Deeper dive:

The way that "usted" and "tú" are used can also vary across Latin American countries and regions. Some countries, such as Venezuela, use the pronoun "vos" in a similar way that "tú" is used. The simplified recommendation is to use the formal "usted" with adults and the informal "tú" with children when working in a clinical setting. This shows respect to your patients. If it is your cultural practice to use "vos" feel free to use that pronoun with children.

In some situations, your patient might request that you use "tú" instead of "usted" (e.g. "por favor, tutéame" or "tratame de tú"). In this case it is respectful to go with your patient's request and use "tú" even if they are an adult. You can also facilitate rapport building and show respect by asking your patient's preference "¿Como prefiere que lo/a trate, de tú o de usted?". Although, it gets a bit difficult remembering who you use "tú" with if you use with some patients and not others. Check out some examples of "tú" vs "usted" below.

Usted:

1. Hola, buenos días. Mucho gusto en conocerlo/a.
2. ¿En qué idioma prefiere hablar?
3. ¿Prefiere que le hable en inglés o en español?
4. Claro, le puedo hablar en español.
   

Tú:

1. Hola, buenos días. Mucho gusto en conocerte.
2. ¿En qué idioma prefieres hablar?
3. ¿Prefieres que te hable en inglés o en español?
4. Claro, te puedo hablar en español.