BGS Statement on job titles

The British Geriatrics Society are proud of the role we played in supporting our late friend, colleague and BGS member, Dr Kate Granger, with her #hellomynameis campaign. This approach has now become established as routine practice across the NHS. At the heart of Kate’s campaign lay an assertion, based upon her lived experience, that patients need to know who is treating them.

Effective care of older people is multidisciplinary by nature and highly specialised. Delivering it to the highest standard demands that we attract, train and retain the best colleagues across all relevant disciplines. The NHS Consultant Practitioner and Capability framework has provided a structured and robust training framework which enables colleagues, from all disciplines, the opportunity to remain patient-facing throughout their career, providing the multidisciplinary clinical leadership our service needs. The colleagues who have moved into these roles, and who are currently training to do so, are expert, experienced and highly valued.

A consequence is that the term ‘Consultant’ is now used by those from multiple professional backgrounds. This is part of a wider expansion of roles across the NHS which has led to a number of job titles that patients may not be fully familiar with. It is important that patients know who is treating them.

Many colleagues, both those who are medical doctors and those who are not, hold either professional or research doctorates. These are substantial achievements. Colleagues are rightly proud of their qualifications and, of course, want to use the title that they have worked so hard for. There is potential, nevertheless, for the term ‘doctor’ to be confusing for patients, when it is used in a clinical setting to denote research or other professional doctorates, rather than someone who is practising as a medical doctor.

The BGS supports the expansion of senior multidisciplinary leadership roles to deliver the best for our patients, but recognises the potential for new roles and titles to cause confusion for the public and the workforce. In order to avoid ambiguity, we suggest members do the following:

• Review their job title – is it clear to those who read written correspondence what their clinical background is? ‘Consultant practitioner’ is ambiguous. ‘Consultant physician’, ‘consultant nurse’, or ‘consultant therapist’ is not.

• Ensure that when they introduce themselves to patients, they explain their role in a similar way, making it clear what their clinical background is: “Hello my name is Alex, and I’m the Consultant Doctor/Nurse/Therapist here on the ward.”

• When using the term ‘doctor’ in a healthcare context, consider that this can be confusing to patients where it denotes a higher professional or research degree, rather than medical training. If using the term ‘doctor’, ensure that they do so with reference to their wider job description: “Hello my name is Dr Smith, and I’m the Consultant Doctor/Nurse/Therapist”.

• In written correspondence, using postnominals in addition, or in place of, the ‘doctor’ title may also be helpful. It is important to recognise, however, that not all patients know the difference between PhD, MD and MBBS/MBChB. Again, in written correspondence full job titles are always helpful to avoid ambiguity.

While some of these nomenclature issues have long been ambiguous in the English language, the continued expansion of professional roles within the NHS raises new challenges. There is potential for BGS members, in particular, to find themselves in this space – because we work in multidisciplinary teams to care for older people, and because members in extended roles may find that the scope of their advanced training extends substantially beyond the traditional boundaries of the degree and discipline in which they initially trained. For example, a consultant physiotherapist working in an acute frailty service may do relatively little physiotherapy and be much more generalist in their practice.

With this in mind, the BGS will work over the coming weeks to meet with relevant multidisciplinary stakeholders, with the Royal Colleges and with NHS leaders to raise the issue of job title nomenclature, and the ways in which it challenges our members, and patients.

We will keep the membership updated as we do so.