The doctor-patient relationship has been a changing one ever since its inception. Traditionally focused on the ideas of beneficence and paternalism, the doctor-patient relationship has now changed into one that focuses on autonomy. The following article addresses the issue of doctors being called by their first names during routine clinical visits. Does this alter the doctor's ability to do no harm? To benefit others? Does this matter at all?
(Submitted by Caren Steinway)
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What at the outset appears as nothing but a case for Ms. Manners, may actually have ethical implications. In treating and caring for a patient to the most beneficient standards, the doctor must be able to communicate adequately. Furthermore, "to do no harm" does not merely apply to physical aspects of the patient. If a patient walks away with a mental sense of degradation or inferiority because of the doctor's ill attention to respect or politeness when naming that person, then the doctor has done harm. Finally, the patient's autonomy might be compromised by the situation. If the doctor calls the patient informally by their first name, the patient may lose trust in the doctor's authority. The patient's decision making will be flawed because they may choose not to take the necessary information into account because of lack of trust for the doctor- thereby hurting their autonomy. These ethical implications point to a method where doctors always treat their patients with the utmost respect, addressing them in the most formal way possible unless the patient dictates otherwise.
ReplyDelete-Kathryn Roberts
After reading the article, I'm inclined to believe that it honestly doesn't matter in terms of medicine what a patient calls his/her doctor or vice versa. In terms of respect and comfort, it may or may not make a difference. As far as doing no harm, benefiting others, I cannot see how calling someone "Mike" or "Mr. Smith" is going to do anything other than either make that patient feel more comfortable or awkward. I would prefer being called Alexis by my doctors because it would make me feel like they've taken the time to review my chart before meeting with me. To me, it seems like they're more prepared and I'm not just one out of a hundred patients they see a day. However, I don't think that addressing me in a more professional manner (Ms.) would effect the quality of care I were to receive. How would this matter as far as doing no harm is concerned? Unless an individual were extremely offended by a name their doctor called them, maybe they're recently divorced or widowed and mentioning the last name is painful for the patient, I do not believe that the name you address someone with effects a doctor's duty to do no harm.
ReplyDeleteAll in all, I think that the point of the article is professionalism, not necessarily the benefit specific titles have to others. I think that doctors should always address their patients as "Mrs., Mr., Ms. or Miss," unless asked to call a patient otherwise, and I think that patients should address their doctors as "Dr. so-and so," as that is their professional title.
I do not believe that in terms of providing medical care, calling a patient or doctor by their first name hinders the doctor's ability to do no harm. In fact, I think the opposite, it has the potential to allow the doctor to do his or her job better, more efficiently and more accurately.
ReplyDeleteWith an increasingly "informal" society it is understandable that a doctor and patient relationship occur on a first name basis. It can has become the norm in our society that professional relationships are becoming more casual and laidback. This is not only seen in health care but in business operations as well. By calling a doctor/patient by their first name, both participants have the opportunity to be more comfortable with eachother and the relationship. If a patient is more comfortable and relaxed around their doctor they will be more willing to be more open with sharing information that could be very important for the doctor to know. This in return would allow the doctor to do his or her job better. Therefor, this act of "non-professionalism" of simply referring to someone by the name in which they were given could benefit both the doctor and the patient.
Doctors calling their patients by their first names has nothing to do with the quality of care the patients recieve. If anything, such a casual relationship between the doctor and patient may foster a better understanding of the patient's medical needs. Typically one discusses problems with doctors that can be awkward and slightly embarassing. If the patient is able to relax and call his or her doctors by their first names, perhaps the patient will be able to more freely discuss medical problems and questions. It is also more helpful to the doctor if a patient is able to conversationally discuss their medical needs, as opposed to having to slowly coax out the patient's concerns. Such conversations are typically easier if the relationship between the doctor and patient is relaxed, as opposed to formal. The doctor should still remain professional in how he or she interacts with patients, but a move towards discussion in the doctor's office as opposed to question-and-answer may be beneficial to how medicine is practiced.
ReplyDeleteI belief that by allowing the patient to call the doctor by his or her first name is a way of establishing a comfortable and open setting, which certainly does not violate the doctors duty to do no harm. If anything, the patient may relax more and feel more comfortable talking to the doctor. If the patient does not want to call the doctor by their first name, and would rather address them more formally, the patient has the right to do so. It is the patient’s autonomous right as an individual to choose what they would like to do and how they would like to act. If the doctor calls the patient by his or her first name and they wish to not be addressed that way, it is also their autonomous right in this situation to correct the doctor. Since I do not believe that being on a first name basis with your doctor violates their duty to do no harm, I feel that name choice really does not matter. It should be a guideline that is established by the parties involved, so both can exercise their right to autonomy and decided what name they would like to go by. Either way, I believe that the choice of name does not negatively affect the medical field nor does it hinder patient care. If anything, the informal name choices betters care by creating an more personal and comfortable visit.
ReplyDeleteTorri
I do not believe that calling a patient by their first name instead of using the title "Mr." or "Mrs" will have an effect on the quality of care given, or the doctors ability to do no harm. Maybe upon first meeting these titles should be used, but after that I do not think most patients would be bothered by using just their name. In terms of calling the physician by the title "doctor" I also do not believe this will have an effect on the doctors ability to do no harm. While some Doctors could take offense to omitting the title, doing so could mean that the patient is comfortable with the doctor and wants a more personal doctor-patient relationship. Since the Doctors duty is to provide the best care possible based on trust and respect, if the patient is okay with something then it should not bother the doctor. While in some cases this more laid back approach could cause the patient to lose trust or respect for the doctor, I do not think this would be the majority. On the other hand, the doctor could feel disrespected by the patient who omits the term "doctor" but the physician should not let this affect the quality of care given to the patient. Overall, the more comfortable a patient is with their doctor the better the exam will go and the doctor will be able to act in a manner that will better benefit the patient.
ReplyDeleteAlthough the issue of patients calling doctors by their first name introduces many social consequences, it should not alter the doctor’s ability to do no harm. Of course there are exceptions to this. The article mentioned the opposite situation where the doctor called the patient by the first name and was reprimanded. In this case if the doctor was distracted and more focused on getting out of the patient’s room by finishing up the exam. Here some level of harm could potentially be done due to neglect of the doctor. However, this seems to be a very “what if” scenario and not a typical result. One could also argue that by eliminating the doctor title the patient may lose the comfort of confiding medical information (perhaps embarrassing or shameful information) to someone they are on a first name basis with. However on the flip side, using first names may make the patient more at ease particularly during stressful or troubling times. As stated in the question the dynamic of the doctor-patient relationship is ever changing and furthermore it varies greatly with every doctor patient pair. Directly the use of a first name should not influence quality of care however based on human nature certain harms could potentially result. Although some doctors may be offended that they are not being addressed by the title they have worked so hard to obtain, this should not influence their ability to do no harm.
ReplyDeleteI also believe that it may be beneficial for a doctor and a patient to refer to each other on a first name basis. Patients may be more willing to talk to their doctor if first-name calling makes the counseling session less awkward. I believe that when a doctor sees his/her patient, it is not a business meeting and formal name calling is unnecessary. When they are in a counseling session, it is simply for the patient to address his/her problems and let the physician know what is going on. The physician’s duty is to do no harm by helping the patient with his/her medical conditions. This would not be possible if patients feel uncomfortable calling their doctor “Doctor _” formally and holds back relative information. By addressing each other with first names, I believe it reminds everyone that a doctor and a patient are both humans and strengthens their relationship. Just that a doctor has had the adequate education that would help the patient and the patient is someone who needs help from the doctor. To me, titles are for writing or introductions, similar to business cards. Of course, whether or not a doctor should be called “Doctor” or a patient “Mr. Ms, etc”, it depends on the individual’s comfort level. I personally see different doctors in the clinic whenever I go and I am comfortable with calling only one of them by her first name and others by their titles. It should not affect the doctor’s ability to perform because either a first name or a title would mean the same thing – they both are ways of referring to the doctor. However, if a doctor knows he/she will not be able to focus if the patient calls him by his first name, then it would be appropriate for him to make this known. Whether people should use titles, I think, is really dependent on the person’s own comfort level.
ReplyDeleteThis article brings up an interesting point, because not only does it address the
ReplyDeleteevolution of the "doctor - patient" relationship, but it also stresses respect for one another, regardless of educational/professional background. I believe there are implications regarding this article that could have unethical consequences. For example, in the article, the nurses are brought up in an informal light that made even the writer of the article, an M.D., feel bad for the informalities with which the nurses are
addressed. If it is enough for the doctor to feel sympathy for them, how do you think the
nurses feel about how they are addressed? Is it possible that being addressed informally,
on a first name basis, diminishes one's autonomy and self- worth? If this is true, there
would be severe ethical implications for this such as negligence and neglect. It is
possible that those who feel neglected or disrespected are going to perform sub optimally out of spite or lack of motivation. This backlash could pose serious harm to patients and may alter the doctor or nurses's ability to do no harm.
Similarly, patients might feel uncomfortable or upset by being addressed on a first name basis. As a result, they may be less likely to comply with the practitioner's advice or come for a follow up visit. Not only would this be harmful to the patient, but would be harmful to the doctor and his or her practice that would lost business.
I believe the doctors and patients ought to inquire about whether or not addressing someone by their first name is appropriate, and not assume it to be one way or the other. Therefore, the patient will have a more trusting relationship with the doctor, and the doctor is able to act nonmalifienctly and fulfill his or her duty toward the patient.
Alexandra Pitkin
I believe that this issue is not important in the ethics of medicine. This seems like an issue that occurs more on a case by case basis. If calling a doctor by his or her first name is an obvious sign of friendship this friendship would have to be set aside during a professional meeting like an exam, but calling the doctor by their first name could still probably be done. If the patient felt uncomfortable with something the doctor was doing because they thought they were more friends than a doctor and patient, this would be something they would have to find another doctor for or ask about. Calling a doctor by their first name, on the other hand, might make the doctor care more about the patient. If they were friendlier, the doctor may have an iota more of motivation to do the best for their patient. Again, if this was a widespread problem of ethics more people would be trying to do something about it. Instead this seems like an interesting anthropological observation that has little affect on what kind of care patients receive.
ReplyDeleteIsabel Shanahan
Despite the fact that, like how the article states, "all communication starts with what we call one another",I don't believe that going on either a first or last name basis has any bearing on the care that you will receive. Other than serving as a somewhat personalized dog tag, one's name serves very little purpose otherwise.
ReplyDeleteOn the other hand, as stated in the above posts, being able to call someone by their first name implies a certain level of friendliness, and even a mutual respect and trust to a certain extent. Certainly, with the doctor-patient relationship veering towards a focus on autonomy, this is a sign to be celebrated.