The doctor-patient relationship is built on trust and professionalism, but what happens when that dynamic is complicated by a pre-existing personal connection? A recent inquiry to advice columnist Miss Manners highlights the awkwardness that can arise when a physician is someone you’ve known for decades, even from childhood. The question centers on the appropriate form of address – a formal “Dr. Smith” versus a casual “Tommy” – and the discomfort it can create for both parties.
The core of the issue isn’t simply about politeness, but about navigating shifting roles and maintaining professional boundaries. As medical care becomes increasingly personalized, the lines between formality and familiarity can blur. This situation, whereas specific, speaks to a broader trend of evolving social norms within healthcare and the challenges of balancing patient comfort with a physician’s desire to establish rapport.
The Childhood Connection and Professional Boundaries
The letter writer, who coached a now-35-year-old ophthalmologist in youth football, found herself in a peculiar position during a recent appointment. Despite the doctor’s invitation to apply his first name, she felt uneasy doing so, opting instead to avoid addressing him by any name at all. This discomfort stems from a long-standing relationship and a recognition of the inherent power dynamic within a medical setting. The writer acknowledges that manners are intended to foster comfort, but in this case, they seem to be doing the opposite.
According to Miss Manners, the discomfort may not be solely the patient’s. The doctor’s request to be called “Tommy” could be an attempt to navigate his own unease, potentially stemming from the fact that the patient once held a position of authority over him. The columnist suggests that the patient’s use of the honorific, “Dr. Smith,” might be a reminder of that past dynamic, and the doctor may be seeking to level the playing field. However, Miss Manners emphasizes a more crucial reason for maintaining the professional title.
The Importance of Professional Titles in Medical Settings
Miss Manners argues that using the correct title isn’t merely a matter of etiquette, but a safeguard for future medical discussions. She posits that should a serious medical condition arise, the patient wouldn’t want to be distracted by questions about the doctor’s past behavior – such as a youthful misstep during a football game – when evaluating his professional judgment. The focus should remain solely on his medical expertise.
This highlights a critical aspect of the doctor-patient relationship: trust in competence. A formal address can reinforce that sense of professional distance and allow the patient to focus on the medical issue at hand. While a friendly rapport is valuable, it shouldn’t come at the expense of clear communication and confidence in the physician’s abilities. The columnist suggests a simple solution: asking the doctor if it’s acceptable to use the title in the office, framing it as a matter of personal preference and a sign of respect.
Evolving Norms and Patient Comfort
This scenario reflects a broader shift in healthcare towards more patient-centered care. Many physicians now actively encourage patients to participate in their treatment decisions and to feel comfortable asking questions. However, as a 2025 article from UExpress points out, some professionals in academic fields are even requesting to be addressed by their titles to emphasize their expertise. This highlights a tension between formality and accessibility.
The question of how to address a doctor is ultimately a personal one, but it’s important to consider the potential impact on both parties. While a casual approach may feel more comfortable for some, others may prefer the clarity and respect conveyed by a formal title. Open communication and a willingness to adapt to each other’s preferences are key to navigating these potentially awkward situations. A recent article published on March 4, 2026, in the Syracuse.com, echoes this sentiment, detailing a similar experience with a long-time acquaintance turned ophthalmologist. The article further emphasizes the importance of respecting individual preferences in this context.
As healthcare continues to evolve, these nuanced social dynamics will likely turn into more common. Finding a balance between personalized care and professional boundaries will be crucial for fostering trust and ensuring positive patient experiences.
Disclaimer: This article provides informational content only and is not intended to be a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.
What are your thoughts? Have you ever experienced a similar situation with your healthcare provider? Share your experiences and perspectives in the comments below.
