Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Thursday, January 15, 2009

Is There a Doctor on the Blog?

I get email:
Greetings and salutations from a humble med student.

Oh great dinosaur, long have I enjoyed/appreciated/laughed my ass off at your blog.
Obviously not someone who has read this. He continues:
Please, please, PLEASE could you repost and comment on this past post from angrypharmacist that I stumbled across today while sitting in physiology class.

I would appreciate it if you would shed some of your Solomon like wisdom on this post for me. And possibly repost it on your own blog so that we can get input from your insightful readers?
First things first: someone pass that guy a tissue to wipe off his nose; I'm sure that stuff smells awful.

Next: The post at hand (which is over a year old, though that's neither here nor there) is about the appropriate use of the term "Doctor;" who can use it "legitimately" and who is just putting on airs. It's a nice post; not one of The Angry Pharmacist's angrier ones, but it can be tiring to keep up that level of rage all the time (as I well know.)

Here's my take:

One of TAP's commenters is correct, in that the word "Doctor" originally meant "teacher," and that medical, dental, law and pharma doctorates are not actually graduate degrees in the purest academic sense. None of which matters.

The use of the title "Doctor" is a purely cultural convention and its usage varies from one country to another. In Europe, for example, PhD's use "Doctor" much more freely than here. In fact, German doesn't even force a distinction between Mr./Mrs. and "Doctor": my grandmother was "Frau Doktor" all the time before she came to this country. (PhD in Mathematics from the University of Vienna in the 1920s, per an oral history recorded by my aunt; awesome stuff.) Furthermore, my understanding is that physicians in several countries are routinely called "Mr." instead of "Doctor."

What this means is that there is no objectively "right" answer to question about who can use the term "doctor" legitimately. All we have are cultural conventions.

In the United States, the convention is that term "Doctor" is reserved for medical professionals, specifically physicians, dentists and veterinarians. Those with academic doctorates may use the term professionally, and optionally in social situations. Because the sine qua non of a graduate degree is a thesis, other bastardizations that do not require one (law; pharmacy; nursing) to obtain the degree may not use it without appearing to be arrogant asshats with hypoplastic egos.

As it happens, I have sufficient ego strength that I do not need to be called "Doctor" all the time. I don't scorn social invitations that lack my "proper" title, nor do I pointedly correct anyone who fails to use it. I often tell patients I encounter after hours that I like to leave the "doctor" at the office; in the supermarket, I'm just "Dino." Actually, my favorite appellation is one of three possessives usually heard at a school event or Ultimate tournament:
  1. Jock's Parent
  2. DinoDaughter's Parent
  3. NinjaBaker's Parent
Solomonosaur has spoken.


At Thu Jan 15, 08:07:00 AM, Anonymous Anonymous said...

In the Netherlands things are quite complicated as well. Physicians are generally called 'dokter'. However, 'doctor' is our highest research degree.

Since that isn't complicated enough, Dutch medicine has also adopted the use of MD and PHD degrees, especially for international purposes. Unfortunately, the Dutch requirements for MD en PHD degrees are somewhat different from those in the USA or Great-Britain.

At Thu Jan 15, 09:08:00 AM, Blogger jen said...

Because the sine qua non of a graduate degree is a thesis, other bastardizations that do not require one (law; pharmacy; nursing) to obtain the degree may not use it without appearing to be arrogant asshats with hypoplastic egos.
Heh. The only context in which I have ever been addressed as "Dr." is when I've gotten mail from my law school . . . . And I thought it was really weird that they did that.

At Thu Jan 15, 09:36:00 AM, Anonymous Anonymous said...

As a PharmD, I really avoid the "doctor" salutation here at the hospital. There are real doctors here, and if a patient hears "doctor," they're just going to ask me for more Dilaudid (which I can't obviously write for). Just a lowly pharmacist, thank you very much.

But any communication that comes from my alma matter or any professional/trade organization is always addressed to Dr.

-"Dr." Mike

At Thu Jan 15, 09:48:00 AM, Blogger CSGiles said...

If I can pick a nit.

In the U.S. clergy with doctoral degrees are also addressed as "Doctor" (think about Dr. Norman Vincent Peale).

In church circles the rules are even more complex than in the secular world:

All clergy with doctoral degrees take the ultia-formal "The Rev. Dr. So-An-So."

However, only clergy with earned doctorates (Ph.D., D.Min., Th.D., etc.) are ever addressed as "Doctor."

Clergy with honorary doctorates (such as the Doctor of Divinity, or D.D.) are always addressed as "Reverend."

However, in our casual times these rules are often ignored, and I've noticed that the colleagues with honorary degrees are the quickest to claim the doctoral title.

At Thu Jan 15, 10:39:00 AM, Blogger Can'tSpell, DVM said...

I usually get the other way around, and am adressed most often as "Miss". (Doesn't help that I still get carded at R rated movies)Most people don't think vets are "real" doctors, even though it takes just as long to go through vet school as med school and is harder to get into to boot. (Sorry, mini rant NOT directed at you rather this morning's clients)

At Thu Jan 15, 10:42:00 AM, Blogger Unknown said...

But the important thing to remember is that when you're talking to someone with an MS/MA, always refer to them as "Master." (There's probably also a joke in there about a husband deciding to get his undergraduate degree because he wants to be a bachelor again...)

At Thu Jan 15, 10:46:00 AM, Anonymous Anonymous said...

I agree with Dr. Mike. As a pharmacist with a PharmD title I alway avoided being called "Dr." because I felt that tacking on one extra year to a BS program did not a doctor make. Also, in the hospital we now have doctors of pharmacy, doctors of physical therapy, doctors of occupational therapy, etc, etc, etc. This is going to become confusing to the patient, as well as to the other staff.
When I was young, a Dr. was a title addressed solely to people with research degrees (Ph.D.'s) or physicians (MD/DO), as well as select members of the clergy. The MD/DO spends 8 years in school plus at least 3 years residency, while the Ph.D.'s spend a similar amount of time in school and on post-doc and fellowship.
If the PharmD degree entitled bearer of said degree with more research opportunities, clinical work and job opportunities (as well as throwing a LOT of additional training in there), I would not be averse to hearing the PharmD addressed as doctor. However, we get paid the same as a guy who graduated 15-20 years ago with a BS (and knows a hell of a lot more than we do from years of experience).
So, are we cheapening the title of "doctor" by handing it out more readily these days? I think so.


At Thu Jan 15, 10:58:00 AM, Anonymous Anonymous said...

I am a Pharmacy student. Let me start by saying I would never ask some one to call me Dr. (after I graduate, of course). But my girlfriend and I are having an interesting discussion. She doesn't know whether she should put "Dr." on our wedding invitations. Let's just say she's planning ahead...way ahead. Any ideas? Too pompouns? I'm kind of in the Dr. camp, but only because I think that it wouldn't be proper to put "Mr.". Any thoughts?

At Thu Jan 15, 12:47:00 PM, Anonymous Anonymous said...

In the UK,doctorates (PhD/DPhil etc) are all research based degrees and entitled to use "Doctor".

As medical degrees here are first degrees (though at 5 years 2 years longer than a standard degree), medical doctors are strictly Masters of Medicine. However, by social convention they use Doctor.

Should a doctor become a fellow of the Royal College of Surgeons (usually at roughly the senior resident/attending point of their career), they revert to using Mr or Miss. This is an historical link to the barber surgeons.

At Fri Jan 16, 08:25:00 AM, Anonymous Anonymous said...

My favorite story was a when an awestruck med student asked how to address an MD/PhD named Frank. We decided on Dr. Dr. Frankie poo

At Sat Jan 17, 09:50:00 AM, Anonymous Anonymous said...

In UK the full title is "Veterinary Surgeon" but that's really to much of a gob full for anything other than paperwork so we use the KISS principle and stick to "vet".
(Keep It Simple Stupid)

At Sat Jan 17, 01:58:00 PM, Anonymous Anonymous said...

OK, LISTEN TO ME YOU NOT SO BRIGHT COMMENTATORS (You are all probably PharmDs, Doctors of Physical Therapy, Doctors of Occupational Therapy, Doctors of whatever TF they are giving doctoral degrees for these days). You are missing the point of the article. The title of doctor is BEING DILUTED!!!! Yes, diluted. We have way to many people calling themselves doctors who are not physicians. AND ADAM, NO!!!!! No you cannot put Doctor on your stupid wedding invitation. You are a pharmacist. ANd your fiancee needs to wise up and realize she's not marrying a physician, but a PHARMACIST who is going to work behind the counter in a retail store or somewhere "clinical" filling out the pink and blue forms. Sounds to me like fiancee is looking for a doctor - dump her now, she'll leave you if she thinks something better is walking her way (LIKE A PHYSICIAN).
SO-the title of doctor is being diluted in this country. It doesn't matter what the British and Germans are doing - this is not Europe.
Peace out, all you not-so-bright "doctors" (lol).

The Wisest of the Bunch

At Tue Jan 20, 12:59:00 AM, Anonymous Anonymous said...

I dunno, Dino. I always hated the fact that as an attending at The Great White Man's Hospital where I worked for 12 years, people didn't even assume I was the nurse. Most of the time they thought I was dietary or the ward clerk, for some reason. Must have been the skin color.

If someone is going to use a title, then Doctor it is otherwise no title at all. I'm damn sure no Mrs. HisLastName.

Oh and too bad I get to post right under the words from Mr/Dr Crankypants.

At Fri Jan 23, 05:43:00 PM, Anonymous Anonymous said...

I think it's terrible that non-doctors somehow pass themselves off as doctors just because people don't understand the real meaning of the abbreviations following their names (or location identifiers).

Kensington MD

At Tue Jan 27, 04:13:00 AM, Blogger Mark said...

Over in Malaysia, I must have corrected my patients a thousand thousand times that I'm not a doctor; I'm the pharmacist!

And their response?

"Oh, that just makes you the medicines doctor, the other fella with the stethoscope is the disease doctor"

I have since then given up.


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