Thursday, March 8, 2007

Mateship and Rapport

"Mate" is a non specific greeting used between Australians. Of both genders in certain regions. It is usually of a positive connotation.

As with much Australian vernacular, subtleties of inflection and context can produce a great variety of meanings.

"Maaaaaaaaaaaate", as a drawn out drawl, accompanied usually by a half-smile and a knuckle-crunching handshake, is the traditional greeting of the Australian male in the wild.

"G'day, mate!" is often used as a general, friendly greeting to an unknown person, especially of the male persuasion. The equivalent of "Good afternoon, sir", "Bonjour, monsieur".

"Mate" can also be used in a derogatory context just as easily and this is what led Dr Dork to consider the topic today.

Whilst sauntering down the street in the vague direction of his morning bus, Dr Dork was nearly cleaned up by a cyclist who barrelled past without warning. A near collision...and partially Dr Dorks fault, as he tends to meander along a circuitous path, especially when his mind is 90% it often is. The words that leapt to Dr Dorks lips, albeit unspoken: "Use your *(edited)* bell, mate!".

Dr Dork sometimes refers to his male patients as "mate".

On his new patient registration forms the only option available is Mr for males.

Being of a certain age, Dr Dork still refers to new older male patients as "sir", unless or until they clearly indicate a preference otherwise. Younger males are usually "mate" or addressed by first name.

This seems to assist in rapport building with younger males, in particular. It is a gesture of camaraderie, of casual "blokiness" that makes the staid old Dr Dork seem less intimidating to a young 'un, perhaps.

Females may select Ms, Miss or Mrs, and are addressed according to their preference. No grey areas.

On the whole, Dr Dork finds it often takes longer to develop rapport with female patients. He is a dork, and thus the instinctive female repugnance to Homo Dorkus Sapiens (and his negative evolutionary corollaries) must be gradually overcome.

The greater flexibility he has in addressing his male patients seems to further facilitate rapport. More scope to tailor to the individual, less possibility of inadvertent offence.

Dr Dork works only in adult medicine. Kiddie rapport is a whole other kettle of fish. Ask Dr Flea.

Children are evil, and should stay off the lawn, anyway.


Moof said...

A truly captivating post!

Now, I don't like honorifics ... so, if I were your patient, you wouldn't call me "Mrs. Moof," would you? I mean, you'd call me just plain "Moof," if I asked?

By the way, I married a Dork ... and I think that Dorks are generally pretty neat people - so don't knock 'em! ;o)

DrWes said...

Oh, the thought of children and a kettle of fish....

jmb said...

Now this is interesting. I can't imagine you using the word mate to your patients, Dr Dork. I get a much more formal feeling from the blog.
As for the female address situation, I'm a little old lady and all medical personel seem to call me j, my first name. So I call them by their first name right back. I do notice that younger physicians I deal with (locum or for someone's medical care that I supervise) now introduce themselves as FirstName LastName. It's pretty informal in North America.
Let's see if the NA doctors hop into this.
My husband still uses mate here, takes people aback a bit.

Nutty said...

I've got used to doctors calling me by my first name. Generally I don't like it, but when my latest psychiatrist bounded up to me on our first meeting saying "Call me P (his first name)" I liked it. I think that it's the formality differential where doctors feel free to call me by my first name without allowing me to call them by their first name that I dislike.

In short, I think that what matters most is not so much how you address a patient as whether you accord them the same status as you accord yourself.

NeoNurseChic said...

Haha - great post! I wish I could hear you talk.

I'm yet another female who tends to like dorks...although haven't married one yet. Do spend quite a lot of time chatting with dorks, however! lol I'm a dork myself - albeit you'd never know by looking at me! HA! ;)

I prefer to be addressed by my first name. People who really know me sometimes call me Lizzie as that's my middle name, and my dad has called me by some form of Elizabeth (usually Lizziebeth) since I was born. Whenever someone calls me "Ms. P" - it makes me feel so old! I'd much rather be called Carrie. I think most of the docs I have gone to generally call me by Ms. P first before saying my first name. This is generally true of the medical students and residents - at least I found that while in the hospital. And it seemed like some of the female med students/residents who were closer to my age were more likely to call me Carrie - maybe because they could relate to me more.

When speaking with parents of babies, I call them "Mom Jones" (insert whatever last name there) or "Dad Jones". If I get to know them really well, I call them by their first name if they would like that. I can't call them "Mrs." because I can't figure who is married and who isn't - and a lot of times, the baby has a different last name than the parents. It gets a bit confusing - so if I just refer to them as "Mom or Dad Jones" then it's easier.

My absolute pet peeve is to be referred to as "Nurse" while at work. It's usually not the docs who do this - they are around us enough to know our names, or at least they ask. And it's not often that a parent will do that. After I introduce myself repeatedly, and they still refer to me as "Nurse", I feel that they are doing that on purpose to assert some implication that I am their servant or maid - and I absolutely loathe it. Whenever someone does this, I generally just say "Please call me Carrie" - and usually after I first introduce myself to a parent, go through the update on the baby - before I walk away, I say again, "And once again, my name is Carrie." If they come back the next day, I once again reintroduce myself. I know it's hard to keep us all straight!

As for the babies - they're not evil!!! I'd say adults are far more evil than babies - today I was just chatting with my psychiatrist about how, over the last few years, I have become aware of the true nature of people - people being honest often means that people are ugly on the inside. It makes me sick. This was in reference to the fact that I was shocked that my psychiatrist has actually gone out of his way to help me with a few things (reducing my fee, getting rid of a charge that I was not supposed to have but wasn't having success in getting rid of it myself, talking to the front desk about scheduling, since I come on days when he doesn't have clinic, and so on) - I was shocked because I'm starting to become a cynic - I'm starting to expect that nobody will ever go out of their way to be kind - so it surprises me when somebody does. I find that us optimists fall harder - and I'm half convinced that a lot of the reason behind our disillusionment is that we were so optimistic and hopeful to find the best in people - and when we realized how much bad-ness is out there, we became depressed.

But I digress - I refer to the babes as peanut, little bug, weeb (wee baby - my dad called me this!), little one, screaming meemie, silly head, or a variety of other names that I come up with on a random whim...depending on the moment. I love my job. :O) I wouldn't work with adults now if you paid me!

Sorry to ramble on and on and on! Take care!
Carrie :)

Dr Dork said...

Hi Moof,
Madame Moof ? Your Moofness ?

Howdy Wes,
Ha! ...mind you, that looks my last attempt at a barbecue...

The clinic I mainly work from is in a low socioeconomic area (and I live close by - not in yuppieville - as well) and the vast majority of my patients are "rough and ready", "blue-collar", "salt of the earth" types who would be offended if I called them anything but 'mate' or by their first name. Irregardless of my own proclivities I endeavour to adjust my manner of speech to whatever is most beneficial to patient rapport. So I flit from formal to informal many times throughout a typical clinic session. I think "mate" is used in the UK a bit but must seem odd in North America!

hi nutty,
Very good point about the "power differential" issue. I was going to write about this in the post but it was getting too long. I generally err on the formal side with newer patients if I am unsure, and when I introduce myself I do so as Firstname Lastname (as jmb mentions) and proffer a hand to shake. This leaves my patients to choose how to address me...some as "Dr Dork", some by first makes no difference to me. How they choose to address me occasionally gives me useful insights into their problems or psyche. Similarly, many patients seem to at the point of hand-shaking offer their first name, when called from the waiting room as Mr, Mrs etc, at which point I will address them as such.

Psychiatrists have funny ideas about therapeutic power imbalances, transference and such, mind you.

Hi Carrie,
Elizabeth certainly has the most wonderful array of abbreviations. The working environment amongst the staff at my clinic is very informal - everyone is on a first name basis - doctors, nurses, allied health, receptionist, cleaner. I must confess I only call my nursing staff "sister" if I am joking about and wish to p*** them off - and vice versa ! Babies are fine. They only become malice incarnate in the toddling years.

Kind regards

Cathy said...

I don't think I have ever called any Dr. by anything other than doctor and last name..Well, there is my brother, who of course, I never call doctor, (even though he is one) unless I want to p*** him off about something.

I've also only had 1 or 2 Doc's who address me as Mrs. A...Almost all have called me Cathy.

BTW, I have you pegged...I Bet you're not a dork at all.

Calavera said...

Homo dorkus sapiens! Love it!

I don't think I could work with kids either. It just isn't my thing.

Flea said...

Regarding the kettle of fish, it's easier than you think: Hold your nose and dive in. In a few minutes your olfactory bulb will be desensitized and you wont smell a thing. Next task is getting used to the squishy feeling.



Midwife with a Knife said...

Interestingly enough, where I was a resident (house officer) we called each other, attendings and nurses by their first names (although usually we used Dr.So-and-So in front of patients). Where I'm in fellowship now, everybody calls me Dr. Midwife, and people call the nurses Ms.Nurse, and it is much more formal. I have to say, I preferred it the other way. I liked the informality of it all. I've spent the lat 8 months to get the residents and medical students to call me by my first name. Still haven't succeeded yet.

Pts I usually call Ms.Such-and-Such. And I introduce myself as Dr. Midwife. I used to introduce myself by my first name, but I realized that when I did that, people assumed I was a nurse or a medical student or a sonographer.

SeaSpray said...

I've always thought "mate" sounded so friendly. I love the accent but then you all probably think we have an accent. Question is do you like American accents? :)

Off topic: Dr,. Dork, is it alright if I put your placebo surgery cartoon on my blog (very funny) and I will of course give you the credit.

Also, Have you ever been specific as to what your specialty is or do you keep that info close to your vest?

Thanks! :)

Bo... said...

Here in Podunk, Texas, we are still very old-fashioned and reverently call our patients "Sir" and "Ma'am", whether they're older than us or not. (Unless it's a preacher, in which case we call him Pastor So-and-So.) We call children by their first names. We call dogs by their names (if we know them) or else just "DOG", as in "Get the heck off me, Dog".

We call our doctors "Sir" and "Ma'am" also-- unless in an argument, in which case we use the whole name, i.e. "Now, Dr. So-and-So, you know dang well that Mrs. Fliberty-giblet isn't going to hush up till you order a milk-n-molasses enema for her constipation."

Foilwoman said...

Interesting. If a doctor or nurse calls me by my first name, I assume I have permission to call him or her by his or her first name. I do have more of a rapport with my doctors than with my kids' doctors, who do seem a bit other. I think there's the needing to communicate clearly with beings (at least the small children) who really can't tell you what's what, and then there's the dealing with the anxious and somewhat aggressive mother (that would be me) or father (probably less frequently) trying to protect/defend/whatever her offspring. Probably screws up a lot of interpersonal dynamics.

Dr Dork said...

Howdy peoples.

It really is a matter of personal preference, in both directions, I guess.

Cal, Flea,
Children smell of brimstone and sulphur.

Interesting, I find myself getting less formal as I get older. Perhaps I am slowly dementing. My clinic has male nurses, and I'm not a formal dresser, so I tend to introduce myself as "Dr Firstname Lastname" or "Firstname Lastname, the **** doctor" if I think the patient might be unsure just who the strange looking dork is.

I am pleased that I seem to have conveyed some of the accent in a blog post! I am no linguist but there are some similarities I think between some southern US accents and parts of Australia. Feel free to use the cartoon - it is not mine - hopefully I credited on the relevant post where it came from originally...but I am a bit slack about that.
I keep my specialty and location in Oz close to my knitted vest.

Milk and molasses - yum! - does that come as a drink also ?

I would agree it generally is a bit presumptious to overfamiliarize with a new patient, and don't unless they are a teenager, which are the youngest patients I see. Even then I often call them Mr or Ms to begin with - some get a real kick out of it. Never call anyone Master, though.

Kind regards

Alison said...

Ah yes,cyclists. They should all die.

SeaSpray said...

Thanks Dr. Dork :)

Mother Jones RN said...

I'm very old fashioned. I address my patients as Sir or "Ma'am."

And I think dorks are great people. They tend to be tender, sweet, human beings.


The MSILF said...

I love you, Dr. Dork.

I am now in this US rotation. It is weird, in the medicine department where I was, even the residents all call each other Dr. LastName. They call the nurses Ms. LastName. Weirder was that I'm older than a lot of the residents, who to me really look like kids, but no one uses first names. To me it always sounds like they are talking to each other in the third person. Especially the residents, who are all together and should theoretically be friends, all calling each other Dr. This and That.

I'm used to first names only. But sometimes it's weird. There is this total classic old school surgeon who is originally from Germany named Herbert Freundlander (last name slightly changed). It was way weird to hear other students calling him, of all things, Bertie. I wondered tremendously if he knew they were calling him that. But the residents did openly.

Dr Dork said...

Alison said...

" Ah yes,cyclists. They should all die. "

Heavens, no, Alison ! I often cycle myself, excellent low impact exercise - but if riding on the road, one obeys the same rules as a car, and if riding on a path shared with pedestrians it is rude (and a bit dangerous) not to give a "tinkle" when overtaking at speed.

Hi MJ,
It never hurts to err on the side of respect, I very much agree.

Howdy MSILF,
I noticed when a junior doc in the hospital system there was a lot more of this "Dr So-andso" to each other, rather than just in front of patients (where it is often apropos). But the older, wiser consultants didn't seem to care as much as the residents and registrars. Perhaps a bit of an ego/novelty thing in shiny, newly minted docs - which I was guilty of myself as an intern/resident as well.

When I occasionally need to refer patients to another specialty I note two things - when I call an eminent surgeon/professor/bigwig for a private referral, it's usually on the first name basis...and when I speak to an unfamiliar twentysomething registrar in the hospital system, they seem too often to be balancing precipitously on a high horse.

I could write a whole post on how doctors relate to each other - from the perspective of both a physician, a GP (which I only dabbled in relatively briefly) and as a psychiatrist. I should, but I am a lazy, slothful man. Ha !

Kind regards,

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