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When I was a kid, I used to read Reader's Digest a lot. My mom used to subscribe to the Chinese version, and when they came in the mail they always came with the English version for free. Those are the ones she usually never read but she kept a few issues in the bathroom, which I'd sneak out to read.

In one column in one issue, I read an anecdote by a physician about how he had a colleague who always addressed his patients as "mister" or "miss". When asked one day why he did that, he replied that he never addressed his patients on a first-name basis until they felt comfortable enough around him to use his first name.

It's been fifteen years since I read it, so I'm paraphrasing, and I might have missed his point. I had forgotten all about this for years, and I only remembered a few months ago, after corresponding with someone through email. I was addressing the president of a club at school, and I had never met her before so I addressed her in every email as "Ms. Dunn". I hardly ever use "miss" or "mister" now that I'm out of high school, so it felt out of place enough to jump-start my memory.

I think that's perfect. I want to start addressing all patients on formal terms until I've earned their respect, until they feel comfortable around me (although obviously, I don't have one so they never need to refer to me with an honorific). In fact, I would do this specifically so that one day I would transition to using their first names.

On the other hand, I don't know if I would even get my point across to most (when was the last time I had been addressed formally? (when was the last time I addressed anyone formally who I didn't have to? (answer: never))), or merely sound rigid and formal. I really have no idea, so I should just try it. When I'm in the practice lab, or when I'm discussing a case study, I'm handling information about an imaginary patient, but in real life, the information I'm given is really very private; it's too easy to use someone's first name especially when I am given so much information about them. It'll be a good exercise to intentionally not do this in practice.