Harriet Wheelock / Tuesday 6 September 2016

Guest Post: Not A Mister, just a Doctor

Today’s Guest Post comes from Dr Stefan Slater, a Fellow of the College. Initially he sent it to me for my own interest, but I asked to share it here as it answers one of the most frequently asked questions during my Heritage Week tours last month; What is the difference between a physicians and a surgeon? And why are some doctors called Mr not Dr?

Cornered by an architect’s wife at a dinner party, I was being quizzed on my place in the medical firmament.
“What sort of doctor are you?” she asked, oblivious to the ambiguity in her question.
“I’m a consultant physician.”
“What’s that?”
“Well, I work in a hospital and deal with what’s called general, internal, medicine: people with heart attacks, strokes, bleeding ulcers, anaemias, lung trouble, bowel trouble – all sorts of things.”
“So, you’re not a specialist.”
“Well, yes I am, because I have to manage all these conditions with their complications and ramifications; cases that the family doctor finds difficult to handle.”
Warming to my theme, I waxed eloquently on the diagnostic detective role that was the meat and drink of the physician.
“Of course,” I added, “like all consultant physicians these days I have, within this field, a particular interest. Mine happens to be endocrinology – that’s hormone troubles.” Noting the instant gleam in her eyes, I quickly went on: “Trouble with the thyroid gland and diabetes – that kind of thing.”
“So, if you’re a specialist I should call you Mister.”
“No, I’m still Doctor.”
She looked puzzled.
“You see,” I explained, “it’s a matter of tradition. When a young man training to be a surgeon passes the postgraduate exam in surgery and becomes a Fellow of one of the Royal Colleges of Surgeons, he is entitled and expected to style himself Mister - and a woman, Miss. It’s just meant to symbolize surgery’s origins from medically unqualified barbers of early medieval times.” (This said with just a subliminal hint of physicianly disdain). “It is a tradition peculiar to surgery and almost unique to this country”, I held forth with evangelical zeal. “Everyone else – nearly everywhere else – remains Doctor when he or she obtains an equivalent postgraduate degree. I, as a budding physician, stayed Doctor when I passed the examination for Membership of the Royal College of Physicians.”
She seemed to understand.
“So, let me see. The surgeon becomes a Fellow and a Mister, you become a Member and stay Doctor – but isn’t a Fellowship higher than a Membership?”
“Well, yes, between one physician and another. I am myself, in fact, a Fellow of the College.”
“So,” (triumphantly) “you are now a Mister.”
“No” (wilting) “I am, and always will be, Doctor.”
“Oh!”
There was a hardly disguised note of disappointment in her voice. She had not, after all, been speaking to someone of the right stuff. Then in went the unkindness cut of all.
“Well,” said she, “I’ve always understood what a surgeon does but I still can’t quite picture how you spend your day.”
I felt like the subject of Stevie Smith’s poem Not Waving But Drowning; not mistering just doctoring. I excused myself and sought the sanctuary of one loyal and understanding fan – my wife.

P.S. Our surgical colleagues in Ireland, Australia and New Zealand share in this onomastic idiosyncrasy. Another peculiarity in that consultant obstetricians & gynaecologists are referred to as ‘Mister’ in England but ‘Doctor’ in Scotland.

Dr Stefan Slater

Previously published in the Bulletin of the Royal College of Physicians and Surgeons of Glasgow, 1991; 21 (No 2): 22-3, and Beta Club 1957-1962. University of Glasgow (Glasgow, 2-13). Shared here by kind permission of the author, Dr Stefan Slater, MD(Hons), FRCPI, FRCP(Edin), FRCP(Glas), FRCP(Lond) - definitely a Doctor!