“Please, call me Phil”
By Dr Phil Riddell
I’ve now been a doctor for 6 months. During that time, I have been a doctor in two different departments and met countless numbers of staff. Remembering everyone’s name is hard and I have often embarrassed myself by getting names wrong. Fortunately, after a little teasing, things have settled and I have managed to remember correct names.
One of the most striking things, is that in both departments staff have resorted to addressing me as ‘Doctor’, rather than using my name.
I can guess why. Every four months the rest of the staff on the ward, who almost invariably are permanently assigned to one ward, have the pleasure of meeting another group of doctors who will be with them for four months. That means every four months, just as they are getting used to one group of doctors, another new group are assigned to them.
I do my best to politely reiterate that I would prefer to be addressed by my first name. ‘I was Phil before I became a doctor’.
This usually draws a comparison about ‘Dr Phil’, the American talk show host, but I cannot claim to be able to grow a moustache that rivals his. More importantly, this misses the point I was trying to make in the first place.
The hierarchy in medicine is something that has been a big conversation in both the patient experience and patient safety worlds for some time now. I think almost everyone within the NHS will be familiar with the brilliant work of the late Kate Granger – who shared her own feelings on what makes the difference to patients receiving healthcare.
Something as simple as introducing yourself by name during each patient encounter fosters that human connection between patients and staff and goes someway to breaking that hierarchy between doctor and patient. This is something that I feel we need to do between staff to improve safety in healthcare.
I was chatting to one of the nursing assistants on my new ward about why I insisted on all staff members calling me Phil. They felt that staff were trying to be respectful by calling me by my title- I could understand their perspective, but I pointed out that by doing this, they may subconsciously be setting up a hierarchy that they did not feel comfortable challenging in situations where patient safety was at risk. The example I used was as follows:
“A patient is becoming more unwell and you think that a doctor needs to come and review them. Would you feel more confident interrupting me by addressing me as ‘Doctor’, or as ‘Phil’?”
They admitted that they had never thought of it that way before.
“I would rather staff feel confident to interrupt me than they address me by a title that has been given to me after years of studying. Knowing and using my name could give people the confidence to speak up when they are concerned that patient safety is in jeopardy.”
This all stems from my time as a student, and subsequently as a doctor in the Intensive Care Unit. As a medical student, I often found myself working on wards where people did not introduce themselves to me. I would sit there and quietly observe the ward in order to learn clinical medicine, but when I noticed things that were affecting patient safety, I did not feel confident to raise them with the staff members. I simply did not know anything about the staff on the ward. This lack of human connection reinforced the hierarchy – with myself at the bottom, it took a lot of courage to speak up.
I contrast this with my first post in Intensive Care. On day one, the consultant team introduced themselves to me by name and recommended that I do the same to all the nursing and support staff on the unit. I walked around the unit, meeting my new colleagues and finding out about them. From then on, I always felt confident asking questions, regardless of who they were directed towards. No matter what the question was, I could rely on that basic human connection; knowing and using their name.
After explaining all of this to my colleague, they agreed to use my first name. Since then, I feel they have been much more confident when asking me questions. What I have also noticed is that members of staff will come to me and ask the names of other staff members, all in order to initiate a conversation with that staff member!
I feel that something as simple as knowing someone’s name can begin the process of mitigating the hierarchy that still exists in medicine and improve patient safety. As it is cost-free intervention, what is there to lose?
So please, call me Phil.
Things to take away:
- Hierarchy, whilst somewhat inevitable in healthcare, can have a negative impact on patient safety.
- Using first names can have a positive impact on removing hierarchy as a contributing factor to patient safety incidents.
- Always take the time to introduce yourself to everyone in the department by first name – it takes 5 minutes at the beginning of your first shift and has the potential to reduce patient safety incidents in the long term by fostering good communication and building stronger relationships between team members
Phil Riddell is a Foundation Year doctor working within East Anglia after graduating from Medical School in 2017. After positive experiences at Medical School, he is planning on pursuing a career within the field of Patient Safety.