But it comes at a price: confidence – in ourselves and from our patients.

When patients enter the emergency department, it is because they are having one of the worst and possibly scariest days in their lives. They are not looking for a friend. They want the confidence that we will take care of them and that we know what we are doing. And while it may be partly an illusion (especially in July of intern year), a certain dose of decorum might even be a form of therapeutic reassurance that we are taking their care seriously.

If we comport ourselves with dignity, patients will take even the greenest of doctors quite seriously and trust them that much more. It is for similar reasons that judges wear robes. When on the bench, they are not just themselves; they are justice. Similarly, when we are in the emergency department, we are just not ourselves; we are medicine.

This is important for patients, but often even more so for their accompanying and anxious loved ones, who so often have an all-too-keen instinct for sniffing out when we are not giving our best. First impressions, how people present themselves in the first few seconds – even milliseconds – of new interactions prove to be crucial, studies show. People make snap judgments when they meet someone, and leading with professionalism can only help.

Sure, some patients will require nuance, but as a default position, a little formality pays dividends.

An area where the inverse logic applies is when interacting with nursing. I always introduce myself to nurses by my first name and position. “I’m Jeremy, the new resident.” But unless they correct me, I refer to them by their title and last name. Nurse Hayes was extremely helpful to me on my first shift, and I wanted her to know from the get-go that I respect the title she has earned and her expertise by addressing her properly.

I hope that, by showing the nursing staff a sign of respect, I will earn trust and respect back over time. However, it is important to remember that humility is a good thing, and its antithesis, hubris, is downright dangerous.

Just because formality confers some benefits does not mean we should take ourselves too seriously. There’s an old story about a cocktail party in which two people meet. One inquires as to the other’s name. “I’m Dr. Williams,” one says. To this the other replies, “I asked your name, not your title!” Touché.