Sense of ‘untitlement?': Female docs more likely to experience first-name calling by patients, says study

An analysis of nearly 91,000 messages from about 34,000 patients in the Mayo Clinic electronic medical record has surfaced gender-based differences in how likely patients are to use the title of “doctor” in addressing their physicians. The study, which used a natural language processing algorithm to analyze the greeting and closing salutations in each message, found female physicians were more than twice as likely to be addressed by their first name than their male colleagues, and that the chance was even greater if they practised primary medicine or osteopathic medicine, according to a Stat article. The gender of patients also made a difference, with the analysis showing that female patients were more likely than male patients to get on a first-name footing with their physician. The age of physicians and patients, and physicians’ level of training made no difference in how doctors were addressed, the study found. Read: Male doctors disproportionately refer patients to male surgeons: study Dr. Jamison Harvey, a dermatologist who is among the study’s authors, said that while the study did reveal an unconscious bias among patients, it did not uncover the actual reasons behind this bias. “We weren’t able to study that,” she said, adding that perhaps, “they don’t see women as natural physicians,” or, “it’s more that they feel like they have a better relationship with the female physicians.” The study, which was published recently in the Journal of the American Medical Association, did not delve into whether or not any of the patients who dispensed with the doctor title in their messages had permission from their physician to call them by their first name. It also did not look at how race or ethnicity factored into patients’ use of the doctor title. Read: Canadian doctor Chika Stacy Oriuwa among 'role models' celebrated in new Barbie line Dr. Melanie Molina, a clinical fellow at the University of California, San Francisco (UCSF) who published a perspective on microaggressions in emergency medicine, noted that the study results—which are based on data from outpatient settings—might also not reflect physicians’ experiences in acute care settings. As an example, she cites a scenario in acute care where a doctor meeting a patient for the first time is mistaken for ancillary staff. “It’s when you walk into the room for the first time and the patient talking on their phone says ‘hang on, the nurse just walked in,’” said Dr. Molina. Dr. Lekshmi Santhosh, an associate professor of pulmonary and critical care medicine at UCSF who co-authored a JAMA commentary to accompany the study, said the findings underscore the inequitable volumes of EMR-related work between male and female doctors. Read: Why do women doctors get sued less? Previous studies have found female physicians get a higher volume of messages through the EMR than male doctors, and they also spend more time after hours catching up on these messages. “In the context of working so hard, spending so much more time and taking such care to craft a reply to each one of these messages, to then get a dismissive reply with your first name is quite jarring,” said Dr. Santosh. After her co-authored commentary was published in JAMA, many female physicians reached out to tell her “that is so true, that happens to me all the time … People have brought up stories saying: ‘This is why I always have to wear my white coat because otherwise people don’t think I’m a doctor—even though I run the division.’” Read: Female doctors are good for your health, we need to support them

Sense of ‘untitlement?': Female docs more likely to experience first-name calling by patients, says study

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