Monday, January 23, 2012
Patient comments about my age
I have gotten some interesting comments from patients regarding my age.
When I was a medical student, patients thought I was in high school. When I was a resident, patients thought I was a college student. Now, as an attending over five years out of residency, I get comments like "you sure know a lot for someone so young," well-intended compliments meant toward the resident I apparently appear to be.
An enviable problem to have, right? Except I would like my patients' initial impression of me to be "professional and competent," not "nice and young." I fear that patients will not trust me to manage their care if they think I'm so inexperienced. I want them to have confidence in the recommendations I give them and the decisions we make together. I have to admit, too, that a part of me wants my current station on the top of the medical training ladder to be acknowledged.
I wish it wasn't so, but it's true: I need my patients' affirmation as much as they may be looking for mine. I'm ashamed of that confession; patients' duties should not include validating my insecurities. I suspect, though, that I am not alone in constantly worrying about whether I am doing my best for my patients.
It's not so easy to evaluate your performance as a doctor, either. No one is directly evaluating us, and the popular markers of success - productivity, income, government ratings - don't reflect the bulk of what our care with patients truly involves. Patient satisfaction scores only go so far, since disgruntled patients can result when we correctly turn down unreasonable requests. Quality improvement measures are a step in the right direction (1) but still don't answer the basic question: "did I follow the best path for this patient?"
It's all too easy to fall back on those numbers and patient affirmations to judge myself. They each have their place in the overall picture of my practice, but I've got to center my focus on patient care where it belongs.
Just like the responsible 36-year-old I am.