What’s in a title?

Surgery was historically performed by barbers without medical training and as such they were not addressed as “doctor” but as “mister”. Surgeons in the UK have retained this quirk of losing the title doctor on obtaining surgical membership, hence all surgeons are not addressed as doctor but as Mr, Miss or Mrs.  It has taken me a long time to feel grown up enough to use my grown up titles but now it is second nature to be Miss KBW and not introduce myself by first name. In some circumstances I do say my full name minus the title especially with kids. At a recent medical wedding we were discussing how we all introduce ourselves and without exception we all keep the barrier up now with use of titles and surnames whereas as juniors we did not. Those of us who had worked in a and e recalled how we never introduced ourselves with surnames back then, it was first name only.
Inevitably there are some patients that you come to be on first name terms with due to a long relationship built over time and I like this very much but I don’t like when it is faked or forced upon me. One patient I looked after with whom I shared a first name and year of birth died after a few years of illness necessitating frequent surgical admissions. She and her family built up a relationship over that time with many of us and crossed into the realms of first names. Many of us were distressed when she died and sat crying with her family and friends. This sort of thing stays with you and would have been impossible to go through using professional titles.
We have got a new consultant in our unit who is keen on the informal, he has all his patients addressing him by his first name. It’s nice whilst the going is good but as soon as something goes wrong or there is a complaint you don’t have your professional identity to hide behind and your laid back attitude suddenly seems unprofessional and sloppy. This is especially true when it is in contrast to the behaviour of your peers, suddenly the other surgeon who looks immaculate, is always professional and is treated with respect by the nurses and his colleagues looks like the man who should have done your operation and not the chatty guy with the hoody.

This is Dave.

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This is Sir Winston Churchill.

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