Germans definitely have a title fetish. So do Austrians, to a slightly lesser degree. For example, titles go on driver's licenses. They certainly do not in the US.

If you use the title "Prof" or "Doktor" when making a restaurant reservation, or getting pulled over for speeding, chances are very good you will get a better table, or escape without a ticket. The word that comes to mind for the stories I've heard from Dr. Dr's in Austria is "boot-licking."

Also, "Dr Dr" is a thing. My mother-in-law is one and people really say it to her, religiously, and not because she is a prima donna about it.

Don't forget, it's illegal in Germany for an American PhD to call himself "Dr" (and not talking about practicing medicine either). People have gotten into serious trouble because of this: http://chronicle.com/article/Whats-Up-Doc-German-Law/40636/

In America, the government officials responsible for that would be laughed out of town.