Fielding questions of age and experience: Honesty is the best policy

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Central MessageEarly-career surgeons may encounter questions related to their age and experience. Honesty, team recognition, and patient education help build physician-patient relationships and instill confidence.See Article page 565.When is a doctor too old, and when is a doctor too young? This fascinating question was the topic of an essay in The New York Times, highlighting sharp contrasts between 2 physician colleagues who graduated from medical school more than 40 years apart.1 Written to emphasize artistically the differences between generations, the essay brings to light a very important issue: we, as physicians, will continually be questioned by patients, families, payers, and the public regarding our competency and expertise. The most famous, experienced, and esteemed surgeons may some day need to answer questions such as, “Are you still operating?” Likewise, the brightest, most talented graduates from top-tier training programs, familiar with cutting-edge techniques and bubbling over with information absorbed from wise mentors and board review books, may find themselves answering questions about their age and their readiness for independent practice. Issues surrounding the latter of these circumstances are discussed in this issue's Young Surgeon's Note by Krantz and Merritt-Genore.2In this article, Krantz and Merritt-Genore2 provide excellent advice for fielding questions related to surgeon age and experience in a professional, honest manner. Sometimes these exchanges are entirely appropriate and anticipated (“Can you tell me how many of these operations you’ve personally performed?”), whereas other comments may be out-of-line and catch the surgeon off-guard (“You’re so young and cute, you must have come straight from your high-school prom.”) Regardless of the tone or intent of the questioning, it is imperative that we, the professionals, be prepared to handle inquiries from patients, family members, and even some colleagues in a manner that will inspire confidence in our abilities. Ultimately, regardless of anyone's preconceived notions, surgeons who exude knowledge and technical expertise will likely be recognized appropriately for their skills and aptitude.Krantz and Merritt-Genore2 provide several helpful suggestions on how to handle a variety of scenarios. They give practical tips, such as being aware of your own case numbers and outcomes. Further, they offer advice on relating to patients, so that they are comforted and feel at ease with their clinician, even if first appearances may have been (fairly or unfairly) off-putting. They discuss finding common ground with your patients and their families, as well as taking the time to elaborate on issues related to the specific case. In addition, they discuss acknowledging the experience of the entire team, which not only takes the pressure off the exact quantifiable, measurable amount of the experience of the young surgeon but also—and importantly—gives credit to the multidisciplinary team members who enable your success. Not only will humility and appreciation for your team instill patient confidence, these attitudes will help build great working relationships and team loyalty. Following the recommendations from this article will simultaneously help the young surgeon impart confidence in his or her skeptics and encourage him or her to become a better doctor. Putting patients at ease by making a personal connection and educating them regarding their procedures will, one hopes, result in more patient confidence than that provided by sheer number of gray hairs on your head. Further, these communication strategies are generally just great advice for improving patient satisfaction and minimizing malpractice risk.Patient evaluations of their health care experiences are becoming increasingly important to the public and payers, and consequently more relevant to our practices.

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