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J R Soc Med. 2006 July; 99(7): 334.
PMCID: PMC1484571

Miss, Mister, Doctor: To protect and serve the patient

We read with interest the article by Treasure and Tan (April 2006 JRSM1). The authors state, ‘Being a surgeon is doing what a surgeon does’. There is no doubt that this is the case, as the quality of care provided by clinician's will eventually speak for itself. A good surgeon doing good work has fulfilled the role of serving the patient. The authors go on to conclude that, ‘How we are titled is of little consequence’. Perhaps in Plato's Republic or any other concept of an ideal world this may well be true. However, when it comes to protection of the patient there is one title and grade that does matter—the hospital consultant.

It is true that the term ‘consultant’ is now commonly used to describe a person giving advice to either another person or an organization on a particular subject in which they are supposedly an expert, such as the heating engineer. It is also true that a variety of titles, such as Mister, Miss, Doctor and Professor, are used by those in the hospital consultant grade depending on their specialty or academic position. However, when a patient is sent to hospital to see the hospital consultant there is no confusion as to who it is they are going to see. The consultant is the clinician who will have the ultimate responsibility for the clinical care of a patient. It is a term that patients are familiar with and understand.

Hippocrates said, ‘Life is short, the art (of medicine) long’. The extensive and arduous training required to become an National Health Service hospital consultant is precisely because of the significant and consequential responsibility, which goes hand in hand with the consultant grade. The hospital consultant is a grade and not just a title, such as Mister or Doctor.

Change is inevitable in any progressive system or organization. However, relentless changes are not always for the best. The NHS hospital consultant grade has an international standing and reputation. Dilution of this grade and title, whether by the confusion of having nurse consultants or propelling clinicians without adequate training to the consultant grade is, therefore, ill-advised and illogical.

Preservation of the reputation of the NHS hospital consultant is ultimately inseparable from the protection of the public.


Competing interests None declared.


1. Treasure T, Tan C. Miss, Mister, Doctor: how we are titled is of little consequence. J R Soc Med 2006;99: 164-5 [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press