I think titles are important and should be used based on context. They are used to show respect, they are used to differentiate professional settings from social settings. They are part of what makes society... society.
I can't imagine calling a bona fide professor by their first name in a university setting. Even when our class was out drinking with the profs we still called them Professor. Unless you established a personal relationship with that specific person which allowed you to be familiar with them they were still a person with a Ph.D, charged by the university to instruct us. They earned their doctorate through years of study and proved their competence through a defense of their thesis, and again worked hard to become a faculty member at the university.
That doesn't mean they deserve my respect, but it does mean that I owe them the public show of respect
. I don't think its elitist at all, its part of what makes us civilized, structure... we're not all equal, no matter how much some people would like to pretend.