{"id":2985,"date":"2020-09-17T15:43:09","date_gmt":"2020-09-17T19:43:09","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2985"},"modified":"2020-09-18T08:08:46","modified_gmt":"2020-09-18T12:08:46","slug":"whats-in-a-number","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/","title":{"rendered":"What\u2019s in a Number?"},"content":{"rendered":"
\"Sneha<\/a>

Dr. Shah is a Chief Resident in Internal Medicine at the University of Colorado.<\/p><\/div>\n

Does your doctor\u2019s age matter?<\/strong><\/h4>\n

If I had $100 for every time I walked into a patient\u2019s room, introduced myself as the doctor, and was immediately asked, \u201cHey, how old are you?\u201d I might be able to retire right now \u2014 at the age of 28. Of course, I am exaggerating, and yet this question echoes for me and my baby-faced colleagues constantly.<\/p>\n

Whether it\u2019s simple curiosity or blatant reverse-ageism<\/em>, I find this question erodes trust before it is built. I haven\u2019t yet found an agreeable way to bypass it; I usually just state my age, before quickly moving on. Rarely, some congratulate me on my accomplishments given \u201csuch a young age.\u201d But these felicitations are like writing in the sand, which quickly wash away in the waves of emotions I begin to feel the moment they ask me that question.<\/p>\n

\"\"<\/a>

“The Doctor Is In” by Joe Shlabotnik (CC BY-NC-SA 2.0)<\/p><\/div>\n

\"\"<\/a>

Courtesy of Valay Shah<\/em><\/p><\/div>\n

Why this question hits too close to home<\/strong><\/h4>\n

Even though I am the oldest child in my extended family, my traditional Indian (specifically Gujarati) family considers me to be a kid. I keep hitting milestones \u2014 16 to start driving, 18 to start voting, 21 to drink alcohol, 25 to rent a car \u2014 but I am still seated at the kids\u2019 table at home. During holidays or celebrations, I often feel left out. Too old to play with the kids and too young to gain entry into adult conversations. I attempt to walk up to a group of aunties and uncles hunched over in a hushed conversation \u2014 abridging their conversation, they turn toward me and ask, \u201cAren\u2019t you getting too old to not be married?\u201d So, I am officially too young and too old at the same time.<\/p>\n

I commiserate being in age-limbo with my brother, who shares similar sentiments. Nonetheless, there is a deep hurt that comes with never feeling trustworthy enough to hear family secrets. And, as I learned on my psychiatry rotation as a third-year student, I am using the mature coping mechanism of suppression to hide that hurt.<\/p>\n

Similarly, I start to feel untrustworthy during patient encounters where my age is brought up \u2014 no matter how knowledgeably or confidently I began that interaction.<\/p>\n

When your competency is questioned <\/strong><\/h4>\n

As new physicians, we are required to start making decisions and to start practicing<\/em> medicine. Even residents who haven\u2019t had my cultural experiences know the feeling of doubting oneself for even minor decisions. We hold the precious privilege of caring for someone\u2019s life, and mistakes can be grave. Knowing this, we double and triple check our work. Despite this, patients and colleagues continue to question us. When we are interns, they want the opinions of our seniors. When we are seniors, they want the opinions of our attendings. Even as an attending (my first time as a chief resident), a patient\u2019s wife asked whether there was \u201csomeone above me\u201d who could confirm my clinical judgment.<\/p>\n

Unlike our patients, members of our interdisciplinary team might not blatantly ask our age, but there are undercurrents of skepticism. For example, nurses will look surreptitiously toward the critical care fellow lurking behind the senior resident who is running a code before acting on the resident\u2019s requests. Pharmacists will congratulate interns for finally<\/em> placing that antibiotic order correctly. We fall victim to the experienced physicians\u2019 \u201cback in my day\u201d comments.<\/p>\n

How we can grow together<\/strong><\/h4>\n
\"Malcom<\/a>

By Source, Fair use, https:\/\/en.wikipedia.org\/w\/index.php?curid=21063227<\/p><\/div>\n

There are times when I simply want to reference this article (BMJ\u00a02017 May 16; 357:j1797)<\/a> about physician age and patient outcomes \u2014 no difference! But, I choose to remember that 3 years of residency barely surpasses the 10,000-hour rule popularized by Malcolm Gladwell<\/a>. And I am thankful for the talented and experienced healthcare providers that surround me. Countless times, an ICU nurse has whispered in my ear about which pressor to start. Pharmacists have alerted me on near-misses and helped me write the correct medication order. Nurse care managers took the time to explain the difference between Medicaid and Medicare. And, experienced physicians have taught me how to hold a patient\u2019s hand and be a guide through the toughest time in his or her life. But, currently, we lack robust evidence about how physician age affects patient outcomes. Thus, we, \u201cyoung physicians,\u201d\u00a0 will continue to double-check our work, and those around us will wonder if we have done so.<\/p>\n

Illuminating the lengthy path it takes to become a physician, a colleague jokingly replies, when asked the age question,<\/p>\n

\u201cLet\u2019s see\u2026 4 years of college, 4 years of medical school, and 3 years of residency, so I\u2019m at least 11 years old.\u201d<\/p><\/blockquote>\n

I pose the following question for our readers: How often, when boarding a plane, do we demand that the cockpit doors be opened so we can inquire about the pilots\u2019 age? We don\u2019t. We trust<\/em> that they have enough knowledge and experience to competently fly hundreds of people\u00a0 to their destination. Isn\u2019t it time we afford the same trust to all<\/em> of our physicians, regardless of their age?<\/p>\n

\"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Does your doctor\u2019s age matter? If I had $100 for every time I walked into a patient\u2019s room, introduced myself as the doctor, and was immediately asked, \u201cHey, how old are you?\u201d I might be able to retire right now \u2014 at the age of 28. Of course, I am exaggerating, and yet this question […]<\/p>\n","protected":false},"author":1306,"featured_media":2986,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[472,1453,1452,33,37],"class_list":["post-2985","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-about-residency","tag-career","tag-doctor-age","tag-physician-age","tag-reflections","tag-resident-experience"],"yoast_head":"\nWhat\u2019s in a Number? - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Shah comments on the bias against young physicians that is common among both patients and senior healthcare colleagues.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What\u2019s in a Number?\" \/>\n<meta property=\"og:description\" content=\"Dr. Shah comments on the bias against young physicians that is common among both patients and senior healthcare colleagues.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2020-09-17T19:43:09+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-09-18T12:08:46+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/09\/Medical-school-graduation.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"808\" \/>\n\t<meta property=\"og:image:height\" content=\"1009\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Sneha Shah, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Sneha Shah, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/\",\"name\":\"What\u2019s in a Number? - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2020-09-17T19:43:09+00:00\",\"dateModified\":\"2020-09-18T12:08:46+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1ffa2dd16f3542a9070d80729adb14b5\"},\"description\":\"Dr. Shah comments on the bias against young physicians that is common among both patients and senior healthcare colleagues.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/09\/whats-in-a-number\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"What\u2019s in a Number?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1ffa2dd16f3542a9070d80729adb14b5\",\"name\":\"Sneha Shah, MD\",\"description\":\"Sneha is a Chief Resident in Internal Medicine at the University of Colorado. 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