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How do you address your physician? Do you refer to them as "Dr. X", or do you use their first name?
Physicians may feel awkward when their patients refer to them with their first name only. Sometimes they wonder if the patient is not showing adequate respect for their training and expertise. A recent study, covered by a journalist at the New York Times, sought to quantify when physicians were more likely to be addressed by their first names instead of by the "Doctor" honorific.
Here are some details about the study, from the journalist's coverage:
It wasn’t easy to answer this question, but [the researchers] found a way — by studying tens of thousands of emails that patients sent to doctors at his institution. The results, published last week in the journal JAMA Network Open, appeared to illustrate a few themes about which doctors find themselves on a first-name basis with the people they care for.
Before reading on, make a prediction: Which doctors do you think will be more likely to be addressed by their first name: Doctors who are men or those who are women?
Here are the results:
Female doctors were more than twice as likely as male doctors to be addressed by their first names...
Now make another prediction: Which patients do you think will be more likely to address doctors by their first names: Men or women?
Men were more likely than women to address doctors by their first name.
And now here are some other results. Do you find any of these surprising?
Patients were more likely to address general practitioners by their first names than specialists.
The study found no difference based on age, whether of patient or physician. And the researchers did not examine the race or ethnicity of the patients or doctors.
Questions
a) Based on what you've read so far, what are some of the major variables in this study? The quoted text above includes at least five variables.
| Variable name. Hint: some variables were about doctors, and some were about patients. Be sure to specify that in your variable names | What are this variable's levels? | Is the variable measured or manipulated? |
| (add rows as needed) |
b) Some might call this a correlational design.Why?
c) Some might call this a quasi-experiment. Why? Which quasi-experimental design is it? (Here are your options: Non-equivalent control group posttest-only design, Non-equivalent control group pretest-posttest design, Interrupted time series design, or Non-equivalent control group interrupted time series design?)
The journalist says almost nothing about how the researchers measured doctor gender and patient gender in the study. If you're wondering about these details, that's a construct validity question! Here's what the study says (quoted from the empirical article): "After approval by the Mayo Clinic institutional review board with waiver of participant consent because of exempt status, a retrospective review was conducted of patient messaging to physicians through the Mayo Clinic electronic medical record from October 1, 2018, to September 30, 2021.....Available demographics of patients (age and gender) and physicians (age, gender, degree, training level, and specialty) were determined."
d) What do you think of the construct validity of this way of determining the patient and doctor variables?
e) Now you might reflect on the ethical implications of collecting the data in this way. Why do you think the Mayo Clinic waived informed consent? What ethical balance might have been considered here?
The original empirical article is open-access here, in JAMA Network Open.
