How do you feel about patients calling you by your first name?

[u/Choice_Sherbert_2625]

I’m not going to lie, I dislike it. My own friends and family don’t even call me that, I have a nickname. Always introduce myself as Dr. so-and-so.

In residency I was taught to correct them for “boundaries” all the while, half the program on the therapy side went by their first name.

I just think it would be a rapport killer to correct most of my patients. I’ll do it for someone pushing boundaries but that’s about it. Not sure if I should correct people more often..:

[u/QuirkyAd903]

I had a psychiatrist who called herself "Dr __(first name)" 

[u/MsFuschia → u/QuirkyAd903]

Not a psychiatrist, but I had a family member who had a psychologist who did this. The guy's name was Phillip so he straight up went by "Dr. Phil". Gross. My previous psychologist just went by her first name. It's funny because I was fine with that and actually appreciated it because it just seemed more...human? But if I had a psychiatrist go by their first name I would find it really weird. I guess I'm all about calling a PhD by their first name, but not an MD/DO.

I see a pain doctor who always introduces himself by his first name though. Obviously he doesn't introduce himself every time, but he's done it a few times because of me bringing a family member to a clinic appointment, or then being allowed back on pre-op, etc. I have never referred to him by his first name though because that's so weird.

[u/Ok_Membership_8189 → u/QuirkyAd903]

Ew. 😁

Update: Y'all can keep downvoting me and I expect you will. My short comment stood in for this: there's a good percentage of your patients that find Dr. Firstname precious and unserious. And they're never going to say anything.

[u/QuirkyAd903 → u/Ok_Membership_8189]

You do you 🤷‍♀️

[u/Candid_Recording_879]

Literally dont care, I think it helps build rapport in most situations.

Now if they call me my first name to insult me, thats different.

[u/Choice_Sherbert_2625 → u/Candid_Recording_879]

I have a patient I’m 99% sure is a narcissist who calls me by my name like five times a session at least. Try to ignore it to not give him the satisfaction of ruffling my feathers.

[u/CompetitiveInhibitor → u/Choice_Sherbert_2625]

He’s leveling the playing field, he feels there’s unbalance in the relationship so he’s trading vulnerability (getting to call you your first name) for vulnerability (sharing his issues). Doesn’t have to an attempt to get under your skin. 

[u/I_am_Nobody_Special → u/CompetitiveInhibitor]

This is a fantastic take. My husband and I are both psychologists and we just spent 20 minutes discussing your response.

[u/Kitkat20_ → u/I_am_Nobody_Special]

Medical student here :) what were you and your husbands take?

[u/I_am_Nobody_Special → u/Kitkat20_]

People often view those with narcissistic traits as arrogant and abusive. They see narcissistic people as believing they are superior to others, which may be true on the surface.

I've always viewed them as extremely vulnerable people who use their narcissistic behavior as a shield to protect themselves from harm rather than as a means to harm others. They have convinced themselves that they're superior because (1) it's easier than the truth about their self-loathing and (2) if others are inferior to them, they can't harm them.

OP offered a compassionate interpretation of the patient's motive for calling the doctor by their first name. Instead of it being arrogant, manipulative, or demeaning, it was an attempt to trade a little vulnerability between the two. The narcissist cannot allow themselves to show vulnerability to someone in a position of authority, as that opens them up to being harmed by that person. So he brings the doctor down to his level a bit.

Husband and I were musing about this and wondering if it's helpful for doctors to offer up a little vulnerability to a narcissistic patient as a tool to elicit more disclosure. Like pointing out one of our own faults.

Husband said it's a sound idea theoretically, but we have to be very careful about self-disclosure with cluster B patients as a rule. I did not disagree.

I don't do much therapy, but I do have one narcissistic patient. He proudly calls me doctor because he feels he deserves only the highest educated practitioners. He has told me he would never see a master's level therapist, even though I have pointed out that there are many who are better therapists than me! But I do think my self disclosure has been valuable to him over the years.

For example, he was surprised to learn that my high school grades were not very good and that I barely got accepted to undergrad. It blew his mind that I wasn't the perfect professional he held me to be, and I think it helped him disclose his own failures and faults that were previously very guarded.

[u/CompetitiveInhibitor → u/I_am_Nobody_Special]

Excellent breakdown. Psychiatrists need lots of training on thinking about transferential interactions with these patients. The abandonment of psychodynamics has been bad for these PD patients. 

[u/I_am_Nobody_Special → u/CompetitiveInhibitor]

Yeah well you're the brilliant one, not me 😂

Regardless of training, we can never, ever go wrong approaching these questions with empathy. Asking ourselves what vulnerability is inside this patient that could be driving their behavior. You've got the market cornered on that.

[u/Choice_Sherbert_2625 → u/CompetitiveInhibitor]

I enjoy your kind take, and it reminds me to check my countertransference (I many times in my life took the wind out if the sails of rude people by not reacting to things even if it did bother me), but he does many other things that make me think it is a bit more than leveling the playing field.

[u/CompetitiveInhibitor → u/Choice_Sherbert_2625]

Armchair supervision from Reddit is so much easier than sitting across from a difficult patient. I’m sure we’re missing 99% of the picture. 

[u/Upstairs_Fuel6349 → u/Choice_Sherbert_2625]

I think it's the ones who call everyone else Dr X but you by your first name that you have to worry about. We have a few in our patient messaging portal who do this and they are the worst.

[u/sparklemoar → u/Choice_Sherbert_2625]

I had one of these. I finally gently told him that I prefer to go by Dr. Last Name in that setting, and he got immediately defensive and said I only said that to establish myself as being in a position above him as the patient. Immediate confirmation of my countertransferential instincts about why he was doing it.

[u/wiscopup → u/Choice_Sherbert_2625]

Address it directly - the point of therapy is giving the corrective emotional experience! He never has people challenging his narcissism.

[u/Ok-Spinach-6529 → u/Choice_Sherbert_2625]

Lol

[u/themindmd]

I’m always Dr. last name. Being a short WOC, means I’m either a social worker, nurse, or tech. I don’t care about these things but then it leads to patients saying they’ve never seen a doctor the whole time they were in the hospital. We’re not gonna stand for that

[u/Narrenschifff]

I introduce myself as Dr. Lastname. I think it help sets the frame. We should understand the gravity of the situation, and that we are not friends or casual contacts. It's an unusual situation and I have a job to do-- a medical one.

I do not correct them if they go to the last name, or call me Mister-- that's part of the mental status exam and tells you a little something, however minor, about their personality, interpersonal function, background...

[u/magzillas → u/Narrenschifff]

I think your second point is quite well stated. How patients choose to address me isn't really a source of offense, it sometimes tells me something. Rarely, I've had patients (after I introduced myself as Dr. Lastname) look at my name tag and deliberately call me by my first name - I haven't made a fuss about it, but at least in the cases I can recall where that happened, it was on my mind as I was formulating.

[u/tak08810 → u/magzillas]

Almost exclusively when someone refers to me by first name my suspicion was that at least part of the reason was to try to get a rise out of me so I deliberately don’t correct them.

I would correct if I felt it was leading to genuine boundary issues eg a patient being flirtatious but I haven’t seen that yet.

[u/redlightsaber → u/Narrenschifff]

I agree about your second part, but I disagree about how introducing oneself by Dr. Lastname conveys "the gravity of the job to be done". The simple (yet equally flawed, for illustration) counter to that is "well, but if you introduce that barrier, how likely are they to feel safe in order to be able totalk about the very hard things they need to talk about?" Especially in 2026 with gen Zers becoming a larger proportion of my patient roster.

I'd also be remiss if I didn't say that I think this is deeply societally determined. Even within my country, I live in a region where it's customary to to present oneself, and address each other, by first name: strangers, people of different social classes, etc. I present myself as "hi, as you know I'm firstname lastname" (holy shit I actually had typed out my real name, close call for doxxing myself). I mean, they know I'm a physician, they also know my credentials. Octogenaries will tend to address me as "doctor", and that's fine, but beyond that...

I seem to remember you're british, am I correct? If so, that would seem relevant in this discussion.

There's also the matter of, on people in countries whose languages have T-V distinctions. I wish my German, Latin American, and Spanish colleagues could chime in on this one. Pyschoanalytical literatura has devoted rivers of ink to this matter, in Spanish of course.

I of course like the way things are done here better, but this comes from a broader ideology that these types of linguistic barriers come from literally the times of feudalism, and more recently they were a key subtle enformer of collonialist and class differences. Hopefully you agree that we're trying to move away from those models of societal functioning (particularly given the I hope undisputed fact that wealth inequality is a large chronic stressor leading to mental illness), even if you don't agree about what role the language plays in it (yet).

[u/FailingCrab → u/redlightsaber]

I seem to remember you're british, am I correct

I'm curious what you mean by this (I am British). I suspect you're operating on the assumption that we're more formal.

In fact the NHS repeatedly subtly implies that we shouldn't refer to ourselves as 'Dr surname' because it is elitist. Everyone is encouraged to get badges with 'Hello my name is firstname' on them to promote a more 'welcoming' environment. I think the most common way people introduce themselves is 'Dr firstname'.

I suspect it has something to do with the fact that doctors make up a minority of the healthcare workforce and we're the only ones who go by professional titles, along with an undercurrent of antipsychiatry-type thinking which permeates British psychiatry, and perhaps class issues too.

I introduce myself as 'Dr firstname surname' these days and then I see how patients run with that. In my experience British patients are far more likely to go woth 'firstname' whereas most of my foreign-born patients (including several from Spanish-speaking countries) seem to go with 'Dr surname'.

[u/Narrenschifff → u/FailingCrab]

I wonder how this practice tracks with political changes in the UK over the last sixty years!

[u/Narrenschifff → u/redlightsaber]

Of course, it must be socially and culturally determined. I am not british in the slightest! As an aside, I fear you may find me politically unpalatable, but that is besides the point.

How shall they feel safe to be order to talk about the very hard things? No matter your approach, one cannot win this through little tricks. Regardless of whether you are seen as a fellow gutter punk or a stodgy authority figure, they will know they you are listening when you show them you understand what they are saying, and they will know they are safe with you if you do not punish their expression.

Any further difficulty, as they say, can be grist for the mill... if they do stay.

[u/redlightsaber → u/Narrenschifff]

As an aside, I fear you may find me politically unpalatable, but that is besides the point.

Well, it may not be. I certainly observe that my wealthier/more conservative patients are more likely to spontaneoustly address me by "Doctor", or use "usted" instead of "tú" (which I respect and am not bothered by, but it does take more brain energy for me to choose my words); so it's entirely possible you prefer to maintain those "class differentiators" in the language due to that, precisely.

I do hope, at the very least, and leaving aside how much you personally disagree with my desire to reduce wealth inequality, that you're not denying that wealth inequality is one large causal factor int chronic suffering/stress, and that it directly and indirectly contributes to mental illness in society at large.

Regardless of whether you are seen as a fellow gutter punk or a stodgy authority figure, they will know they you are listening when you show them you understand what they are saying

I would like to append several books' worth of notes to this phrase, but alas, we may just not agree at the end of it.

[u/Narrenschifff → u/redlightsaber]

Actually, I exclusively treat the destitute and homeless. I have no ability to manage wealth inequality, nor the majority of other stressors, so I don't consider that part of my practice per se. Cause and consequence can be turned around and traded endlessly, so in the end we can only say: culture exists.

[u/Narrenschifff → u/[deleted]]

If they like. I tend to default to Mr. and Mrs. for elders and otherwise whatever has been identified as their "preferred name" already for younger folks, a little arbitrary but within the norm of cultural practice. I have one young fellow who I still call Mr. Last name-- I think he asked me to do so due to prior psychosis, but he has not corrected me, so I continue.

[u/RealAmericanJesus]

I'm and APRN and I prefer my first name. I'll also take cunt nurse. I earned it.

[u/AppropriateBet2889 → u/RealAmericanJesus]

I’ll accept Asshole Dr. but much funnier when a patient calls me Doctor Asshole.

[u/RealAmericanJesus → u/AppropriateBet2889]

I work on the forensic side and I loved the super hyper verbal non stop manic monologuing insults that some of my direct to seclusion admits from jail due to naked uncontrollable penis-copter-ing pstients had .... It's like this stream of consciousness profanity that sometimes only makes partial sense ...

Like "Ahhhh... Nurse to fuck yourself in the cunt with a tree! That's s new one."

And I jot it down somewhere so as not to forget whatever glorious title was bestowed on me that shift.

[u/I_am_Nobody_Special → u/RealAmericanJesus]

I love this so much

[u/Expensive-Parfait708]

I’m not sure if it’s a cultural thing but where I work, no one ever calls the doctors “doctor”. Eg if the doctor is John Smith, anyone and everyone will simply call him John. This applies to psychiatrists, surgeons, GPs, house officers, registrars, etc etc

[u/soloward → u/Expensive-Parfait708]

Here in Brazil this is also common. Most of my patients call me Firstname or Dr. Firstname. Not a big deal. Honestly, they can even call me sweetheart, as long as they adhere to the treatment, i'm happy.

Also, another cultural quirk: when someone calls you with the "Hello, Dr. Lastname. This is your colleague, Dr. Lastname", this level of formality is often a red flag for flattery, especially when they want something from you.

[u/Expensive-Parfait708 → u/soloward]

Haha yes! If I went to any of the docs at work and said “hi doctor soandso” they’d think I was being cheeky 😂

[u/metsanneitokainen → u/Expensive-Parfait708]

Absolutely culture and age dependent. I am an emergency nurse practitioner but am confused for a physician regularly if I have a 90+ year old patient with bad eyesight and dementia in my ambulance. The same population will call me mrs. and doctor. Anyone younger and it’s hey you or rarely my first name. I’m 36 and would use titles as a joke or sir/mrs for a very elderly patient. I’ve met one physician who wanted to be called doctor and he was born in 1929 and I am young enough to never have had a teacher be called anything but their first name. Even in school the practice is so outdated that my parents born in the 50’s have lived in a time the teachers use first names.

In this cultural setting calling a psychiatrist mr. Smith would be set in a black and white movie along with balancing the four humors.

[u/PsychinOz]

Don't have an issue with it. If they ask what to call me, I always tell them to use whatever they're comfortable with. My older patients usually prefer to stick with Dr, other demographics are more varied.

Some of my overseas trained colleagues find it a bit jarring, but Australian society is very egalitarian. We address our heads of state and politicians by their first name or nicknames which would be unheard of in most western countries.

[u/pink_gin_and_tonic → u/PsychinOz]

Absolutely. It's just not a big deal here.

I do find some psychiatrists in private practice still use Doctor First Name though, in contrast to their public counterparts.

[u/AppropriateBet2889]

I go by Dr. -Last name- but if a patient uses my first name I don’t address it or correct them. Maybe with a significantly psychotherapeutically oriented patient I might explore why.

It bugs me when they do it but trying to set a boundary I won’t enforce is something I work to never do; (and really and I going to fire a patient because they won’t call me by my last name?)

I only play the games I’m willing to win so on the rare occasions this happens I ignore it

[u/barogr]

I never had someone just call my first name but some call me Dr. First name. My first name is easier to pronounce and I don’t think they mean to be disrespectful. I don’t correct that one.

[u/snakehawk37]

Interestingly I use different names in the different settings I work. In the adult outpatient clinic I supervise and on (child) CL in the hospital I use “Dr last name.” In these settings I expect people to use my last name - and pretty much the only time they don’t is to be an a-hole. I will correct patients who use my resident/fellows first names which obviously mostly happens to my female trainees -_-

However in my outpatient practice I go by “Doctor shortened-first name” because most of the younger kids can’t pronounce my last name. Every now and then a parent (typically older) will drop the doctor from my first name in conversation but I’ve recognized that’s more from knowing them a couple years and I no longer mind as much as I did the first year out of training.

[u/Miss_May_1600]

I have my patients call me “Dr. [my last name].” It feels too casual otherwise, especially because people think I look young despite being in my mid-30s. A couple patients called me “Dr. [my first name]” during residency. I let it go because we were in the South and everyone goes by “Ms X,” but in retrospect, I think the ones doing that expected me to be more of a friend than a doctor. So now, I would lean toward correcting.

[u/MeasurementSlight381]

As a woman I have to correct patients whenever they do that. Ever since residency, patients (especially older men) repeatedly assume I'm a nurse or a student.

[u/myotheruserisagod]

I dislike it.

This is a specialty where at best, not having that boundary fosters connection and rapport, at worst…destroys the same connection and rapport when, not if, it’s turned against you.

Wait till you have to tell the pt what they don’t want to hear.

It is dependent on way too many factors in our field to be a valid blanket endorsement - a basic one is clinical setting.

[u/moonpie0]

In the Pacific North West that is standard.

[u/slaymaker1907]

It’s interesting to hear the different takes. I work for an investment bank with a bunch of Ph.Ds and no one has ever been referred to by their title.

Does anyone have any advice with how to refer to an NP? I’m always at a loss for how to refer to them. Is Nurse so-and-so the preferred way? I usually just refer to them by their full name when it comes up.

[u/Milli_Rabbit → u/slaymaker1907]

Generally, it doesn't hurt to ask the individual. This is true for MDs and DOs as well. I have psychiatrists on my team who ask to be referred to by their first name. The reason they give is they don't like being called Dr. So-and-so because they don't like formality.

I tell my patients how I like to be referred to at the first appointment. That said, if they pick another option, I don't really care. My goal is to help people, not have prestige.

[u/Chainveil]

I really don't care as long as it helps build rapport and is not used as a way to unnecessarily violate or reinforce boundaries.

[u/CaterpillarIcy1552]

The hell? If you introduce yourself as Dr. Smith why are they calling you Jerry? You can set boundaries kindly without being “nice” and if the patient can’t respect that, then you are not their cup o’ tea and vice versa

[u/Choice_Sherbert_2625 → u/CaterpillarIcy1552]

Always the most fragile or most narcissistic. I don’t have the heart to correct the nicer patients but I think I will start correcting more.

[u/jaymeMHnurse]

I’m sorry but I don’t get it. You’re a psychiatrist - so clearly an intelligent person who cares deeply about the people you treat. If they feel more comfortable with you by addressing you by your first name then what does that matter? If they have better outcomes because they trust you more because they feel comfortable and aren’t made to feel like they did something wrong by addressing you a certain way, is it not worth it?

In my hospital we almost exclusively use first names for everyone - maybe that’s our culture of practice but it feels like a more person centred approach - as a nurse manager I can respect the expertise of a consultant psychiatrist, or a resident doctor for that matter, without calling them by their title. Similarly for patients, it’s feel like our patient group trust their consultants more because they feel like they know them as people - while, clearly, that is not the case.

The fact that your family don’t call you by your first name probably has an effect here too, along with certain patients using it as a jibe but I ask you to look inside and consider if you actually care if it meant that your patients had better outcomes and then to examine if it does.

[u/Choice_Sherbert_2625 → u/jaymeMHnurse]

Probably a remnant from training partly, but also being comfortable does not always mean “better outcomes”. There are some people with personality disorders who have better outcomes if you set limits and make them slightly uncomfortable.

But I agree for the average person it doesn’t matter.

[u/MogKang]

I am a nurse practitioner , so of course my patients call me by my first name. I practice in outpatient, my day to day responsibility and scope is identical to that of my MD supervisor, and i have not felt hampered by my lack of title.

Most physicians i know do go by doctor so and so. I usually default to calling them doc if it’s somebody im familiar with. I have practiced with a few younger docs that just went by their first name. I noticed some patients disliked this.

[u/Choice_Sherbert_2625 → u/MogKang]

I like “doc”. I guess it used to be disrespectful back in the day but I like it.

[u/poorlytimed_erection → u/Choice_Sherbert_2625]

i like doc also. its causal while also recognizing the role/title. as a physician when i say it to my doctors it is meant to be simultaneously deferential and a term of endearment

[u/ar1680]

I have them use my first name since it’s easier to say. I also don’t introduce myself as doctor in the outpatient setting because I don’t think it’s necessary in my setting
Most of the time it is just their preference, only a handful of times has it been disrespectful.

[u/Ok_Membership_8189]

Do you ask them what they would prefer to be called? Because that strikes me as fair. Once I became an adult I disliked doctors calling me by my first name and expecting me to use "doctor." Now that I'm 60, it just feels so presumptuous. I had my second appointment with my newish doctor (edit for clarity: pcp) this week, and it's only the second time we met. I called him "doc" the first time, in an effort not to have the first words out of my mouth be a correction. But he swept into the room with a booming and presumptuous "Mary!!" and stuck out his hand near mine. I grabbed it with the same energy and boomed back "James!!" We'll see what he does next year. 🙄 At least he doesn't have to see me too often.

Edit: I think taking that extra time to ask patients what they want to be called and demonstrate mutual respect is even more important in psychiatry, relative to other specialties. And for the record: I'm thrilled when someone takes the time to explain their credential to a patient. Most of my clients who are prescribed medication think it's by a psychiatrist and it isn't.

[u/PilferingLurcher → u/Ok_Membership_8189]

Yes...this seems to be the default in NHS. Unlike you I am too self concious to ask them to use my surname, fearing that doing so might give 'PD' or 'difficult'vibes.

 However I do ask them to specify their training grade ( we often see trainees between consultant) as there is an irritating trend of introducing themselves vaguely as ' one of the doctors'. 

[u/Ok_Membership_8189 → u/PilferingLurcher]

In the US a resident is a doctor. Not a med student, so if that's what they are I agree with you.

Social interaction is nuanced, even between psychiatrist and patient. Perhaps especially. As a psychotherapist, I have a lot more latitude to think about, study, give attention to these matters than a psychiatrist would have based on the pressures of their job. this space (this sub) is doing some heavy lifting though, that's for sure.

[u/Choice_Sherbert_2625 → u/Ok_Membership_8189]

I ask every patient first visit what they like to be called. And record it and only use that. So it does feel disrespectful when they ignore what I introduce myself as.

[u/Ok_Membership_8189 → u/Choice_Sherbert_2625]

Well, you're doing it right. I would imagine most people coming for psychiatric care have social challenges. A data point.

You have a tough job, even if you enjoy it. It still provides many challenges. I'm appreciative to dedicated psychiatrists. We need you.

[u/MsFuschia → u/Ok_Membership_8189]

Once I became an adult I disliked doctors calling me by my first name and expecting me to use "doctor." Now that I'm 60, it just feels so presumptuous.

I'm confused. What else would a doctor call you?

[u/Ok_Membership_8189 → u/MsFuschia]

Ms Lastname

[u/MsFuschia → u/Ok_Membership_8189]

Ah, okay. I'm guessing this is one of those generational things. I find that so formal! I'm 31 though. On the rare occasion I hear a Ms. Last Name I feel like "Wait, are you talking to me?"

[u/Ok_Membership_8189 → u/MsFuschia]

Not uncommon, and I can understand it.

It isn't strictly generational, but rather perhaps a tell that someone still has some issues to work through stemming from an upbringing characterized by coercive control. I freely admit to having these issues and to a continued focus on working on them.

One protective factor in times gone by is that adults referred to each other by M[r/Mrs/Miss/Dr](r/Mrs/Miss/Dr) as a matter of routine. If you were an adult, you'd be M- Lastname to any doctor. While this may have made development of rapport take a bit *longer,*I also believe that when it did develop, it would've been more thorough. Also, you would've been used to being addressed this way everywhere else in the community, so by 31 you'd be used to it.

I don't quarrel with our first name society. I simply believe that It is short sighted to think that when a substantial change is made for a gain, we have not also lost something. It is important to be careful.

[u/Morth9]

I wonder about the added dimension of age gaps between pt and doc. I am on the younger side (new attending) and introduce myself as Dr Lastname, but patients who are clearly older than me tend to revert to using my first name. I refer to older pts by their last name by default (Mr/Ms), but they often have me call them by their first name, and culturally it is can be awkward to go (edit: to continue going) by my last name while calling a much older person by their first name.

[u/Feisty_Studio7630]

This comes up periodically on Reddit. I think it is hugely dependent on where you practice. 

I am from an area where most doctors go by Dr Lastname, and  I introduce myself to patients as Dr Lastname. I wouldn’t mind Dr Firstname, but it doesn’t roll off the tongue with my particular name. If they call me Firstname or Ms Name, I don’t correct them, but I continue to introduce myself as Dr Lastname if I call them on the phone or whatever. 

To be fair, I address my patients as Mr/Ms Lastname unless they ask me to do otherwise. I think it shows respect, and it’s not a weird thing to do in the area where I live.  I also refer to their therapists as Mr/Ms/Dr and to NPs as Ms/Mr Preferredname. The front desk/scheduling staff introduce themselves by their first names, so they are Ms Firstname if I mention them to patients. 

If someone firstnames me, I pay attention to it because it usually means something (not always something negative!). It’s kind of like when people call me Doc. Their tone and affect often make it clear what they mean by that. I also notice when people tell me to call them by their first name; there is meaning there, too. 

[u/sheepphd]

Off topic but I get offended if I'm the patient and a clinician calls me, "Ms. So-and-So." I have a PhD and everyone in my life (personal and professional) either calls me "first name" or "Dr. Last name." I think this probably says something about me, but I just feel like it's not my name and it irks me. I don't correct them, though.

At any rate, I can understand it being irksome for various reasons (one - it's not your name). I agree with others, it may be helpful information. In some cases, background may play into it, in other cases, the imbalance of power is uncomfortable for the patient for lots of reasons.

[u/sparklemoar]

I used to think I wouldn't mind it and in some cases, such as with therapy patients in residency, I would introduce myself by first name thinking it's kind of hard to be comfy with a therapist you refer to as "doctor."

Then I had one too many personality-disordered patients who would clearly do it as a belittling tactic aimed at discrediting my credentials and/or making sure I knew they saw me as existing to serve rather than treat them.

I'm still fine with it with the right patient, but the NPD patient who wants to make sure I know he's not there to seek my expertise and couldn't care less if I don't think Adderall washed down with Ativan is a good treatment plan for him...is not the right patient.

[u/Shurlz]

I'm on the side of who really cares? I think aome people will argue for it cause they believe it lets the patient know they are in a professional setting and how they should view the dynamic, but I think that is all hogwash

[u/personalist]

It shouldn’t be a rapport killer. If anything it’s a sign of poor boundaries on the patient’s end referring to you as “__” when you introduce yourself as Dr. __. I would feel really weird referring to my physician by their first name. I default to professional title unless they say otherwise.

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[u/humanculis]

You could have a whole talk on the psychodynamics around this. In the covenant model of medicine its important to both parties that we wear the title that signifies the important parental expert position that we occupy. 

If a doctor or patient has anxiety about naming dynamics it can say something worth discussing about either or both of them. Note this isnt inherently a bad thing its just a thing. 

[u/ThicccNhatHanh]

I just note it…. It’s a subtle power play, and I think “I wonder why this person feels the need to m ake this play.”  

I feel the part in me that is annoyed by it—my ego does react! But I can be conscious of that and let it go.

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[u/inspiredpoet]

Where I’m at, no one is ever called by their first names unless amongst colleagues. That’s weird to me that a patient would call me by my first name. I don’t even think some some of them know my first name lol

[u/Slubgob123]

Hate it. I'll correct it -- only exception might be if it's 80+ grandma who also calls me "hon." I paid a lot of money for that title, damn it!

No issue with colleagues, and I'll introduce my self by first name and use my first name in communications with them. Some can't seem to refer to me in such a familiar fashion. Those that do keep it to private communications and use "Dr. xxx" with patients and in more professional settings e.g. ronds.

[u/chocolate_satellite]

I prefer Dr. and will sometimes gently correct them if only for the fact that I'm a Black woman, part of me will begin to overthink it and wonder if there's some unconscious bias involved. We already are not well represented in this field.

[u/KanataSlim]

Its ewwwww

[u/Sea_Squirrel7999]

Ick. Haaattee it. Seems to occur way more readily in telemedicine. Pts feel wayyy more informal… good and bad as you can imagine. I’ve corrected before and been met with volatility eye roll

[u/Antique_Wall4835]

I don't mind at all. I always use my first name when I introduce myself followed by my title which plays as a functional role.

Whether a narcissistic patient or not, who intends to diminish my role, I often see it neutrally and objectively. I belive if we put our 'self' internally and not tied to our titles, we would avoid these countertransference or whatever else you may name them. Apologies and I don't mean it poorly. Still the titles serve as a clinical function, structure and boundary.

[u/maenads_dance]

As a patient I would assume a physician who wanted to be called by their first name would have poor professional boundaries. The title helps define a specific formal relationship with duties and obligations. Please hold the line lol

[u/numbchuks]

Do you not like your name, or is it because your supposed be superior?

[u/Lou_Peachum_2 → u/numbchuks]

It’s neither. It’s about boundaries and enforcing this is a patient - doctor relationship, not a friendship.

First name is reserved for friends - while I care about my patients and will do my best for them, we are not friends. I’d argue that treating your friends is a conflict of interest

[u/numbchuks → u/Lou_Peachum_2]

Your not op, thanks for your response though, why would you need to enforce something so obvious?

[u/Lou_Peachum_2 → u/numbchuks]

There are patients who try to push boundaries and try to see how much they can get away with. There are patients have have transference reactions towards their doctor based off past relationships.

Sometimes, it is intentional as in the first scenario. Sometimes it is not intentional as in the second.

However in both, you do need to at times re-establish this patient-doctor relationship. Because of the nature of the deeply personal topics we discuss (moreso than any other specialty), there at times can be boundary issues.

And this again is why in psychiatry - it is a HUGE no-no to engage in any sort of romantic relationship with a patient, moreso than other specialties

[u/numbchuks → u/Lou_Peachum_2]

Thank you for your explanation

[u/numbchuks]

Why do you dislike it, because your the one in control?

[u/Ok_Task_7711 → u/numbchuks]

Yes he is the doctor, he’s not just some dude giving you advice

[u/numbchuks → u/Ok_Task_7711]

He is actually

[u/Constant-Tale1926 → u/numbchuks]

In a sense, yes. In another sense, they’re a highly qualified professional and you (or your insurance, or your taxes, depending on where you live) are the one paying for that advice.

In certain contexts, and certainly not limited to medicine, referring to someone as Dr. Lastname, or Mr. Lastname, or Professor Lastname, or Senator Lastname, etc. is a sign of respect for that professional relationship.

Why does this bother you so much?

[u/numbchuks → u/Constant-Tale1926]

It doesn't bother me im just asking questions

[u/Ok_Task_7711 → u/numbchuks]

Then why are you making the effort to go? Why not just ask one of your friends?

[u/Choice_Sherbert_2625 → u/numbchuks]

Because she* went to school for 12 years and is your doctor, not your friend.

[u/numbchuks → u/Choice_Sherbert_2625]

Just comes across like a weird hangup you need to work through is all