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What's In A Title

Updated: Sep 20, 2019

"Hello Mr/Mrs. 'Smith'. I am Dr. Mannix, the supervising doctor who will be helping to take care of you today."

This is how I start nearly every patient interaction, whether I am working with a resident or not. In less than 20 words, I have used the word "Doctor" twice. Even with 10% of introduction being the word "doctor," I'm still frequently not acknowledged to be the physician.

I had this discussion recently while on shift with two other female Emergency Physicians as we watched a male resident introduce himself. He used his first name, and word "resident", yet without using the word "doctor," he was accepted by the patient and family as the physician.

The three of us imagined what that would be like:

We imagined not getting called back into the room because the doctor hasn’t yet seen the patient.

We imagined not getting referred to as nurse immediately after introducing ourselves as doctor.

We imagined not being called our first name by a patient, instead of "doctor."

This moment reminded of a time during my final year of residency when I received an email from a non-clinical male staff member. The email was addressed to myself and my male co-chiefs.

It began "Dr. Barr, Dr. Javed, and Lexie."

I had all but forgotten about this email experience until one of my good friends in emergency medicine texted me about a similar interaction. Once again, in the salutation portion of the a email she was referred to by her first name, while the other physician by Dr. XXXX.

A similar phenomena was discussed in the article from 2017 entitled

The authors found that women introduced by men at Internal Medicine Grand Rounds were less likely to be addressed by professional title than were men introduced by men. Differences in speaker introductions may amplify isolation, marginalization, and professional discomfort expressed by women faculty in academic medicine.

The issue lies in the fact that women, at baseline, have a more difficult time being recognized as a physician. Our coworkers introducing us without our title exacerbates the issue. It continues to marginalize women in medicine, as unequal to the men with whom they work.

The use of female physician titles is important for many reasons of reasons. One very important reason is the fact that in the current medical environment patient satisfaction surveys directly affects physician salary. If patients believe they were never seen by a physician, this can greatly impact female physician reimbursement/bonus. In the current era where we are acknowledging a gender pay gap, female physician introductions is an area where we can all work to narrow the gap.

We, all healthcare workers (physicians, nurses, PAs, ARNPs, paramedics, RTs, etc), need to be aware of this important topic in gender and medicine. Acknowledging and recognizing the problem is one of the first steps towards resolving the issue.

Word choices matter in the world of medicine- especially in the way we refer to one another.

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