” (E)

To this day I never call a doctor by his or her first name without asking first and being comfortable the answer will be “yes.”

“I speak to everyone in the same way, whether he is the garbage man or the president of the university.” Albert Einstein

(A) What doctors should call their patients, by Michael Lavin,
(B) Should Patients Call You by Your First Name?, by Roxanne Nelson,
(C) What’s In a Name: What Should Patients and Doctors Call Each Other?, by Richard C. Senelick,
(D) Should doctors be addressed by their first name?, by Jennifer Middleton,
(E) Calling a Doctor by His or Her First Name, by James C. Salwitz,


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