Patient misunderstanding of the academic hierarchy is prevalent and predictable

Medical personnel introduce themselves to patients using titles that reflect their level of training, although these titles may not be inherently obvious to the patient. This study explored patient understanding of commonly used physician and student titles.

A survey was developed asking patients to match six mutually exclusive medical titles to six levels of training. Categories included attending physician, chief resident, resident, intern, medical student, and pre-medical student. Respondent age, gender, medical training, employment in a healthcare field, educational level, income, and number of visits to a physician per y were requested. A brief intervention was then performed in which a second group of patients were advised of the designations and then asked to match the same categories.

A total of 365 surveys were collected from the first group and 102 from the second group. Respondents accurately identified the level of training required for all six titles in only 44.5% of surveys collected, and in 52.0% after the intervention. Patients with at least some college education or income>$50,000 per y were more likely to answer correctly (P<0.001). On the other hand, even respondents with graduate degrees or incomes>$100,000 per y had difficulty correctly identifying the training of all team members.

Patients do not understand the distinctions in training of surgical team members, especially those patients with decreased income or education; therefore, clinicians may wish to pay particular attention to these introductions. The survey did identify this as being important to patients.