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  • Writer's pictureBruce Campbell MD

Not on a First-Name Basis

“Hello, Mr. Jones!” I reach to shake his hand as I enter the exam room. “You look great! How are things going?”

“I’m doing just fine,” he replies. “PLEASE call me Ken,” he adds.

“Um, okay,” I respond, but I will probably never call him by his first name.

Ever since I was in training, I have addressed patients by their last name: “Mrs. Thompson,” or “Mr. Silverman,” or “Ms. White.” Despite this, some patients insist at every opportunity that I address them by their first name. Occasionally, patients call me by my first name. I don’t protest when they do this, but I continue to call them by “Mr.” or “Mrs.”

Names are a funny thing in a professional setting. When I am getting an X-ray or lab test myself, the technologist usually calls me “Bruce.” Their training must assume that by adopting an unearned sense of intimacy, the patient is put at ease. When I was in medical school and residency, however, most of my role models maintained professional distance and decorum whenever they addressed their patients. These mentors would never have dreamed of addressing a patient by his or her first name. Of course, as I get older, I realize that their maturing memory banks probably didn't allow them to retain first names, in any case.

What does using a first name imply? In social settings, taking the step to using a first name implies intimacy and friendship. On the other hand, calling someone by his or her first name can also assume a sense of power over that individual. Even the ancients felt this.

So, I continue to address my patients the old-fashioned way. My philosophy of patient care seeks neither intimacy with my patients nor power over them. If I begin using a patient’s first name, I worry that the important relationship between patient and physician will be irreparably altered and also realize that, for some of my patients, a dreadful day will arrive when they will need a physician who is objective rather than one who is intimate.

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