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How Do Patients See Me? Impact of Age and Gender

June 30, 2021

Written by Clay Smith

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Younger patients may perceive older anesthesiologists as more confident and intelligent. Female anesthesiologists may be perceived as more confident and more likely to be recommended to patients’ family members than males, but only in a subgroup of white patients.

Why does this matter?
Patients used to say to me every shift, “OMG! How old are yoouuu?” Ok, first of all, didn’t everyone’s mom tell them to never, under any circumstance, ask that question? Second, I’m now a little bummed because I haven’t heard a patient say that in years. Age, gravity, and donuts are apparently “doing their thing” on me…alas. Anyway, patients have biases that impact the way they view us as physicians. How does age and sex impact the way patients view us?

“How old are yooouu?”
This was a study of 300 pre-op patients who viewed 4 different 90-second video clips in random order, with actors playing the part of anesthesiologists – an older female, older male, younger female, or younger male – controlling as best they could for body language, posture, tone, etc, in order to to convey confidence while reciting the same script describing general anesthesia and associated risks. Patients were asked to rank each anesthesiologist for perceived confidence, intelligence, likelihood of choosing them to care for their family member, and to pick the one who seemed most like a leader. On the whole, this was a negative study. There was no statistical difference in age or sex among all patients in perceived confidence, intelligence, or likelihood to recommend. However, they noted some hypothesis-generating findings when analyzing subgroups. Among patients <65 years old, the older anesthesiologists were ranked as more confident, intelligent, and likely to be a leader, but there was no age preference among patients >65 years old. Female anesthesiologists were viewed as more confident and more likely to be recommended to family members than males among white patients but not non-white patients. In this study, all actors were white. The authors are looking at the impact of race in a subsequent study. So, what do we do with this information? First of all, it was a negative study, and findings in subgroups may be due to chance. That said, what we face in bias, we may be able to shore up with empathy, compassion, genuine kindness, and actual (not just perceived) smarts. I would remind us all, however, that we don’t have to use big words to make ourselves appear smart. I love this quote from Vala Afshar, “Smart people use simple language.” Also, as simple and vain as it may sound, physician attire also impacts patient perception as does something far more important – cultural competency. All that said, we should remind ourselves not overcompensate in any area. Patients can tell if you know what you’re talking about, if you really care about them, and if you’re comfortable in your own skin. That alone will overcome a lot of bias.

Anesthesiologist Age and Sex Influence Patient Perceptions of Physician Competence. Anesthesiology. 2021 Jan 1;134(1):103-110. doi: 10.1097/ALN.0000000000003595.es