> The short of it is that the title has arisen as a result of a form of professional jealousy, primarily with medical professionals. Everyone wants to stand out

> The short of it is that the title has arisen as a result of a form of professional jealousy, primarily with medical professionals. Everyone wants to stand out and mark their social class even in supposedly "classless" societies. This is my understanding too. In my opinion, use of honorifics demonstrates a character flaw that should be corrected, not accommodated or encouraged. My general M.O is to use the same level of formality with a person that they use with me. For example, if my physician uses my first name, I use hers. This lets me match their desired level of familiarity, but disregards any pretense they might try to introduce.