For the past several years, I have been befuddled by patients calling me by my first name (Sara) instead of my professional title (Dr. Jones). At first, I ignored this, but as it became more common, I started telling some of these patients that I preferred being called Dr. Jones rather than by first name. This took some patients aback — probably thinking I was a snob — while others quickly acquiesced. Some just ignored my request and kept calling me by my first name.

Initially, I thought that this was because of my female gender. There certainly is plenty of evidence that gender bias does exist. But that doesn’t compute in this situation, because I didn’t have this problem during my first 20 years of practice as an MD.

So, now I’m wondering if it could be related to the fact that now there are so many nurse practitioners and physician assistants working side by side with us in providing care to patients. In their practices, NPs and PAs have the opposite problem with titles: their patients or even staff call them “doctor,” even when they have appropriately identified themselves as a nurse practitioner or physician assistant. Advising patients that they are not doctors is sometimes effective — but usually, not so much, and I’m sure it gets tiresome to be constantly correcting those who call them doctor.

Here we need to note that neither PAs nor NPs have appropriate titles by which they can be addressed. What title should we and patients use? Calling them “Nurse Practitioner Smith” or “Physician Assistant Johnson” is cumbersome and certainly not very practical, so in the end, these highly educated professionals have patients call them by their first names.

In high school and college, our teachers were never called by their first names. We called them Mr. or Mrs. (or Ms. Or Miss) or professor or doctor if those with PhDs preferred that. Shouldn’t such professional respect extend to PAs and NPs?

When I was a registered nurse before I became a physician, I wore a name tag identifying me as Ms. Sara Jones, RN. This seemed to work, and there was no confusion about my profession. I wasn’t called by my first name, and I certainly was never mistakenly called doctor.

So, here’s my suggestion: Until other professional titles for NPs or PAs can be agreed upon, I suggest that name tags be worn with the prefix “Mr.” or “Ms.” (or Miss or Mrs.,) followed by first and last name and professional designation. For example, a name tag could say, “Ms. Nancy Johnson, PA-C,” with “physician assistant” on the line below.

Finally, I have to add a fun note: At one point I had a male nurse working with me at my practice. At the end of the day, we’d compare notes: how many times had he been called doctor against how many times had I been called nurse? Most of the time it was pretty much a tie.

Karen Fahey is an internal medicine physician.

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