What if you don't look the part?

[Lola]

This at first might sound like a fairly shallow topic and some of you might even bite at me for this one, but for some reason I think there's some validity to it. Do you think that looking the part is important for patient compliance and trust. Let me explain, if you work in dermatology does it help to have really good skin? If you work at a weight loss clinic, does it help to not be overweight? If you work in women's health does it help to be a woman?Now I know that there is no correlation between looks/gender and ability to properly treat a patient, I just wonder if some patients react/comply differently based on what the person who is treating looks like. What are your thoughts? Have you ever heard/experienced something similar?

[rev ronin]

I think having graying temples is awesome.  I wouldn't dye my hair to rid myself of them for anything.  I have never once been asked when the real doctor was coming in, nor if I was a nurse... I do get questioned when I am going to finish up and become a full doctor, but that's about it.

 

Medicine is one area where there still is some respect for apparent age.

[CAAdmission]

My old family doctor was fat, unkempt and the best diagnostician I have seen to date.

[newton9686]

We have a student in our class in his late 40s, early 50s. He was shadowing in the ER and was mistaken by the paramedic as the doc. The paramedic handed him the chart and gave him his verbal report on the patient. Our student just sat their and listened intently while he read the EKG. The paramedic finished and asked what he wanted to do. He said, I don't know, I'm just shadowing, the doc is over there. The paramedic ripped the EKG away and stomped off. It really is true, we as a society equate 40 to 60 year olds as being your typical docs. I can't wait to see how people react to me in practice given I'm only 25 with a baby face and an inability to grow any respectable facial hair.  Point of the story is patients and healthcare professionals alike absolutely make assumptions based on appearance.

[sk732]

People, especially some of the moldier one's, don't believe me when I tell them I'm the wrong side of 45, have 30 years of army time under my belt and that I'm collecting a pension.  I have a lot of grey hair, just tend to keep it really short so folks don't notice. 

 

I do believe that people take you a bit more seriously if you look some of the part - not like you're Doogie Houser for instance - but also in reasonable shape, not caught smoking out back, that sort of thing.  It's made me take a look at myself as well - one of the principles of leadership (old school one's - not the "management" BS one's) is lead by example.  It's pretty hard to look someone in the eye and tell them they've got Fat Bastard Syndrome and need to watch their weight, exercise, etc when you yourself are a mirror image.  You don't need to look like a super model, but a realistic expectation of what you want out of your patients.  When I was in family med in a teeny tiny little town, I made sure people saw me out walking daily on my lunch breaks, or out hiking around the area, or running in town, etc.  It's little things like that that make people stop and think for a second.

 

$0.02 Cdn

 

SK

[BruceBanner]

I think in general patients (especially patients over 50) tend to see male providers and providers over 40 as more authoritative and competent. Just my experience. They all think I'm a doctor until told otherwise. I'm 34.

 

Being in visible shape helps, because your average sedentary or overweight patient notices this and will say "wow, you must work out every day", or "gee, you're making me feel guilty for not getting back to the gym!"

 

They will also ask you for fitness advice.

 

I will say I almost never get female physicals anymore because the call center gives them the option of seeing a male or female.

 

I think having "good skin" in derm is just vain, although if you are covered in zits they may wonder what's up with you.

 

In general, PA programs screen for clean cut people pretty well, and they pound the "professionalism" thing in to your head for 2 years.

[Reality Check 2]

I am what I prefer to call well upholstered - fighting the battle.

 

I am slowly winning. I try to use that to relate to my patients and help them understand it is easier said than done. We talk about what works and what doesn't and the roadblocks or road bumps - growing up with emotional eaters and grandparents from the Depression who told us to clean our plates - starving kids in _______________ (insert country of concern).

 

While in school years ago - I was often called the nurse by patients, staff, etc. Despite name tag and introductions. A very sexist assumption that I was female therefore nurse and not PA or MD student. It drove me crazy. I was raised by a houseful of nurses - male and female. 

 

Older patients often still don't know what a PA is. Anyone military knows what a PA is and usually no problems. 

 

Over the years, the gray hairs have helped as some folks see maturity as being equal to wisdom or experience. I don't cover my gray. I have earned every stinking one of them - can name them after kids, husband and dogs, etc.

 

I try to instill confidence in all my patients by helping them and explaining things in a way they understand. That helps most.

 

To me - I am real. Not Barbie or June Cleaver. I am fluffy and working on it. I stay active. I know about food choices and cravings.

 

I think you have to look the part as a professional - not necessarily pretty or shiny. Derm likes shinier people and, yes, good skin helps. Cosmetic Plastics and Derm REALLY likes pretty. 

 

Most important to me is relating to patients. 

 

In Family Practice - I dress nice but not pretentious. I don't wear a white coat. I have a name tag. My patients are comfortable with our surroundings in the office and how we dress. We tend to look like them. 

 

So, yes, looking professional is important. Exuding confidence and intelligence will shine through whether one is in scrubs or slacks and tie or whatever. I wouldn't hire someone based on Barbie or Ken qualities. I like brains. Brains can be pretty or average - whatever works.

[ventana]

I noticed I have to explain less what a PA is when my hair turned grey and I broke 40....

 

not sure if it was looking the part, or acting the part...  probably both

[sk732]

When I get American patients up from the US, I don't need to explain PA too much to them...yocals here are still getting used to us.

[cbrsmurf]

Patients definitely have an impression of you based on gender, height, appearance, eloquence, race, fitness, title etc etc.  Patients are human beings and EVERYONE have prejudices, preconceived notions, etc.  Not everyone lets it affect their judgement, but many do to a different extent.  

 

I have my own prejudices in medicine/health.  I would rather have a general pediatrician who has kids of their own.  I would rather have a personal trainer who is fit.  I'd rather have a medical student who doesn't yawn in the room with a patient even if they are super tired (holy f-balls that is a pet peeve of mine)

[Lauren R]

I think inevitably there is some degree of initial bias from first impressions, but that is everywhere you go no matter what you're doing.  Most of the time, if you're good at what you do, you'll get the respect you deserve from your patients and coworkers.

 

I am a young looking, blonde female and sometimes people think I don't belong when they first see me.  I usually shrug off their comments and proceed to make it very clear that I will be their primary caregiver during their hospitalization and I know my stuff like the back of my hand.  I have to work a little harder than my male, graying co workers to be taken seriously, but at the end of the day, I get of a lot of respect despite first impressions.  I think anyone can do that. 

[Z PA-C]

I am a petite asian female. I was once denied a sample at Costco because "my parents weren't there". I will probably look "too young" to practice medicine for much longer than I like to think about. The thing is, your appearance is your appearance but confidence level is adjustable. On rotations, I went in there introduced myself, took care of the patient, and owned everything I said and did. At the end of the visit, the patient said "wait you're a student?...you don't seem like a student to me". That is how you can overcome the perception.

[UGoLong]

It is not surprising that people make snap judgments based on their initial impressions, including how you look, dress, and talk. There is some advantage to being older (I am), but I've also seen young women do a great job. It can take work...

 

A 25 year-old-female PA in our office asked for 9-1-1 to be called to have a patient transported to the ED. The medic crew -- made up of three macho guys -- came in and gave her a hard time. She eventually got done what she wanted done. Afterwards, we had a talk. As a medic myself, I told her that she had to take charge of the situation and be assertive. 

 

A few weeks later, she told me that she had called 9-1-1 again. I asked if she wanted help, but she said that she could handle it. OK I said and went back to my area. A bit later I asked one of the MAs how it went. She said, "I almost felt sorry for the medics. They were 'yes maaming' all over the place." I asked the PA how it went. She smiled, and said "Fine."

 

Lesson learned. Younger women can be at a disadvantage sometimes, but with a little polite yet assertive behavior, the world will come to respect them.

 

If you are a young woman (and I'm not), learn some lessons from some of your older sisters. Talking with my wife and daughter, I gather that the same sort of thing happens in many work environments.

[Strohmboli]

I'm a ER tech and came in to work on a day off to check schedule, talk to dept. mgr, etc. I had scrubs on bottom and a patagonia pull over on top... I quickly stepped into a room to help FD transfer a possible stroke patient to our bed as no other Techs/nurses were in there yet. Neuro came in as we finished transferring the patient and thought I was the ED resident taking care of the patient, presumably due to my age (mid 20s), gender (male) and my stereotypical ER Resident dress. He was surprised to learn that not only was I not a MD, I wasn't even working at the moment, just lending a quick hand. 

[AliB]

It will be, um, interesting? to see what happens in clinicals ... at present (by people outside the program), I get mistaken for faculty here in my didactic year.  :)  I don't have any gray hair (yet!), but I don't look twenty-something either!  Maybe I should get a really cool ball-cap that's custom engraved with "student" (maybe with some bling!) across the front and back!  That will keep my long hair tucked back and away, too!  

 

As has been shared already, pretty much EVERYONE makes initial assessments based on appearances.  I do it; I know I do it.  One of the clinics where I worked part-time, I knew there was a female MD on the dozen or so physician staff.  I was working with 3 of the MDs and one NP (side note:  this NP was about 4'10", looked about 17 - she ALWAYS wore black slacks and her white coat so that her attire conveyed that she was a clinician ... side side note:  she didn't wear a long coat as she would have looked like she was playing dress up!).  It was probably 6 months before I realized that the slovenly dressed (as in her hair was sloppily secured in a pony tail, no make-up of any sort, always in rumpled and faded scrubs) woman that I occasionally saw in passing was the one female MD.  The nursing, MA, and reception staff presented a more professional appearance!  

 

After that first impression, I agree with other comments made.  A lot depends on whether you "practice what you preach".  A clinician can set precedent with their patient by example ... or by empathy ("I too struggle with my weight/smoking/skin condition, but I'm working on it; you can too -- though I would avoid that with anything that could be a confidence-killer like substance abuse!  ).  A lot depends, too, on the PATIENT's prior experiences and personal bias - and those aren't necessarily something you can plan for and address in advance.  

[Statko]

I think this all depends on the setting and diagnosis/severity of what the patient is presenting with. If I show up to the ER with crushing chest pain, I really don't care if the doc taking care of me just had a cigarette and put down his donut before coming in to take care of me.  If I go to the ENT to be worked up for allergies and I see a Tinkerbell tattoo on my PA's arm, I might give that a second look and wonder why she doesn't wear 3/4 sleeves. If I have the luxury of choosing a primary care provider, I would care more about having an empathetic, careful listener and superior diagnostician than someone who is a certain BMI or meets other outwardly judgements of health.

 

I do notice that I have a certain bias and seek providers - male or female - who are in their mid-40's. I think this is because I assume they're not green anymore but aren't so burned out yet that they'll still probably read JAMA and keep their skills up. I know, I know... this is a terrible judgment/assumption to make, but I've noticed it's my tendency. Perhaps I perceive that I've gotten the best care from providers that fit this demo. (?)

 

As other posters have mentioned, how one carries him/herself tends to reverse whatever snap or initial judgements a patient makes based on age, looks, ethnicity, etc. Confidence, relatability, and clinical effectiveness trumps everything else - because in the end, it's about them (the patient) rather than you (the clinician).

[weezianna]

Post deleted, entered in error