Best response to patients who say "you look too young to be a doctor?"
September 25, 2016 9:13 PM   Subscribe

After finishing 11 years of school I now work as a general practitioner. I am 30 years old. Almost all patients tell me I "look too young to be a doctor" - some are just making conversation and some seem genuinely concerned about my credentials. I usually respond in a joking manner that after "finishing so many years of school I certainly feel old". People however often keep asking me questions about my age. This is within the first 10 seconds of meeting them so do not think it is a reflection of my clinical skills or demeanor. What would be the best response that would 1) Reassure them I am not doogie howser and fully qualified 2) Allow me to quickly move on to what brought them to the ER
posted by 2whitehorse to Work & Money (56 answers total) 10 users marked this as a favorite
"You're too kind. Now, about your spleen..."
posted by juniperesque at 9:15 PM on September 25, 2016 [21 favorites]

Just say, "Thanks for the compliment" and move on.
posted by discopolo at 9:20 PM on September 25, 2016 [3 favorites]

Pretty much every doctor I know got some variation on this until they were over 40 or visibly going gray. I think it's a bit of a nervous tic from patients, especially in the ED where they are feeling anxious about what's going on with them and sort of wishing for a kindly old authority figure. Your answer is fine.
posted by The Elusive Architeuthis at 9:29 PM on September 25, 2016 [25 favorites]

"Graduated from XSchool in 20NN, fully qualified and here to help you! So what's going on today?"
posted by Lyn Never at 9:32 PM on September 25, 2016 [3 favorites]

"You are sweet. So what about that missing finger you came in about?"
posted by Toddles at 9:39 PM on September 25, 2016 [3 favorites]

"Thanks. I moisturise."
posted by His thoughts were red thoughts at 10:31 PM on September 25, 2016 [42 favorites]

While I don't have a real answer to your question, my new GP is significantly younger than me, and I consider that a large point in her favor. She is incredibly smart and not cynical! I just wanted to point out that there are people who will see your youth as a major plus. If you're not in the US South, just say "well bless your heart" and move on.
posted by Ruki at 10:44 PM on September 25, 2016 [5 favorites]

I think this an expression of either mild flirting, or concern that you don't have the "experience" they are hoping for in a doctor. If it's flirty, say "Haha, my [mother/father] gets that all the time too, and [s]he's a [career]." If they seem genuinely nervous, say "Well, this certainly isn't my first rodeo [or insert other colloquial expression if you wish], and I'm fully trained to help you with whatever you need," then move on.

And seconding Ruki, don't say "well bless your heart" if you ended up in the South. Oh my, no.
posted by ananci at 11:11 PM on September 25, 2016 [2 favorites]

1) comfort: they're breaking the ice because they're tense, and they're choosing a potentially awkward ice breaker because they're tense. Diffuse the situation by taking their comment as an awkward joke and move past it, assuring them that yore a reasonable person with whom they can be comfortable and vulnerable.
2) Acknowledge: to every joke is a kernel of truth. Acknowledge their underlying concern - that they are being seen by someone with limited experience - and help address it.
3) proceed: move into the next topic of discussion.

"Well, you know what they say about sunscreen. But don't worry, I've been working with patients for X years and (other tidbit about you), and have the good fortune to have many others on the team with even more experience. Now - what brings you here today?"
posted by samthemander at 11:13 PM on September 25, 2016 [7 favorites]

Just tell them how old you are-ish, and how long you've been at it, "it's ok, I'm in my thirties and I've been practicing for ten years"
posted by Iteki at 11:18 PM on September 25, 2016 [4 favorites]

"Old enough that I spent 11 years studying medicine, ho ho." It's a good large number.

It may be worth doing some fashion things to look a little older/more serious. I mean, I'm not assuming you're wearing Hello Kitty barrettes or something, but there are still probably things you could do with your clothes and makeup that will give a more businesslike look.
posted by Ursula Hitler at 12:43 AM on September 26, 2016 [2 favorites]

I agree with the comments above that suggest that part of it is just a tension icebreaker, but when people reach for a comment to break the ice they’re most likely to latch onto the thing that’s most unusual to them about their current environment. Clearly this is your apparent youthfulness, as it’s a recurrent phenomenon.

Is it possible that you’re wearing clothes or using make-up / hairstyles in ways that are associated with a younger look? Is there anyone you could ask about your work “look” that you would trust to give a disinterested answer?

Maybe the best answer is a more severe haircut that removes the though from the patients mind in the first place!
posted by pharm at 12:55 AM on September 26, 2016 [1 favorite]

"I'm 30"
posted by thelonius at 1:57 AM on September 26, 2016 [2 favorites]

It's funny to me that you just asked this because recently my GP retired and in her place is a doctor who looks really young. Swanky sneakers, hot-mess high ponytail -- she looked like she just finished her morning run. It was unnerving. When I met her I immediately want to say, "You're too young to be a doctor!" and if I was meeting her in an emergency setting, it's likely my nerves would have word-vomited that thought.

My question to you is do you give off an authoritative, doctor-like vibe or do you instead come across as a bit too youthful and lacking gravitas? If you're sure it's not you, then the best thing you can do is thank them and move on.

Please don't tell them the year you graduated because then patients will be doing math in their heads trying to subtract X from the current date to figure out your age.

Just say, "Thank you. Now about your missing nose..."
posted by yes I said yes I will Yes at 2:22 AM on September 26, 2016 [9 favorites]

I also wouldn't mention anything about how old you are, or the year you graduated or anything that indirectly addresses your age. I was recently in a high-stress ICU situation with a young-looking doctor and to be honest it made me anxious, despite knowing that recently-trained doctors are often better at their jobs. It will require a lot of empathy from you, but hearing a simple "You can trust me, I'm well qualified to be here, now about your loved one" would have put me at ease if I'd expressed my unfounded concerns.
posted by third word on a random page at 2:34 AM on September 26, 2016 [10 favorites]

"I think you should get checked out for cataracts".
posted by rongorongo at 2:48 AM on September 26, 2016 [2 favorites]

I get this a lot and my standard answer is that I'm older than I look.
posted by dhruva at 2:52 AM on September 26, 2016 [7 favorites]

"You should see the picture in the attic" (may not work in the US, but this was my go-to response in the UK as a young woman in IT, back in the day. They'd all read Dorian Gray, so it worked a treat.)
posted by finding.perdita at 3:03 AM on September 26, 2016 [18 favorites]

Alternatively "I like to be a role model for my patients. Let's talk about healthy living after we get that nasty rash sorted out."
posted by finding.perdita at 3:08 AM on September 26, 2016 [1 favorite]

I'd be tempted to say something like, "You're welcome to wait for the next doctor, who comes on in [x] hours."
posted by Bruce H. at 3:14 AM on September 26, 2016

The best comeback I've seen was a patients son saying Mum, you're eighty nine, everyone looks young to you. But i can't say that. I say I stay out of the sun.
posted by chiquitita at 4:47 AM on September 26, 2016 [6 favorites]

Changing your clothes/makeup if you wear it/hair etc. is not going to help (source - I look 10 or more years younger than I am depending on the day, ditto my youngest sister, and when we try for older or more businesslike or wtfever in our clothes, we still look young, just nicely dressed, and still get comments). I went through this for years when I first started grad school and then started teaching (I even had a student try to card me!), down to murmurs ("I can hear you guys, you know that, right?") of "is that the professor?" as I'd start class on the first day. It sucks, and it's NOT a compliment that I've come to appreciate (as many people have insisted before me).

I just tell them up front "Yea, I'm [age], I look younger, it is what it is." If they seem to need more reassurance, I mutter something about "funny how our perceptions of age are changing as we're living longer" (I'm a sociologist, I can get away with that, your mileage may vary) or if they really need reassurance, about how I can't tell people's ages anymore - that student I once had in class that looked 40 that's actually 40 with 4 kids. Somewhere in there, they settle down and we get down to business. (And now that I'm almost 40, telling them "yea, I'm almost 40" startles them and we don't have to go through the rest.
posted by joycehealy at 5:28 AM on September 26, 2016 [3 favorites]

Is it possible that you’re wearing clothes or using make-up / hairstyles in ways that are associated with a younger look?

don't worry about this, jeez. It's reasonable for scared patients to be worried their doctor is too new and to reassure them by saying e.g. you're not a college kid or med student, you're an actual working doctor and they're not your first patient, or whatever, and then shut it down if they keep going. but it's not reasonable to reassure them because you're a woman and they don't like your fashion sense. if busy docs even have any fashion sense at work whatsoever, good or bad, which would be a surprise to me as a patient. You have to be polite like in any other service profession but worrying about the subtler implications of your 'look' as a woman, if you are a woman, is not within the scope of either politeness or professionalism.

this is not just a political stance either; hyperconcern with your image or worry about being too cute for respect are submissive attitudes that do not comport with the stereotypical image of a doctor that many patients have and hope for - the grizzled and unflappable old woman they wish you were does not give a shit what patients think about her hair. so it may be a practical help not to care about this.

& when they're not being patronizing or sexist or just wishing you were a parental-looking figure, what these patients are doing is trying to wish away the doctor-patient dynamic (that is, the situation where they are maybe sick and dying) by engaging you on a social level by saying to you what they'd say if they met you anywhere else. You're doing the right thing by humoring them once and then no more.
posted by queenofbithynia at 5:52 AM on September 26, 2016 [13 favorites]

It may be irritating after hearing that so many times, but try not to let it get to you. Give them the benefit of the doubt that they're just nervous/curious/taken aback and brush it off the first time with a casual, "Yes, youthful looks run in the family." Then immediately redirect by asking them about their injury. If they persist in asking questions about your age, don't indulge that kind of talk; shut it down right away because once you start answering those types of personal questions, you're allowing the balance of power to shift from you to them and they'll continue to question and second guess everything you do. (And even if you were Doogie Howser, so what. You're fully trained and qualified to do your job, otherwise you wouldn't be there.) Assert yourself!

Patient: How old are you anyway?
You: That's a personal question. Now let me get you fixed up.
Patient: But you look so young.
You: Mm-hm. So how long have you had that cough?
Patient: About a month. It started when...

Just keep redirecting and stay professional. If they get belligerent or uncooperative, I like Bruce H's idea of asking them if they'd like to wait for another doctor. Nobody likes to wait even longer after spending time in an emergency waiting room. (Then send in a doctor even younger looking then you! j/k)
posted by LuckySeven~ at 5:57 AM on September 26, 2016 [2 favorites]

I tend to say "Oh Mrs Smith, I think that's you getting old!" with a big "oh you silly billy" smile. Goes down fine - most people chuckle and tell me I'm probably right. I have the sort of bedside manner that can get away with it though. Most people do mean it as a compliment/icebreaker, the odd few that don't aren't worth worrying about. Nobody ever wants to know my actual age, or ever keeps pursuing the question.

And fwiw, I have at least two female colleagues in their 50s who still get this. Both are short and slim, but both definitely look over 50. One is grey-haired. It has nothing to do with how you dress or how you look. A lot of it is about being a woman - very few of my younger male colleagues get this at all.
posted by tinkletown at 6:12 AM on September 26, 2016 [4 favorites]

Laughing it off/making a joke is only going to reaffirm your perceived youth, and it also isn't going to dissuade them from making a rude comment like that to someone else in the future. Responding in an unimpressed, slightly irritated way would make you seem more "serious" and business like and older. You don't need to be rude, but you can make it clear that you don't appreciate that sort of comment. How would you react if they said some OTHER rude thing to you?

ie. "You look too young to be a doctor!"
You, look at them disapprovingly and pause for a second to make things slightly uncomfortable for them. "...Right. So how long have you had this rash?"

NOTE: I'm a 34 year old short fat woman in a male dominated field and I apparently look younger than I am, so I get comments about that fairly regularly. From assumptions that I'm a secretary, to "Oh you must be a student co-op" etc. I've become very sensitive to this kind of thing because they all feel like they're casting doubt on my ability to do my job.
posted by PuppetMcSockerson at 6:48 AM on September 26, 2016 [1 favorite]

Part of your job is to help your patients feel comfortable. If they seem concerned about your credentials, give them a one sentence summary: "After med school, I did an X year residency in Y at XX hospital, followed by a X year fellowship at ZZ, and have been on staff here since [date]." Your age is optional, as it's not directly relevant.

If you feel that people are mocking you or just making conversation, just pretend they are honestly concerned about your credentials and give the same answer.
posted by Mr.Know-it-some at 6:58 AM on September 26, 2016 [3 favorites]

You, look at them disapprovingly and pause for a second to make things slightly uncomfortable for them.

Please don't be rude to your patients. That's lousy bedside manner. Most of them are asking this because they're nervous - they're being a bit inappropriate, but don't match their impropriety with your own. Just say, "Oh, thanks - I use sunscreen religiously!" or "You know, that compliment makes the decade of medical education worthwhile!" or something like that to diffuse the situation.
posted by schroedingersgirl at 6:59 AM on September 26, 2016 [25 favorites]

If you want to be professional, the correct response is "thanks" then get on with your job and sore them how old you are with your skills and bed side manner. If you want them to confirm their belief you are too young to be a doctor make a stupid or sarcastic comment so your patient no longer feels they can be open with you but so you feel better.
posted by wwax at 7:13 AM on September 26, 2016 [4 favorites]

How about "I hear that a lot!" It's not about you.

I'm almost 40. First the residents at the ER were babies, and then the residents and many of the nurses, and now suddenly I'm Doctor Age and one of my besties is a leading surgeon in her slice of neurology and my psychiatrist and I are the same age, and how did everyone get so young?

It's about the patient. They're getting a double dose of mortality: illness and age. Be gentle with us. It's not about you.
posted by chesty_a_arthur at 7:23 AM on September 26, 2016 [14 favorites]

PS also the dentist, that's extra freaky for some reason.
posted by chesty_a_arthur at 7:24 AM on September 26, 2016

I got this a lot until I hit my 40s and, truth be told, I kind of miss it. My response was to thank them for the compliment and turn the conversation back to them in a way that clearly communicated that I was there, present and actively listening. If they were nervous about my credentials, I would give them a quick one-sentence summary of my experience and move on. They are in a vulnerable position. It's natural that they will want to ensure they are receiving good care. I found it was hard to let this stuff go, because somewhere in me I was also questioning whether I was really qualified for this too. As I gained confidence, the comment bothered me less, and we generally spent less time on it.
posted by goggie at 7:26 AM on September 26, 2016 [6 favorites]

Smile and say "I'll take that as a compliment!" and then move right along. If you're other than a health care provider/helping profession, you could push back a little more but I think people are right to point out that these are patients who may be vulnerable. "I'll take..." may be a bit aggressive for this situation but it puts you in the driver's seat a little more.
posted by BibiRose at 7:32 AM on September 26, 2016

It's not that you're so young, it's that they're vulnerable and feel so old. It's that uncanny feeling of vulnerability and mortality that comes up when sitting across from a doctor. Don't take it personally. Be gracious and take it as an opportunity to use excellent bedside manner and relax them with humor.
posted by vivzan at 7:44 AM on September 26, 2016 [6 favorites]

In a similar situation (lecturing med students, as a post-doc) I would just laugh and say "well, I am" those those people who implied I wasn't old enough.
posted by gaspode at 8:04 AM on September 26, 2016

It's a good idea to reassure the patient by briefly covering your experience and credentials. However, I'd also suggest you cultivate some acceptance of the fact that at 30, you are in fact young! Many of your patients are older than you, and that is a real difference in life experience, no matter how many years you worked your ass off.

I work in healthcare, and my favorite doctors are the ones who make their humility obvious and clearly value their patient's life experience and self-knowledge. I know that is more of a primary care kind of style thing, but even in the ER, showing your patients that you respect their experience will increase trust and also give you the opportunity to learn more about their disease processes than you would if you came in with the "I'm the doctor here" kind of attitude.

Not to say there is anything wrong with your attitude, just to say, your older patients have valid reason to react to your youth.

So again, reassure with your credentials, but be honest with yourself that you're young and show humility to your older patients.
posted by latkes at 8:10 AM on September 26, 2016 [5 favorites]

I also work in healthcare, and when my patients ask me how old I am I tell them
"Old enough."
posted by ActionPopulated at 8:28 AM on September 26, 2016 [1 favorite]

Not a doctor, but I look like 20 years younger than my actual age. I say stuff like "I don't believe it either" and chalking it up to "clean living and a fat head."
posted by jenfullmoon at 8:45 AM on September 26, 2016 [1 favorite]

Yeah, this has got to be a female-skewed question, how many fresh-faced male doctors in their thirties get that question?

I'd thread the needle with: "You'd be surprised how many years I've been hearing that for-- now, lets focus on your health and get you all fixed up..."
posted by Static Vagabond at 8:49 AM on September 26, 2016 [2 favorites]

"I worked really hard to complete my medical training!"
posted by cnc at 9:13 AM on September 26, 2016

I'm 31 and in fellowship in oncology. Most of my patients place me at 25.
I was not at all nuanced in this as a resident.
Example: Third year Resident. Middle of the night, my 8th admission (and many more to go). Patient is sick as stink. Wife wants a "real doctor."
Wife: "You look too young to be a doctor."
Me: "He looks too sick to be too picky. You're welcome to decline to be covered by the resident service but to be honest, it would delay his care."

My approach is different now. I do what I can to age myself up with clothing and jewelry. I still can't afford much but I rent much of my wardrobe and for some reason, wearing dresses seems to help. I wear a nice set of pearls. Red lipstick and otherwise conservative makeup. Now when people say it, I try to approach with a little more grace than I did as a resident. Also, often when I introduce myself, I give a little background spiel about where I'm from and how I got here (training to date, etc.). That seems to quell a lot of those statements.

Also note that you need to be polite but firm - you are their doctor. I still have patients who think that it's appropriate to call me by my first name because I'm the same age as their kids. You worked hard to get here and if you address your patient as Mr. Ageist, they should at least respect your experience.
posted by honeybee413 at 9:32 AM on September 26, 2016 [3 favorites]

I think they key is to say whatever you decide to say, AND THEN MOVE THE CONVERSATION ALONG.

Don't say your thing and stop - this just gives them a chance to reply with another observation or question and then you are off down a rabbit hole about your age.
posted by CathyG at 9:36 AM on September 26, 2016

Look, it really doesn't matter. Once you get past a certain age the junior doctors - ie the doctors patients are most likely to see first and oftenest in hospital - they look like babies. That's because they are (you are) comparatively young people with a lot of responsibility. It happens with police officers too, if we're talking about the uk. Maybe think of it as your patients vocalising the fact that they are unexpectedly growing older and older, rather than that you're unexpectedly young? Patients feel vulnerable in hospital and suddenly being faced with the thought, O my god I've got old, I'm so much older than the professional here! is part of that vulnerability.
posted by glasseyes at 9:37 AM on September 26, 2016 [2 favorites]

I get misread as younger than I am. You might try:

"It runs in the family"
"It has its good points and bad points"

Or come up with some one liner about how it is one of the perks of being a doctor because it taught you to take good care of yourself. I say that because I think there is some truth to it. In my early forties, I got misread as about five to eight years younger than I was. In my late forties, after working hard on my health issues, I was getting misread as early thirties, so more like 18 years off. Taking good care of yourself makes a difference and that is a point in your favor:

"The really good doctors always look younger than they are. It's one of the perks of studying medicine. It teaches you to take good care of yourself. Now about that rash..."

(Only, ideally, it should be shorter than that. Ideally, it should be a one liner, a quip.)
posted by Michele in California at 10:04 AM on September 26, 2016 [2 favorites]

Think less about your feelings and more about your patients'. They're the ones who are sick or injured and depending on your help. Some of the suggestions here to treat them as if they're busybodies are astonishingly cruel and inappropriate.

Patients are commenting on your youth because they are scared that you don't know what you are doing. They don't care about your skin care regimen, they just want to know they're safe. They are in a vulnerable position and they DEPEND ON YOU. Just be kind and reassure them. "Don't be worried, you're in good hands, I've been practicing for years."
posted by fingersandtoes at 10:13 AM on September 26, 2016 [12 favorites]

Note, the OP does not mention his/her gender in the question.

Honestly, I think your stated strategy is great, and you should stick with it. At 30, you are in fact pretty young, though you probably aren't feeling that way (I'm about your age in a profession with a similar amount of education required, and I spend a lot of time feeling older than I have a right to). The point, of course, is that you're fully qualified to be their physician, and by referencing the years of training you've had you obliquely communicate that information without making your age a bigger deal than your patient already did. Doing so in a friendly/jokey way is good bedside manner and should help alleviate most patients' anxieties without ramping them up with a more confrontational tone.

So if this conversation typically goes something like,

"You don't look old enough to be a doctor."
"Thanks, but after eleven years of school and residency, I feel old enough to be two doctors! What brings you to see me today?"

then I think you're doing great. If you have a patient who's really persistent, then a direct approach is probably best. When they ask about your age, you know they're asking about your qualifications, so just address that:

"Seriously, how old are you?"
"I'm old enough to have completed a full course of medical training, but young enough that the latest and best medical practice is still fresh in my mind. I'm fully qualified to be your physician and help you with what brought you to the E.R. Now, what seems to be the trouble today?"

If they really can't accept this, then perhaps they really should see an older doctor, but that's their decision and they should understand that they're delaying their own care by doing so.
posted by biogeo at 10:20 AM on September 26, 2016 [2 favorites]

It's really not about you. It will start happening to you with your perceptions of other people when you're around 40 or so. I just had an opthamologist appointment with a doctor who was probably in her late twenties or early thirties and I spent most of the appointment thinking "oh my gosh, she is so YOUNG!" I'm not a jerk, so I didn't say this out loud, but it was definitely a thought that was there. I definitely agree that it's more about the patient and their own perception of themselves as getting older. It's a shock when your mental image of yourself is around 30 to meet an actual 30 year old and realize that isn't you anymore at all. (See also, when you stop getting carded by anyone. Like no one even has to guess that you're not even remotely close to your twenties anymore.) It's a big mental adjustment.

On the plus side, at least you're not the doctor I had in the hospital last year who literally looks exactly like Neil Patrick Harris. All the nurses refer to him among themselves as Doogie Howser and it's probably never going to stop until he either goes completely grey or people forget that show exists.
posted by MsMolly at 11:02 AM on September 26, 2016 [2 favorites]

I'd go with a joke, like "that's the power of sunscreen." Worst case scenario, the patient uses more sunscreen.

I'd avoid a self-deprecating joke (even though I'm in favor of them in general), or a line that jokes that you really are that young, e.g. "If you don't believe me, ask my pediatrician."

Seconding moving on immediately. This is small talk and your time is too valuable for a lot of small-talk.
posted by Sunburnt at 11:34 AM on September 26, 2016 [2 favorites]

I get this, but with my height. I tell people how tall I am. Then I move on.

Drastic solution: move to the UK. Most people go to medical school straight out of high school, so the most junior doctors are usually around 23-24. Smaller ERs overnight and you'd definitely be the oldest doctor there.
posted by Vortisaur at 12:28 PM on September 26, 2016

I was once told that medical students at a particular school were told to introduce themselves as "Dr.," so it's possible patients are concerned about your credentials. I always appreciate it when doctors don't make assumptions about what I'm thinking, so maybe ask, "Does that concern you or are you just surprised?" If they're actually concerned, you can say you've completed training, residence, and have been in practice for x years."
posted by FencingGal at 12:51 PM on September 26, 2016 [2 favorites]

Consider wearing glasses even if you don't need them, most studies say they lend authority. And I would simply say I passed my board certifications in 2015 or otherwise emphasize your credentials.
posted by theora55 at 1:08 PM on September 26, 2016

"I get that a lot. But if it makes you feel any better, I was a college student 12 years ago."
posted by yellowcandy at 8:31 PM on September 26, 2016

I'd go with a joke, like "that's the power of sunscreen."

This is brilliant.
posted by yes I said yes I will Yes at 3:37 AM on September 27, 2016

I'm not a doctor, but I get that a lot -- I get carded occasionally, and I'm 46. I usually say something like "yeah, it's the hair" (my hair is brown and the grey doesn't show, plus it's usually a mess) and move the conversation along, because I don't want to get into weird gendered conversations about appearances. It works.

Maybe you have a similar thing you can say -- one innocuous trait you can point to, to make them feel acknowledged, but that doesn't dwell on it.
posted by The corpse in the library at 10:36 AM on September 27, 2016

This was my first time posting on metafilter and many thanks for all of the very helpful responses - you have all helped me 1) have a better understanding of my patient's perspective and 2) realize the key is to say something, whatever that is, (and you have given some really great potential responses) and then move right along.
posted by 2whitehorse at 3:47 PM on September 28, 2016 [2 favorites]

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