What Should You Call Your Patients (and What Should They Call You)?

When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos. We exchanged pleasantries, made comments about the weather, and then he asked, "What should I call you, Dr. Hanks or John?"

This happens sometimes. I often introduce myself like I'm in a James Bond movie:"Hi, I'm Dr. Hanks ... John Hanks." So, it may have been my fault that I had set myself up for this question. But what could I say in response? If I said, "I prefer Dr. Hanks," I could already hear myself saying, "I prefer Dr. Hanks, Master Healer and Superior Person. This level of formality is not something I would ever demand. Most of my patients call me Dr. Hanks, but this patient had asked me what I preferred!

If I replied, "Calling me John is fine," I felt I might be sending a message that my authority in this new professional relationship is weak or diminished. If I said I'm called "John," I might feel as if I'm standing there wearing Birkenstock sandals and a ragged sweatshirt.

So, I said, "I answer to either one, or you can just call me Doc." The patient seemed a little relieved. "OK, Doc, I'm Findley, but just call me what my friends call me: ‘Spanky.'" And with that, we were ready to start the "Doc and Spanky" chiropractic experience with the monikers we had agreed upon.

A Look at What's Trending

I actually like being called "Doc." It reminds me of my youth, when my small-town doctor, respected highly in my community, was always called "Doc" or "Doc Jones." It is a good mix of semi-formality with friendliness. But several of my younger DC colleagues have told me they prefer being called by their first name, or "Dr. Tammy," "Dr. Jason," etc. And if their last name is difficult to pronounce, like Prysbysny, "Dr. P" will do.

The trend toward casual dress and address in the medical profession was noted in a 1987 Journal of the American Medical Association article titled, "Patient and House Officer Attitudes on Physician Attire and Etiquette." This piece discussed what patients and doctors prefer to call each other. Of the patients surveyed, 18 percent wanted their doctors to refer to them by their last name, while 40 percent preferred to hear their first name. On the other hand, 74 percent wanted to address their physicians formally, by title and last name.

How We Address One Another Could Impact the Therapeutic Relationship

The natural tension between doctor and patient in the therapeutic relationship give importance to the "what to call each other" dilemma. Most patients want to be treated by the best-skilled doctor, so calling them "Jimmy" or "Judy" seems to deflate that perception unnecessarily. Yet a minority of patients, if given a chance, will use the doctor's first name to intentionally steal some authority, usually out of fear.

This topic is discussed in a 1988 article by Michael Lavin in the Journal of Medical Ethics. He points out that a patient clothed only in a skimpy, thin gown in a cold examination room may feel helpless and undignified. In such a case, if the doctor calls the patient by a first name, but prefers the patient call the doctor by title and last name, it exacerbates the inequality. In Mr. Lavin's stated opinion, informally addressing the patient without being invited to do so does harm to the therapeutic relationship.

With that in mind, I apparently have been doing it wrong all these years. I start calling patients by their first name as soon as I feel comfortable with them, which in a few cases, I never do. There will always be a "Mr. Birkey" in his three-piece suit or a "Ms. Kopopkins" age 90, with her ebony cane.

The Need to Tread Carefully

What prompted be to give this subject some thought was an embarrassing mistake I made. I did not look carefully enough at a new patient's intake forms and called him out of the reception area by just saying, "Chuck, are you out here?" Around the corner of the room came a Catholic priest in formal dress. He turned out to be the Archbishop.

It's so easy to call young girls "Honey" or little boys "Buddy" as it is to call elderly women "Dear," or men and women my age by their first names. I've got to stop it, be more thoughtful, and avoid putting my foot in my mouth while still wearing a shoe. But it's hard to be formal with a guy who has a picture of Mick Jagger's tongue tattooed on his buttocks.

When "Doctor" Matters Most

I couldn't come across anything written about chiropractors and preferences in DCs and patients addressing each other. However, I did have an experience in court once concerning attorneys and chiropractors. I was an expert witness for the plaintiff, my patient, in a personal-injury case. My patient's lawyer had just gotten done with my testimony, and now it was the insurance company attorney's turn to cross-examine me.

It wasn't my first court rodeo, so I knew it was his opportunity to verbally abuse me in any way possible, in order to damage my credibility with the jury. This is what they do. He slowly rose up, looking amused, and addressed me: "And now, chiropractor Hanks..." he began. I don't know what came over me at that moment, but I turned to the judge and said, "Your Honor, I consider that a deprecating remark and I don't appreciate it.  He agreed, and instructed the guy to address me as "Doctor." I felt quite heroic.

Many of you may remember a TV character named Raymond J. Johnson Jr., made up by the musician / comedian Bill Saluga. He wore a Kentucky colonel-type suit, with sunglasses and a fancy straw hat. His "shtick" was to say, "You can call me Ray, or you can call me Jay, or you can call me J.J., or..." (and then he would continue with a litany of ways to address him), until he would end the skit by saying, "but you doesn't hasta call me Johnson!" So, to paraphrase Mr. Johnson, you can call me Doc, or you can call me John, or you can call me Dr. Hanks, or you can call me Dr. John, but you don't have to call me Chiropractor Hanks!