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Old Enough: How to Gain Patients’ Trust as a Young (or Young-Looking) Physician

“Hey, Doogie Howser!”

“So you want to be a dermatologist? Are you in High School?”

“Must be Bring Your Kid to Work day.”

These are just a few of the many comments that I have received about my youthful appearance since starting my Dermatology residency.  Being a young doctor in my 20’s, many of my interactions with patients start like this: they expect some seasoned, authoritative figure to walk into the exam room, and instead they are met with me: a short, boyish resident, practically swimming in my white coat.  Truth be told, most of the time patients do not comment on my age at all, but when they do, it may be a sign that they doubt my medical knowledge or clinical skills based on appearances alone.  Fortunately, I have had many experiences to prepare me for these comments.  Within the last few years I have been asked where my parents are at the grocery store, carded while buying a ticket to a PG-13 movie, and even mistaken for a patient during my pediatrics rotation in medical school.  When met with similar comments in clinic, I am able to take them in stride.  While some may find these experiences bothersome, I’ve come away from them with strategies that allow me not only to prove my competence, but also to create interactions which bring me closer to my patients.

My personal favorite way to address such a situation, if it is appropriate, is to use humor.  A commenter on our Facebook page notes, “I usually answer ‘I look younger than I am’, and they immediately laugh and forget. It seems to calm them that I answer or acknowledge their comment with some humor.”   I agree that sharing a laugh with a patient gets us off to a good start and creates a sense of warmth between us.  For instance, if a patient asks, “are you sure you’re old enough to be the doctor?” I might answer, “that’s what they tell me!”  Furthermore, being dermatologists means that patients will often associate us with the much sought-after goal of “antiaging.”  As such, if a patient remarks on how young I look, I might answer with “that’s why you should wear daily sunscreen” or “it’s the Botox!”

It is also very important to read the patient’s tone and demeanor in one of these situations.  Sometimes, patients just want to make conversation and are commenting on the first thing they notice.  In situations like this, the humorous comments above will do the trick, and act as a good segue from your introductions to the actual visit.  You could also address the comment in a sincere and concise fashion.  Dr. Alison Leung, and Emergency Medicine physician, often finds herself seeing patients who comment on her presumed age.  She notes that simply addressing the problem directly will do the trick: “I usually tell them that I’m a lot older than I look and then move on.”

On the other hand, patients may be genuinely concerned with your credentials.  In writing this post, I began to wonder if a patient’s perception of their physician’s age really does correlate with their appraisal of that physician’s experience, clinical skills or ability to care for them, and if, in the end, any of it impacts the patient’s trust in their doctor or expectations about what kind of care they receive.  Unfortunately, there is no information in the literature about this topic.  A google search did turn up various articles and message board postings about the subject, and I would say most of the advice that’s out there is either heavy-handed (“tell the patient they can wait longer if they want an older doctor”) or completely tone deaf (“to gain your patients’ trust, you should start wearing different clothes or makeup that make you look older”).

My experience has shown me that the best approach in one of these situations is to be completely forthcoming.  I will answer most of my patients’ questions about my professional and life experience with candor in order to gain their trust – anything from my age to where I went to medical school.  While some may feel that they do not want to share too much personal information, it can never hurt to have a one-liner ready with the basics, like how long you’ve been practicing and the broad strokes of your qualifications.  Becoming visibly annoyed with a patient’s questions can only serve to start out on the wrong foot, and taking their comments in stride will likely result in a smoother interaction for everyone.