I have been in practice for 34 years. Some of my first patients have been with me from the get-go. That means I have known them longer than my husband or son.
For example, in the summer during the '90s, Sara, now in her 80s, and I both registered for courses at the Omega Center for Holistic Studies, situated on a former summer camp in upstate New York. I offered her a ride, and we drove up together. She stayed in the lodgings; I tented. One night an insect bite landed me in the infirmary. She heard and visited me there.
Sara has always been independent and self-sufficient. Yet these days she needs my help more than ever. I do not wait for her to call but check on her without prompting. It seems reasonable that she should call me by my first name. Besides our long history together, both social and professional, she is almost a generation older than me.
One of my older patients remembers my son as an infant. When I first met Elizabeth, also the mother of an only son, her boy was still single. Now he is married and has a son of his own. Whenever Elizabeth texts me a medical question, she also asks after my son. We move seamlessly from doctor and patient to mother and mother. It’s one of the things I love about my practice.
Two other patients, Caren and Martha, have also been with me for years. Caren and I share interests and friends. I recently tried to arrange a match for her son. A designer, she admires my colorful office decor. Yet even after we took turns serenading each other on my piano, she still called me “Doctor” at the conclusion of the visit.
Martha, several years my senior, has sent me her husband, her son, her granddaughter, and her cousin as patients. She invited me to her son’s engagement party. I personally delivered packages of supplements to her house. Although her husband calls me “Doctor,” Martha addresses me as Marjie. I get it; it’s a woman-to-woman thing.
Although we are colleagues, I would never dream of calling my own physician by his first name. I find it reassuring that he calls himself “Doctor.” Even if we have friendly conversations in the course of an appointment, he is still my physician. I like to keep the boundaries clear.
It can be tricky to strike the right balance with patients. I want to be distant enough to command respect but close enough that they trust me with their innermost concerns. It’s like the relationship between parent and child. I need to be treated with both respect and love. Recently a teacher showed me how to use meditation in prayer. “Imagine,” she said, “a baby looking up lovingly at its mother. Then imagine something awesome, like Niagara Falls. God is at the same time intimately close yet infinitely awesome. He is close like a parent and still divine.”
I face the same challenge in relating to my patients. I want them to know that I’m always thinking of their well-being. But, if I wish them to follow my instructions, I also need their respect.
On that note, I find that patients with a religious upbringing are more likely to call me “Doctor.” In Japan, where I lived as an exchange student, I learned to always show my teachers the utmost respect, even going so far as to address them in the third person. I don’t need my patients to go that far, but I do want them to acknowledge the nature of our relationship. It is not one of friends or equals. They may call me Marjie in a social setting, but it’s appropriate for them to call me “Doctor” in the office. I think the formality maintains the proper tenor of the relationship — even if they just call me “Doc.” In fact, I like that — it’s intimate yet respectful.
Recently, at her new patient visit, a patient exactly my age called me “Marjorie.” What in heaven’s name, I thought, gives her the right to address me that way, especially at our first appointment? It’s not even the name I go by.
The woman was referred to me by our mutual dentist. Yet I noticed she didn’t refer to the dentist by her first name. Perhaps I need to don a white coat, my husband suggested. Every time she called me “Marjorie,” I felt an annoying prick in my chest. But what was I supposed to do? Say, “That will be ‘Doctor’ to you?” I’m glad she feels comfortable with me, but at the same time, she needs to acknowledge that, at least in my office, we are not equals.
My uncle, a renowned cardiologist, was a favorite with the medical students and residents at the hospital. I ran into one of my former classmates some years after graduation, and he told me, “Everyone loves Ira.” But when I repeated the compliment to my uncle, all he said was, ”Who told him he could call me Ira?”
If a patient calls you by your first name, how do you respond? Share your tactics in the comments.
Marjorie Ordene, MD, is an integrative physician practicing in Brooklyn, New York. Her essays, short stories, and poetry have been published in various magazines and anthologies including The Sun, Tablet, Lilith, and Michigan Avenue Review.
All names and identifying information have been modified to protect patient privacy.
Illustration by Yi-Min Chun
