Each professional must decide how to address patients and how they would prefer to be titled. Some doctors strive for a casual office while others prefer formality. There is a way to have both and to please most everyone.

The way to greet patients varies from one geographic or socioeconomic setting to another. As a rule of thumb, staff should address young patients (under thirty years of age) by first name and older patients (over thirty years of age) by surnames. Doctors may use first names for most patients under sixty years of age.

A twenty-year-old calling an eighty-year-old woman Sally may be offensive, just as a ten-year-old boy may not like being called Mr. Jones. You must be aware of generational differences and understand how respect is defined and interpreted.

While some doctors prefer introducing themselves by their first name, considering it a plus for bedside manner, it is inappropriate and should be avoided. A title defines the relationship, and calling doctors by first names degrades the doctor-patient relationship. Most patients want you to be the doctor. They look to the doctor for care and healing. Most patients aren’t looking for a friend.

If staff members use your name repeatedly before you meet the patient, it precludes your need to be formal and you can offer a friendly, “Good morning,” otherwise it is best to greet with your name attached, “Good morning, I’m Dr. Fleisher.”

Some patients like to call their doctors by first name, probably because it makes them feel important. If a patient asks to call you by your first name, go along with the request to avoid appearing stuffy.

Using endearing names at the appropriate time is an easy way to express affability and compassion to your patients. This involves no learning or personality changes on your part other than picking the names and using them.

Be very careful in choosing endearing names. Sweetheart, baby, or honey could be considered sexist by some adults, while others appreciate the affection and concern it shows. These same names work well with children.

“You are doing great, sweetheart,” is the proper way to use an endearing name. Phrases like this can be repeated several times during a lengthy procedure. On the contrary, it sounds rather odd and sarcastic to use an endearing name during a reprimand for not following your orders: “Sweetheart, I asked you to stay off that broken leg; now you made it worse.”

There are endearing names for different ages, personalities, socioeconomic groups and cultures. Decide upon the ones you are comfortable using. They should fit with your personality and demeanor. You don’t want to overdo it either. Most people do not appreciate over solicitousness. Using endearing names at the right time is an easy way to improve your bedside manner.

If you are the quiet retiring type, saying hey baby may not be the best choice. Likewise, hey baby may not be right for a seventy-year-old during a routine gynecological exam. Yet hey baby may work just fine for the cosmetic surgeon practicing in Beverly Hills. Buckaroo works very well for a little fellow around five years of age, while an accountant may think you are nuts if you call him by that endearing name. The following list offers endearing names most suited for professional practice along with suggested uses.

During treatment you should try to use an endearing name whenever you receive nonverbal communication, i.e. wincing in pain, cringing, sudden tenseness.

Mary shows some signs of distress during treatment. You say, “You are doing so well, darling, and we are just about done.” You read and acknowledged that Mary is having some distress, you offer comfort by telling her it is almost over, and you provide the endearment by using the term darling. This response to Mary is the difference between a doctor with great bedside manner and the doctor who is busy performing a procedure and completely oblivious to the patient.

Certain names work better with different socioeconomic groups. Pal is more of a blue-collar name while friend may be better for the doctor who is your patient.

The use of endearing names should be avoided upon initially meeting an adult patient while it is very acceptable and helpful in developing a fast bond with a child. When you walk in the room of a child, greeting them with a, “Hi there soldier (cowboy, buckaroo, or buddy),” works fine. Upon greeting an adult male patient, saying, “Good morning, Mr. Jones (sir or John),” is a better way to start the relationship.

Once you begin treatment, you can switch to pal, buddy, friend, or my friend if your relationship and personality, and the personality of the patient, warrant such familiarity. “You are doing great, my friend!”

“We’re just about done, buddy” works much better than ignoring the patient’s body language or than using the patient’s formal name: “We’re just about done, Mr. Jones.” The tone of the endearing name does just what it is supposed to do; endear you to the patient.

Except for some stuffy patients, you can never go wrong using a first name, especially in a matter of duress.

“Do you need a little more Novocain, Mary?” works much better than, “Do you need more Novocain, madam?” Sir and madam are too formal. First names are friendlier than last names, and while there is nothing wrong with using the first or last name, in most cases the endearing name works best.

Besides being too formal, using the terms madam, ma’am and sir may be interpreted as expressing disdain. Addressing the patient as dear, madam, ma’am, or sir is often used when the health-care provider is frustrated, or otherwise fed up with the patient and will engender hostile feelings. These terms can also be used in a respectful manner, so don’t totally avoid them if they work for you, just recognize the tone you use.

“Are you alright, dear?” is fine while, “Dear, this can’t be hurting that bad,” sounds condescending and hostile.

Physical contact with patients can convey the highest level of caring, comfort, and compassion. The most common form of physical contact is the handshake. This gesture helps to form an immediate bond. While you socialize with professionals all the time as part of your training and station in life, it may be difficult for you to understand that patients often think of doctors as special people and to take the time to shake hands is often appreciated more than many realize.

The hand on the shoulder and pat on the back are other ways to convey friendship and good wishes. The hand on the shoulder works well when a patient becomes upset over something they realize is out of anyone’s control. A hug works for cases where you have to deliver bad news and the patient is about to cry. You have to be careful with hugs, as sometimes the patient may not expect, or want, this type of contact. If you have years of history with the patient, physical gestures are often more welcome.

All physical contact should be avoided when you are alone with the patient. While it never used to be a concern, the last thing you want is an accusation that you were trying to make sexual advances toward your patient.