A Review of the Literature on "Sama" as an Honorific Suffix for Referring to Patients as Patient Services in Medical Institutions

The purpose of this study was to clarify the course in which the honorific suffix for referring to patients changed from “san (Mr./Ms.)” to “sama (sir/ma’am)” for patient services, but returned to “san”. This was based on an examination of the literature on referring to patients in medical institutions. Considering 64 references from 1989 to 2010, 468 sentences were extracted from the following 4 viewpoints: [Medical situations and medical institutions’ principles and movements associated with the use of “sama”], [Effects/influences of “sama”/“san”], [Health care providers’ feelings and reactions], and [patients’ feelings and reactions]. These sentences were classified according to periods and analyzed, and the following results were obtained: 1. The guidelines proposed in 2001 by the Ministry of Health, Labour and Welfare promoted the active use of “sama” in medical institutions. This movement aimed at improving hospitality and patients’ satisfaction. 2. From 2002 to 2004, due to a criticism of the use of “sama”, a movement for re-evaluation of “sama” as an honorific suffix occurred. This movement was based on the opinion that the honorific suffix for referring to patients should not be standardized, but should be determined by each medical institution, which led to the return from “sama” to “san”.