[Cyber Wolf]

I don't think it's pretentious if at all if someone has earned the certification that conveys the title. If someone is officially a doctor, by degree and training, then there's no reason why they couldn't be or expect to be called doctor.

Both my parents are medical doctors and how they want people to refer to them completely depends on the situation and the person. In a professional setting, such as in the doc's office or in a medical meeting, they introduce themselves as Doctor. In social settings, like a dinner party or at church events or similar, they'll use Mr. and Mrs. If the event or the conversation causes them to mention they're doctors, they will accept either Mr./Mrs. or Dr. from other people... they let them decide. If it's a social function where they're friends with every one or a family function, then first names or familial titles are fine. They don't stress the Dr. title at all, even if everyone knows.

Generally, I call people by how they introduce themselves or are introduced to me. So if a doctor is introduced to me as Mr. Lastname, I call him Mr. Lastname, unless he asks for otherwise. Of course, if the person warrants it, I will instead call him "schmuck".