Introducing Dr. Fauci and Deb
Author: Karen Catlin
This excerpt was adapted from Belonging in Healthcare. Copyright Karen Catlin 2022. It has been republished here with permission.
At a press conference during the early days of the COVID-19 pandemic, then President Trump deferred a question about mortality rates, saying, “I’d like Dr. Fauci or Deb to come up” to answer it. “Deb” is Dr. Deborah Birx, a physician who should have been referred to with the same respect as her colleague Dr. Fauci.
Similarly, in a study of how people were introduced during grand rounds, researchers found distinct gendered differences. When men introduced women, they used their formal titles 49 percent of the time. When introducing other men, this jumped to 72 percent. By contrast, women introduced speakers of any gender by formal titles almost all of the time (96 percent).
In other words, men showed more professional respect to other men. Not so much for the women.
This microaggression also happens to women speakers at medical conferences. Several studies have found that women are less likely to be introduced by their formal doctoral titles when compared to men.
Women physicians often head to Twitter to share personal examples of the “Dr. Fauci and Deb” phenomenon. Here are a few:
Dr. Sophia Kogan posted, “Just received group work email. Men physicians were ‘Dr’ & women physicians were ‘first name’.”
Dr. Oni Blackstock shared a screenshot of an email addressed to three people: “Dear Oni” and two people referred to as Dr. along with their last names.”
Dr. Arghavan Salles tweeted, “Just last week was in a mtg where other people were introduced as Dr A, Dr B, Dr C, Dr D. I was Arghavan.”
Dr. Nancy Yen-Shipley tweeted a photo of two almost-identical hand-written notes from a medical equipment sales rep. The letter to a woman doctor started with a salutation of “Hi (first name redacted).” By contrast, the salesperson wrote “Dr. (last name redacted)” to a male doctor.
I’ve also heard this happens on call schedules and during hospital rounds. It’s so pervasive that the medical satire site Gomerblog posted a fictional story about a woman surgeon who was fed up with being called by her first name for years when her male colleagues were called by their title. Out of frustration, she decided she would take matters into her own hands and legally changed her first name to “Doctor.”
Kidding aside, it’s important to note that this differential treatment may not be caused only by gender bias.
Some people attribute their behavior to familiarity and camaraderie. Dr. Shikha Jain is an associate professor of medicine in hematology and oncology at the University of Illinois Chicago and the founder of the non-profit Women in Medicine. After she published a paper about gender disparities in introductions at oncology conferences, a former boss reached out. Jain told me, “She admitted that she didn’t realize she had been doing this, explaining that she introduced women she knew by their first names and others by their titles because she didn’t know them. Yet, because of my paper, she changed her approach.”
Others justify their actions by insisting they use titles for more junior people to elevate them and first names for more established doctors. When the host of the Docs with Disabilities podcast introduced his first guest, a woman doctor, as Diane, followed by his male guest as Dr. Bullock, he was called on it. He went on to explain that he uses the Dr. title for residents, fellows, and junior faculty, and first names for colleagues. For him, it had nothing to do with gender but instead reflected their level of training.
Regardless of the intent or reasoning, the bottom line is impactful. Not using someone’s title can undermine their perceived authority and expertise, especially when their peers receive different treatment. It can make them appear less qualified than their colleagues.
When introducing people or referring to people in emails or call schedules, let’s use their formal titles. Regardless of their gender, how well you know them, or their level of training. This is an allyship practice rooted in equity and hopefully, an easy one to employ.
About the author: Karen Catlin is an author and advocate for inclusive workplaces (Twitter: @kecatlin and @BetterAllies)
