Don't call us mister, say surgeons after 150 years

Surgeons are set to end 150 years of inverse snobbery by dispensing with the title of "Mr" or "Miss" and adopting the more elevated "Dr", like their physician colleagues.

Surgeons are set to end 150 years of inverse snobbery by dispensing with the title of "Mr" or "Miss" and adopting the more elevated "Dr", like their physician colleagues.

Moves are afoot to end the centuries-old tradition which sees the most highly lauded and best rewarded members of the medical establishment addressed by the same title as plumbers and butchers.

Increasing confusion among patients over the proliferation of medical titles has forced a rethink. Nurses, dentists and podiatrists are among those trained to wield the knife. Some surgeons have grown anxious that the modesty of their title may lead patients to overlook their importance.

Hugh Phillips, president of the Royal College of Surgeons, writes in the May issue of the Annals of the College: "The important thing [is] that the patient knows who is treating them. Titles are confusing to patients; perhaps there is a good case for surgeons returning to the title of 'doctor' as in the rest of the world."

He said yesterday: "There will be people who feel very strongly about the use of 'Mr'. If you wear a white coat and you are called 'Mr' you are slightly different. It's the old tribalism and we have to get rid of it. I have started the debate and no doubt people will respond to it."

The use of the title dates back to the Middle Ages when surgeons served an apprenticeship, like other tradesmen, while physicians required a university degree in medicine before they could enter practice. On account of their university training physicians were entitled to call themselves "doctor of medicine".

Since the mid-19th century, surgeons have also had to obtain a university degree in medicine. As a result, today's surgeons start out as "Mr" or "Miss" in medical school, become "Dr" on qualifying and revert to "Mr" or "Miss" when they pass surgical exams for the Royal College.

Mr Phillips made his suggestion after complaints that the new breed of "surgical care practitoners" - non-doctors trained to assist with surgery - might be mistaken for surgeons and should instead be called "surgical care assistants". Similar complaints have been made about other health workers. It is alleged that the new "nurse consultants" have in some cases dropped the "nurse" from their title.

Mr Phillips said: "There are a lot of different terms and titles. Patients have got to know who is treating them. Unless we get precise about it, no one will know who anyone is any more. I am ... in favour of extending the skills of people in the health service. But if non-medically qualified practitioners are doing components of operations we need to know who the doctors are."

Some academics argue that the title "Dr" should be reserved for holders of doctorates who have done original research such as John Reid, the Secretary of State for Health, who is not a medical doctor but has a PhD in economic history.

One consultant physician said: "The way surgeons have stuck to 'Mr' and 'Miss' has been a form of inverted snobbery for years."

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