I’ve always preferred informality to formality. I think it even played a role in leading me to my career in psychology, which I enjoy so immensely. As an undergraduate, I was drawn to psychology in part because my psych professors were more informal than the professors in my other courses.
I adopted the same informality with students when I became a professor. For example, when I interviewed to teach a course at a local university, I asked whether it was okay for me to encourage the graduate students to address me by my first name.
Now, after decades of settling into that way of interacting, I’m wondering whether I was wrong all along. That reappraisal started when I read about a study showing that female doctors are more often called by their first name, while male doctors are called by their title. Then I read about other studies suggesting even more consequential ways in which female doctors are treated as less valuable, and less worthy of respect, than male doctors. Maybe by encouraging students to call me by my first name, I have been exacerbating a whole dynamic by which female professionals are not taken as seriously as their male colleagues.
I learned about the study of first names and titles from “What’s in a title? When it comes to ‘Doctor,’ more than you might think.” That article was written by Professor Patricia Friedrich, as Associate Dean at Arizona State University who studies the ways we use language. Professor Friedrich and her colleagues kept track of the way speakers were introduced during grand rounds (meetings in hospitals where clinical cases get discussed). More than 300 introductions from academic medical centers in Arizona and Minnesota were analyzed.
The researchers found that women almost always introduced speakers by their title, regardless of whether the speakers were men (95%) or women (98%). When men were introducing other men, they also used titles nearly three-quarters of the time (72%). But when men were introducing women, they used their title less than half the time (49%).
Professor Friedrich, whose “Dr.” title comes from having a doctorate rather than a degree in medicine, has had the same experience: “I have many times witnessed a male colleague being called “Dr. Last Name,” while I am simply called “Patty” in the same breath.
Dr. Ranjana Srivastava, an Australian oncologist, has also had her share of cringeworthy experiences. For example:
“What do you think, doc?” a patient winked at a man. “Does she know her stuff?”
“She’s my boss,” my resident stammered.
The use of first names for women and titles for men, and anecdotes suggesting disrespect for female doctors, may seem like small stuff. But Dr. Srivastava thinks it is part of a broader pattern of discrimination:
“Female doctors are overlooked for opportunities to become dean, chief executive, tenured professor, editor-in-chief, first author, and lead researcher. Even after adjusting for years of training, productivity, specialization and billing, women in medicine earn nearly 30% less than men.”
That’s not because female doctors are not good at their jobs. Based on the emerging research picture, Dr. Srivastava finds that in some very important ways, they are better than male doctors:
“…female doctors listen to patients longer, interrupt them less and may provide more cost-effective and patient-centered care associated with lower rates of hospitalization and mortality.”
Treating female doctors with respect is not just a matter of being nice. When female doctors are treating patients in ways that turn out to be cost-effective, it is good business to treat those doctors well. And for the patients who may have a better chance of living longer when treated by female doctors, well, it doesn’t get much more consequential than that. Those doctors have earned the respect that they are not yet getting in equal measure to their male colleagues.
What can be done? Dr. Srivastava thinks it would help if salaries were published. She also recommends steps such as “promoting more women, giving them a seat at the important tables and… holding senior doctors accountable for their conduct toward women.”
I’m still not sure I will give up my informal ways. I’d like to think that students are more likely to become your intellectual equal (or better) in your field of study if they are addressed as equals. I could also tell myself – and it would be true – that there is no research showing that female doctors get promoted less often or paid less because they are addressed by their first name or disrespected in other seemingly small ways. But more seriously than ever before, I’m considering changing.