Vik or Vikram: The challenge of physician identity

“Does he speak English?”

As I was busy working at my computer dictating on the last patient, I overheard the question posed to my receptionist.  The receptionist, unfazed, responded with a polite, “yes.”

My medical assistant ushered the patient into one of the exam rooms where Ms. Smith proceeded to expound on how she had experienced some less than ideal interactions with Indian physicians — they had seemed cold and curt; their accent was often difficult to understand; it was hard to pronounce their names when asked by others to repeat it.

I walked into the room, introduced myself to her, and shook her hand.  After finishing the exam, I informed her that she would be a good surgical candidate and that my medical assistant would be calling her to schedule a procedure in the near future.  Upon leaving, she commented that she enjoyed the experience and that, “my name wasn’t too hard to pronounce.”

I would like to say that the above interaction is exceedingly rare.  It is not.  While rarely hearing directly about a patient’s concern about my ethnicity, I have heard from both colleagues and nurses that some patients have paused when hearing my name, even though I had done my best to Anglicize it.  Moreover, as an administrator in the hospital where I practice, I have been privy to comments on patient experience surveys expressing frustration over the “foreign” doctors who need to “learn how to speak English.”

When I was applying for residency, my mentor, a surgeon who contracted multiple sclerosis early in his career, and was forced to give up his clinical practice, gave me a bit of advice: “You should go by Vik rather than Vikram.”

I nodded my head, but he could see the confusion on my face.

“These surgeons, and other people, they will prefer to call you Vik.  It’s easier for them to digest and it will be better for you.”

My mentor passed away a few years ago, but I am still struck that a white, male who came from a storied New York family had the emotional intelligence to understand what challenges a brown-skinned, immigrant would face.

So, I adopted Vik as my professional name, and I have kept it ever since.  Beyond this, however, I have also learned to modify my interactions with patients based on their own personal experiences.  I have been fortunate enough to have lived in various parts of this country: When I encounter a patient from the South, I slow down my Midwestern speech pattern and do my best to mimic the Virginian accent I was exposed to in medical school.  While trying to steer clear of religion, when asked about my own, I mention that my wife is Catholic, and that both of my kids have been baptized as Catholics (I rarely mention my own Hindu faith).

Some have called me to task for playing into the prejudices of patients or that I am acting as a self-loathing minority by minimizing my differences.  Maybe.  I counter, though, that patients are inherently anxious, and that, despite all of the talk about entering into a partnership with patients, the physician-patient relationship is still fundamentally asymmetric with the physician decidedly holding the power.  Why wouldn’t a patient grasp at some kind of connection with their doctor to minimize their fear?

Diversity among the physician workforce is important, and I feel that the growing number of women and minorities is essential to the populations we serve.  Unfortunately, several physicians will continue to encounter patients who will have concerns about them based on their identity whether that be gender, race, or religion.  The question physicians will have to ask themselves is this: How am I going to take care of these patients?

Vik Reddy is a plastic surgeon.

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