What Do Pediatric Caregivers Want to Be Called? Hannah O’Donohoe, MD; Patricia Beach, MD; Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas Abstract Since doctor-patient-family relationships are of upmost importance when it comes to patient care and patient/family satisfaction in the pediatric clinic, we wanted to study this closer. We hypothesized that use of caregivers’ preferred form of address may be important to families and that there might be differences based upon their age, ethnicity or relationship to the child brought to the clinic. We collected data from surveys of caregivers, surveys of residents and observations of the resident interactions during clinical encounters. Overall caregiver preference of name use is by relationship, similar to what our residents are currently doing. We hope to use this information to determine future directions for our resident continuity clinic providers. Figure 2. The overall total name preferences of pediatric caregivers. Background Patient satisfaction and the facilitation of good patient-family-doctor relationships are essential to the healthcare system. There is evidence that many aspects of a doctor-patient relationship can contribute to the patient/caregiver emotional response during an appointment, and communication is key to a successful relationship. (Frankel, Stein; 2001) Addressing the patient during a clinic visit is often the first contact a healthcare provider has with their patient. The family’s comfort level is very likely affected by how a doctor greets them and continues to address them. Furthermore, patients and parents may be uncomfortable spontaneously identifying a name-designation because of the perceived authority of their physician, but may be uncomfortable or even offended by the designation selected without their input (Makoul, Green; 2007). When it comes to pediatrics specifically, parental involvement and trust are major aspects of overall care of the pediatric patient as parents and physicians should share similar goals for the patient. (Amer, Fischer; 2009) This is why it would be beneficial to study what patient caregivers would prefer to be called by their children’s health care provider. Figure 3. Comparison of preference by age and relationship to the child. Description of Study This study used three data sources: Structured review of videotaped clinical encounters of well child visits which are routinely used to evaluate and give feedback to residents about their clinical skills Survey of caregivers regarding experience and preference of mode of address Survey of pediatric residents regarding their own preferences for mode of address Figure 4. Names used for caregivers during their visit. Sample Survey Questions Caregiver Survey: Did anyone who works in our clinic address you today? Please check below all the different ways they spoke to you: Mom/Dad Grandmother/Grandfather/Grandma/Grandpa/etc. Mrs./Mr. XXX (child’s last name) Mrs./Mr. XXX (your last name) Your first name No one used a name for me Did anyone ask you how you were related to this child? (mother, father, aunt, uncle, sister, brother, guardian?) (Y/N) Did anyone ask you how you would like to be addressed? (Y/N) When you bring your child to the clinic or hospital, how would you like the doctor to address you? By a title and your last name (“Mrs. Jones/Mr. Jones, I am so pleased you came today”) By your first name (“Pat, I am so pleased you have come today”) By your relationship to the child (“Mom/Dad/Grandmother, I am so pleased you have come today”) I don’t care Resident Survey: 1. You are a patient in the dermatology clinic. How do you want the staff to address you? a. Dr. XXX b. Mr./Mrs. XXX c. By your first name d. I don’t care 2. Try to recall your last visit to a physician’s office. When the staff called you back for your vital signs, how did they call you? d. I don’t recall Video Review Results Figure 5. Observations of the resident taped patient encounters. Figure 1. Sample survey questions for both patient caregivers and residents Figure 6. Overall name preferences of residents for themselves when seeing a physician. Results Conclusions Notable Observations from data sources: Caregiver surveys (n=98): Of the uses of more formal names (such as Ms. Last Name), it was more likely to be said by the support or nursing staff. One aunt in the study was actually called “mom”. Two of the participants were called “Ms. Last Name” but the last name was actually that of their child’s which was different than the mother’s. Despite what might be shortcomings, many caregivers expressed gratitude and appreciation to their resident providors, understanding that they are busy and may not have time to learn all of their patients’ names. Resident videos (n=25): In two videos, even when mothers introduced themselves (by first name), the resident used “mom” when speaking to the mothers. One resident used the name “Mom” for the mother of the patient thirty seven times in one visit. Two residents did not establish relationships of multiple adults in the room during the visit. In two videos, residents referred to the caregiver as “Mom” to a third party without ever addressing the mother herself. Overall pediatric caregivers prefer to be called by a name reflective of their relationship to the child. This is what most of our resident physicians are doing. However, stated caregiver preference may be based more upon previous experience than actual preference. The data reflect varying preferences with some differenced based upon age and ethnicity. The obvious next step is to prospectively offer parents an opportunity to state their preferred means of address during the patient registration process. We hope this information can be implemented in our pediatric clinics as part of our continuous process improvement. It is also important to consider this information during medical student and resident education. References 1. Amer, Adhi; Fischer, Howard Don’t Call Me “Mom”: How Parents Want to Be Greeted by Their Pediatrician. Clinical Pediatrics. 2009 Sept; 48(7):720-722. 2. Frankel RM, Stein T. Getting the Most out of the Clinical Encounter: The Four Habits Model. J Med Pract Manage. 2001 Jan-Feb;16(4):184-91.  3. Makoul G, Zick A, Green M. An Evidence-Based Perspective on Greetings in Medical Encounters. Arch Intern Med. 2007;167:1172-1176. Texas Pediatric Society Electronic Poster Contest Insert Program or Hospital Logo