My First Name is Doctor

 

By Shawna A. Flanagan, MD, FAAD

Twenty plus years ago I decided to establish a practice that I could call my own.  However, I soon realized that establishing myself as a female business owner and doctor in a male dominated industry would be no easy feat.  Fast forward to 2020, I have established myself as a successful dermatologist and business owner. As my journey progressed, I somewhat foolishly believed that many of the gender specific roles placed on doctors in the past had dissipated.  However, this notion quickly vanished when one of my younger female colleagues lamented that she was struggling to get her patients to address her by her preferred title, “Doctor”. 

Although I am not typically one to get hung up on the details, soon after she brought this issue to my attention I couldn’t help but notice thereafter every instance patients referred to me by my first name and not the title that I had worked so hard to gain.  No matter how hard I tried to ignore those unwilling to give me the respect I believed I deserved, I couldn’t help but allow it to bother me; this is when I decided to investigate this issue and figure out what was truly going on.  

THE FACTS:

In researching this, I discovered that for women physicians, one’s preference matters little.  A study done by two female physicians at the Mayo Clinic during 2012-2014 shined light on this issue.

Drs. Julia Files and Anita Mayer published their findings in The Journal of Women’s Health.  They filmed Grand Rounds at The Mayo Clinic in Minnesota and Arizona over a two-year period.  In reviewing the speaker introductions over the two-year period, they found male colleagues introduced female speakers by their title only 42 percent of the time and introduced them by their first name 58 percent of the time.  However, when the same male introduced his male colleagues, he used a title 72 percent of the time.  Females were also subject to their own gender bias when introducing their colleagues.  Females used a title when introducing male speakers 96 percent of the time but only 66 percent of the time when introducing female speakers.  The take home message is both male and female physicians are more likely to address their male colleagues by the title Doctor XY. 

IS THIS A BIG DEAL?

According to Dr. Patricia Friedrich, a professor of English and Sociolinguistics at Arizona State University, the answer is absolutely “yes”.  The above study showed that women are less often called “doctor” than their male equivalent, not just by a small margin but by an impressively large margin even by their same gender professors.  

Dr. Friedrich conducted an informal feedback study and learned that this practice concerns some female physicians.  It is possible that others may have not realized the bias, as I had not until it was brought to my attention. 

Dr. Friedrich said that within the same interaction between herself and a male colleague someone has addressed her male colleague as Dr. XY and her as “Patty”.  This has happened to many of us as well.  I personally know many of my patients who I address as Mr. XY will respond back, “Okay, Shawna!”

As a linguist, Dr. Friedrich discusses what else is happening in those contexts of communication that can lead to gender inequality.  Women in academic medicine are paid less than men in equivalent positions and are less likely to rise to the level of full professor or program chairperson (which is usually still called Chairman).  Women are promoted less often because of the biased belief that family obligations may interfere with the position.  Women are also more likely to be subject to harassment in the workplace than men. 

Although all the above inequities are not necessarily directly correlated with their professional title not being used as often as their male equivalents, the possibility of an inadvertent correlation must be considered.  

WHAT DO WE DO?

It is vital we accept that women are affected by these behaviors even if you do not realize it, as I did not.  There is an opportunity for those who might not be directly impacted by this to become more aware of the gender bias and speak up to make others aware.  By becoming female physician allies and recognizing the bias, we could help other male and female physicians remodel their behavior. 

Another area that lacks research, and may benefit from physician compliance of being addressed by our professional title, is that of non-binary and transgender physicians.

If we all start the discussion, the possibility of undermining the advancement of certain physicians in the professional workplace may be stopped.  We should all demand the respect of a title we have worked hard to earn.  I think it is time we all addressed each other with our professional titles during our conferences, grand rounds and professional events as this may lead to more respect from our patients as well as one another.  

If you want to continue this discussion, please register to attend the “Strategies for Addressing Workplace Sexism for the Young Dermatologist” virtual WDS Regional Educational Series event hosted by Dr. Terrence Cronin on August 20, 2020.  Follow the WDS on Instagram, Facebook, Twitter and the WDS website for details. 

        

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