
residents' forum
What's in a Name? A Lot More Than You Think
BY JULIE SCHULMAN, M.D.
"Doctor." I like that title; I’m really quite fond of it. I remember being called "Doctor" for the first time while I was still in college, when a visitor to my research lab thought I was a physician. I was so proud that I felt two inches taller. I felt the same way when I first put on a white coat and went into the hospital for my very first rotation. By the time I finished medical school, people I barely knew were telling me their intimate secrets and asking me for advice about everything from rashes to hemicolectomies. I had finally reached my lifetime goal of becoming a medical doctor.
Then I became a psychologist.
Yes, I know I’m a psychiatrist—or at least a resident two months away from becoming a psychiatrist—but no one else seems to know it. I just can’t take it anymore. What happened to my medical degree? I’m tired of hearing this: "Are you allowed to prescribe medications? My last psychologist (sic) couldn’t prescribe medications." Or, while taking a medical history: "Well, I’ve had hepatitis [or colitis or mitral valve prolapse. . .]—do you know what that is?" Or, incredibly, after I’ve spent a full 15 minutes explaining the risks, benefits, and side effects of the medication I’m about to prescribe and then take out a prescription pad: "Oh, you’re going to write it? I thought a doctor would have to write the prescription."
I’ve tried to fight it, but no matter what I say, people don’t remember the difference between psychiatrists and psychologists. "No, I’m a psych-I-A-TRist, it’s got the ‘iatro’ in it for medical doctor. You know, as in ‘iatrogenic illness’ or. . .um. . . never mind."
I’ve tried to avoid long, dangling earrings and flowing skirts. (I wonder, do psychologists worry if they carry too many pens or write something illegibly?) My name tag and my business cards all have a big "M.D." on them. My officemate even keeps a white coat hanging on the coat rack in our office, with various cards and tools poking out of its pockets. None of this seems to have any effect.
Surely there must be alternatives to the word "psychiatrist." "Psychiatric physician" is one term that has been adopted by various psychiatrist groups, including some of APA’s district branches. OK, it is the most technically accurate. But aside from the obvious disadvantages of having such a long title, the acronym is, well, PP. Enough said. I’ve also seen the term "medical psychiatrist." As opposed to what? An engineering psychiatrist?
So, here’s my idea. Almost all physician specialties are named in one of two ways. One is with the "ist" ending: oncologist, radiologist, psychiatrist. The other is with the "ian" ending: pediatrician, geriatrician, obstetrician. Why not call ourselves "psychiatricians"? It puts us in friendly company—after all, people trust their pediatricians—and it makes perfect intuitive sense. We could always follow the lead of surgeons and become psycheons, but personally I think it sounds like a type of energy particle. "Psychiatrician" is easy to remember and different enough from "psychologist" that I may never have to explain again that, yes, I can sign my own prescriptions.
Now, before someone complains to William Safire, I admit that the next linguistically correct step would be to call our specialty "‘psychiatrics" instead of "psychiatry." I think this is probably optional. But then, I’m a psychiatrician, not a grammateon.