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The editorial by Treasure and Tan (April 2006 JRSM1) about the origins and meaning of medical titles—Mister, Miss and Doctor—made interesting reading. These terms are indeed often puzzling for many patients. What struck us though was the assumption that it is necessary in this day and age for medics to be addressed by these titles at all. Why not call us by our given names—John Smith and Anne Brown? And perhaps even John and Anne once we've got to know one another a little better. Do we really need the continual ego-massage of being called Doctor or Mister (knowing the user has taken the trouble to learn its surgical meaning)? We are aware that these titles make our patients uneasy—why don't we ditch them?
There are of course benefits to moving away from these titles among work colleagues too. Over the last decade, industry has come to recognise the benefits of a flat structure and less rigid observance of hierarchy; bosses and employees are now mostly on first-name terms and companies are found to be more effective as a result. The rigid hierarchy in the cockpit has been responsible for at least one airline crash—the co-pilot felt too timid to over-rule the captain, even though he feared the plane was heading for a mountain in the fog. As a result, the airline industry has taken steps to break down these hierarchical inhibitions. Perhaps it's time for the medical profession to follow suit?
Competing interests None declared.