While the definitive image of a doctor may still be open to discussion, television viewers and moviegoers have been conditioned to expect a rather stereotypical version of what a doctor should look, act, and talk like. If you watch old movies on television, you will rarely see women doctors. Moreover, males portraying the role of a doctor are usually depicted as being over 40, graying at the temples, smoking a pipe, and wearing a suit or sports jacket. Their speech pattern is moderately slow and deliberate, clearly articulated, and well-modulated.
Around the middle of the 20th century, the image of a doctor began to undergo some change. More female doctors began to appear on the scene, male doctors appeared younger, and "token" racial members of the healing arts (Black, Asian, and Hispanic) surfaced. Among the new crop of younger television doctors were the very popular Drs. Kildare and Ben Casey. The best example of the old-fashioned type was Marcus Welby, M.D.
Whatever your mental picture is of a "real" doctor, it inevitably conforms with a prototype, one generated by the mass media. This perception is conventionally determined by such external variables as dress, manner, credentials (DC, MD, DO), reputation, props (stethoscope) or physical surroundings (medical or chiropractic group/center). Beyond these indicators, we find the indispensable ingredient of a real doctor -- one's self-image.
Such expressions as self-esteem, self-worth, self-evaluation, and self-concept have also been commonly associated with the phrase self-image. While the notion of self-image is often treated rather simplistically, nothing could be further from the truth. It is probably one of the most complex aspects of the professional persona.
No single characteristic or personality trait immediately commands the declaration, "Oh, he must be a doctor." While the social determinants mentioned earlier are certainly valid, they are only valid to a point. For example, could you immediately single out the doctor solely by his appearance, in a steam room filled with naked men? Probably not. Hence, the objective of this article remains to explore some of the other characteristics that make someone look, act, and talk like a doctor.
Here is a rather lengthy definition of self-concept: a relatively stable set of perceptions you hold of yourself that are consistent with the public view; the sum total of everything you call your own -- your body, characteristics and abilities, material possessions, occupation, hobbies, friends, enemies, etc. Also what you have inherited, acquired through experience, learned to do, and have the potential to do. Obviously, this kitchen-sink definition leaves very little to the imagination.
Have you ever gone to a local mall wearing gardening clothes and run into one of your patients? There you stood being introduced to your patient's friend. "Marge, this is Dr. Smith, my chiropractor." Somehow, the way you are dressed and the title of doctor doesn't quite agree. Although doctors are certainly entitled to a private life, encountering them out of uniform often creates some cognitive dissonance. I do not mean to imply that you should always wear your white coat in public, but rather that a particular professional look inclines to be expected.
When students first enter a chiropractic college or medical school, the perception they have of themselves does not include the image of a doctor. This perception of self does not emerge spontaneously; it requires some serious introspection, time, and patience. The most rigorous imprinting of the doctor-to-be self-image occurs during internship. At practically every turn, interns are addressed as doctor. Hospital and clinic paging systems continuously reinforce the title of doctor. Soon, should someone call out the word doctor, 16 young people in white coats will turn around. The label will have begun to take hold. Once in practice, the process is repeated in a variety of ways; e.g., your shingle -- Dr. Smith, your card -- Dr. Smith, your answering machine -- you have reached the office of Dr. Smith, the telephone book -- Alan Smith, D.C., and, perhaps, on the door of your private office -- Dr. Smith. The transformation from an ordinary citizen to doctor is by no means an effortless transition.
To complicate matters further, your self-image is not static, but dynamic; it is constantly susceptible to changes in your attitudes, values, and beliefs. As you continually receive positive and negative feedback from others, the perception you have of yourself is susceptible to change. Because your self-image is not cast in stone, a number of factors have the capacity to reshape aspects of your life.
Being a doctor has been associated with a unique stumbling block, the "halo effect." It refers to an instance in which someone possessing expertise in one field is, axiomatically, taken to possess equal expertise in another field. Examples of the halo effect can be seen regularly on television. A commercial for razor blades is being touted by a famous baseball player. Just because he is a famous baseball player, the viewing audience is expected to extend that player's expertise to razor blades.
This same phenomenon is frequently imputed to doctors. Just because they are doctors, the general public assumes that their knowledge and schooling qualifies them to speak with authority about car batteries, lacrosse or chamber music. Unfortunately, many doctors are lured into this deception and develop a "holier than thou" self-image.
A distinction should be made between self-image and self-esteem. Self-image is the descriptive part of yourself, while self-esteem is the conceptive or evaluative part. We are not born with a ready-made self-image. It develops from how others categorize us; e.g., he is intelligent, sympathetic, and enthusiastic, etc.
Although the law classifies us as legitimate and qualified doctors of chiropractic, the legacy of not being perceived as "real doctors" still haunts a great many of us. In such cases, neither our self-image nor our self-esteem has satisfactorily come to grips with the title of doctor -- our professional persona has still not attained full maturation.
The nature of our professional persona consists of two parts: (1) how the media refers to us, and (2) how we refer to ourselves. Although chiropractic is now almost a century old, and has achieved substantial credibility in the public mind, there are still people saying, "But, you aren't a real doctor, are you?" As long as we refer to ourselves as "chiropractor," rather than "doctors of chiropractic," or "chiropractic doctors," this public tendency will persist. Hence, when asked the aforementioned question, we should answer, "Yes, I am a real doctor -- a doctor of chiropractic." Having once identified yourself in this manner, it then becomes necessary for you to look, act, and talk like a doctor.
I am reminded of a court case in which a member of our profession (the plaintiff) was called to the witness stand to testify. The prosecuting attorney deliberately and repeatedly refused to address the plaintiff as a doctor. All the jury kept hearing was Mr. this and Mr. that.
I was present at the pretrial preparation of this witness and recall him being advised by someone from our profession to speak simply, so that the jury could understand. I distinctly remember disagreeing with such a tactic and argued that using layman's terminology (speaking simply) would not convey the image of a doctor. I urged that he first explain his response using conventional chiropractic and medical terminology. Then, if asked to explain in simplier language, do so. I am convinced that if you speak like a doctor, people will more readily address you as a doctor.
Incidentally, the strategy I have just described did exactly that for me when I testified in court as an expert witness. The attorney who cross-examined me, repeatedly addressed me as Mr. Eisenberg, rather than Dr. Eisenberg. Offended by his unwillingness to afford me the courtesy of a proper title, I answered his questions using very technical language that I knew he would not understand. Instead of saying that the patient's spinal condition involved nerve pressure, I said, "The vertebron in this patient's spine revealed moderately severe neurothlipsis at the level of C 6-7 involving the concomitant neurodokon. There also existed a biotropistic diathesis toward an ergotropic dynamogenic response involving the patient's autonomic nervous system." Needless to say, the attorney was overwhelmed by my technical sesquipedalian approach and immediately said, "Doctor, would you mind explaining that in plain English for the jury?" Then, and only then, did I concede to speak simply. First and foremost, I wanted to "sound" like a doctor.
Watch for Part II of this article in Dr. Eisenberg's next column.
Abne M. Eisenberg, D.C., Ph.D.
Professor of Communication
As a professor of communication, Dr. Eisenberg is frequently asked to speak at conventions and regional meetings. For further information regarding speaking engagements, you may call (914) 271-4441, or write to Two Wells Avenue, Croton-on-Hudson, New York 10520.