Cranky Prof has a mini-rant at the end of her latest post, about being called "Mama" by people other than her own spawn, but when she moved on to her annoyance at her given name being used by health care professionals, I realized something about my own practice.
I always tried to be good. I remembered what I was taught as a med student about treating patients respectfully by not using their first names until invited to do so. All through residency I was good, never using patients first names until invited to do so. I did notice that relatively few older patients seemed overly upset when nurses and aides and other little chippies running around the hospital used their first names without permission; almost like it wasn't worth the effort to take offense, although they certainly had every right.
When I began my practice, I was good. My default address form to my patients was Mr./Ms. Lastname. I would then introduce myself by my first and last name, without the "Doctor;" I figured it was assumed, although sometimes I would add, "I'm the doctor."
As a young whippersnapper, it worked just fine. I was nice and polite, and none of my patients had reason to be cranky about me, at least not about any promiscuous use of their first names.
What about children, though? It would have been terribly stilted to call for "Miss Droolmeister" when she was there for her four month checkup. So of course I always called kids by their first names. And teens. Not their parents, of course, but with younger patients it felt perfectly appropriate.
Then from time to time, I found myself uncomfortable calling people Mr. Smith or Ms. Jones. Can you guess who? Yep; people much younger than I. College kids. Folks in their twenties (once I was well into my thirties.) I finally realized that it was ok to use first names with people younger than I, both because younger generations tend to be less formal, and because etiquette has always allowed it. Given that I always know how old patients are before I face them (name and date of birth are at the top of every page of the chart, even if I don't sneak a peek at their registration form, which I usually do) it's easy enough. Here's how the greetings break down (not that I consciously decided to do this; I do what feels right, and am only now codifying it):
- More than 20 years younger than I (ie, young enough to be my kid): "Hi, John; I'm Dr. Dino."
- Less than 20 years younger than me: "Hi, Jane; I'm NumberOne Dino."
- Older than me: "Hi, Mr. Dinkleheimer; I'm NumberOne Dino."
- Usually patients up to about 10 years older than me will say, "Please call me Shlomo."
I also notice is that things bother me less and less as I get older, like being called by my first name by some young chippie in the dentist's office. No offense intended to CrankyProf and others who get all bent out of shape at the indignity of inappropriate familiarity, but I find it just doesn't bother me nearly as much as it used to. I must be getting old.