Much of the time I’m called Ian, and at others I’m called Dr Wacogne. \u00a0I do get called some other things, but I can’t write them here.<\/p>\n
We’ve just greeted a new group of foundation (intern) doctors, and I have, as ever, entirely befuddled on them by emphasising that I am Ian, at all times unless I’m in front of a patient. \u00a0There is light hearted fun to be had from this – the refusal to hear them if they address a question to “Dr Wacogne”, for example. \u00a0(I call it fun, I guess they probably find it downright irritating.) \u00a0I should emphasise that this is a team rule, not one of my own invention.<\/p>\n
They find this very difficult. \u00a0This is most evident when they’ve come from a particularly rigidly structured area of medicine – and is also resurgent when they’re about to return to a similar sort of area.<\/p>\n
I’ve asked this group to try and work out why we, as a team, insist on it. \u00a0Of course, if they read about here, then they could win an extra prize. \u00a0These are some of my reasons.<\/p>\n
The first and most obvious answer is that we’re a bunch of fluffy paediatricians, who all hug trees and ride bicycles with signs saying “my other car is a Prius”. \u00a0 OK, well, that’s about 10% of the answer.<\/p>\n
The second is a little deeper. \u00a0It’s to do with what I’d call asymmetry of address. \u00a0What I mean by this is an environment where one group consistently accords another a higher level of formality of address. \u00a0I was trying to think of a range of examples of this; the trouble is, there aren’t actually that many. \u00a0I might be hopelessly unworldy, but I can’t call to mind that many environments where in an exchange, person A would address person B by their given name, while expecting person B to reply using their title and surname. \u00a0I ran through a few examples in my mind, and none of them work that well. <\/span><\/p>\n Well, that’s it, isn’t it? \u00a0<\/span>And isn’t that an odd link to make? \u00a0Because how did your teachers make you feel? \u00a0My foundation doctors are in their mid twenties; they’re adults, who can make decisions, vote, have families and so on. \u00a0And yet we still use the same form of address as a teacher would use to a schoolchild.<\/p>\n The third is deeper still, and goes back to my previous post.<\/a>\u00a0 For me it is about ensuring that the environment I’m working has the combination of a clear\u00a0hierarchy\u00a0 but also a shallow enough authority gradient<\/a> – meaning I minimise the effort it takes other people to\u00a0interrupt\u00a0me in the middle of a mistake – so that I can be kept as safe as possible. \u00a0Certainly air crews have learned this lesson the hard way; the safest crews address now each other by their given names as a matter of policy.<\/p>\n There’s one last minor reason. \u00a0I’ve been a doctor for a couple of decades, and I’ve got a pretty big ego. \u00a0I don’t need to be reminded of my qualification all of the time; it’s lodged pretty deep into who I am now…<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Much of the time I’m called Ian, and at others I’m called Dr Wacogne. \u00a0I do get called some other things, but I can’t write them here. We’ve just greeted a new group of foundation (intern) doctors, and I have, as ever, entirely befuddled on them by emphasising that I am Ian, at all times […]<\/p>\n\n