FL - my sense of humour only regarding titles. Many people have titles, earned or unearned. Of the several I can choose from, 'Mr' is the only one not earned, and you sometimes need to be called something! At-least people generally understand Dr., and those who have it, earned it.
Regarding the lapsed medical, I wonder if there was a general view that as a physician, medical certification is the one he could, and should, have taken most seriously?
G