re: Would you refer to this person as a “doctor” outside of an academic setting?

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People with a PhD who insist on being called "Doctor" outside of professional settings are attention whores.

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People who insist on others using any professional title outside of a professional setting are attention whores.

The MD’s I know wouldn’t introduce themselves as “Dr. [name]” at a tailgate, or a party, or whatever. That would be pretty weird for anyone who isn’t a raging narcissist.

ETA: I think PhD’s are the ones usually making a big deal about this because a lot of them have some sort of weird inferiority complex.