I’ve been a Hospitalist for the last 14 years and still encounter sexism regularly at my job. It’s not the big stuff like pay differentials or career advancement. I work with groups that are at least half female and usually led by women so my colleagues or superiors aren’t the problem. The sexism I face is subtle, almost mundane, and it comes from the people I’m pledged to serve. My patients.

Every female physician I’ve ever met can relate to stories of patients mistaking them for nurses or other members of the healthcare staff. In fact, I believe all female physicians are regularly subjected to the casual sexism of mistaken identity. In my experience women of color have the hardest time getting patients to accept their status as Doctor. Younger and smaller women also seem to really struggle. But this phenomenon is not limited to skin color, age, or physical stature. Recently an older, tall, white female co-worker told me how patients at our hospital often complain to nursing staff that they haven’t seen a doctor in days when she’d seen them every morning. This woman has been in practice for decades, wears a white coat with her title and name embroidered on the front, and wears a visible ID badge.

Stories like these range from the offhandedly insulting to the ridiculously comical. I often have the experience of entering a patient’s room and hearing them tell someone on the phone they have to go since a nurse just walked in, even after I’ve been their primary doctor for days. After recently complimenting another hospitalist on her shoes she confided to me she always wears high heels so she’s not mistaken for a student, something she feels happens to her often since she is an Asian woman. One of the most amusing stories I ever heard happened to my former Medical Director. One of her patients complained to their nurse they had yet to see a doctor shortly after she’d left their room. When the nurse pointed out she’d just been in to see the patient they assured the nurse that no one had seen them all day except for a very nice chef in a long white coat. In 14 years I have never heard stories like these from my male colleagues, even the ones that wear no white coat or visible signs of our profession.

Because of this bias I have always gone out of my way to introduce myself as Dr. Walker. I’ve never offered my first name and flinched when patients asked it. If patients called me a nurse or used my first name I’d be quick to correct them. Or at least I used to.

Something has happened to me over the last few years. I’ve noticed a number of my patients starting to call me Miss Walker. Interestingly, it always happens after I feel I’ve made a genuine connection to the patient. It’s as if the more the patient feels at ease and trusts their interaction with me the more likely I am to hear myself called Miss instead of Doctor. And instead of irritation or frustration with the misplaced title I find myself relishing it. I’ve come to realize it means I  somehow transcended the distant role of unknown hospital doctor and became a respected member of that patient’s more intimate community, like a reliable neighbor or a beloved teacher.

Now I consider it an honor when a patient or family member ends our conversation with a heartfelt “thank you Miss Walker.” And it’s made me view how female physicians are treated compared to our male counterparts in a somewhat different light. Yes, we are often mistaken for members of the healthcare team considered to have lower status, but maybe that’s because our ability to communicate, to empathize, to listen, and to understand is not associated with the stereotypical expectation of a doctor. The power gap between the sick patient and seemingly omnipotent physician is immense and scary. I think women are much better at bridging that gap.

I have a three year old niece. When she’s an adult I hope the inherent expectation of what a woman can be will be as vast as that of a man. And I hope if she’s a doctor her patients will afford her the title she has earned. But even more than that I hope this next generation of doctors, both men and women, will be able to lessen the great divide between doctor and patient, will be able to make patients, at their most vulnerable, feel at home. Then no matter how these doctors will be addressed it will always be with affection and respect.