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Addressing Perceptions Of Age And How They Affect Our Interactions With Patients

The question of what age a person should be considered “young” and “old” has fascinated me throughout my 27 years of podiatric practice. I have always had a diverse range of ages in my practice, treating children as young as a few months to adults in their 90s. During my personal interactions with my patients, the topic of age seems to come up frequently. This has made me realize that our perception of age affects how we think about ourselves, how we consider our patients and how our patients consider us.

   One of my first distinct school memories was as a 5-year-old child attending kindergarten in a K-6 elementary school. Being walked to school by my mother the first few days of kindergarten, I saw much bigger children who were also going to the same school. These bigger children seemed “old” to me. “They must be at least 10 years old,” I thought to myself. However, I did not feel I was “young” because I certainly wasn’t a baby anymore. I was finally going to school.

   When I was in my senior year of undergraduate college at the age of 22, anyone that was in elementary, junior high or high school was definitely “young” since they certainly couldn’t know all the things that I thought I knew and do all the things that I thought I could do. Anyone older than 30 was “old” since they seemed past their prime to me.

   Now at the age of 55, I have two grown men as sons, three grandchildren and over a quarter century of private practice under my belt. I now consider anyone who has not yet reached their 50th year as “young” and anyone who is over 60 as “old.” In addition, kindergarten-aged individuals are “babies,” college seniors are “kids,” podiatry students are “very young” and all the professors from my undergraduate college and podiatry school days are now “old.”

   Is it just me who is having these delusions about what ages define the terms “young” and “old”? I don’t think so. Our definition of the ages that define “young” and “old” tends to get older each year. People don’t define the terms “young” and “old” as an unchanging or absolute range of ages. Rather, people use the terms “young” and “old” to describe the ages of people relative to their own age. I call this theory, in which our definition of “young” and “old” increases exactly one year for every year that we age, the “theory of age relativity.”

   How might the podiatry student, podiatry resident and practicing podiatrist apply this “theory of age relativity” to help them better understand each of their patients and better understand how each of our patients perceives us as medical professionals, no matter what our ages?

   First of all, if you are in your 20s, 30s or even early 40s, don’t even start to consider calling one of your patients over the age of 50 “old.” If you do, you may immediately become “too young” and your doctor-patient relationship may immediately become very short-lived. Rather, you may try using a more indirect method of suggesting a correlation of your patient’s injury or pathology to his or her “maturity.” One might say, “Well, you know that you’re not 25 years old anymore.”

   To give you another example, I may see patients who are obviously injuring themselves by continuing to participate in aggressive sports activities during their second half-century of life. They can’t understand why they may be getting injured more frequently, even with indirect suggestions that their age may be a causative factor in their continued injuries. Sometimes a more direct analogy works to get the message across: “How many automobiles are still on the road that were built the same year you were born?”

   In all seriousness, there is no doubt that age has a significant health effect on all of us. We must, as medical professionals, find a gentle way to inform our more “mature” patients that their age may be a significant cause of their medical condition and may affect their healing rate. Age relativity means that our age relative to the age of our patients will play an important role in how we perceive our patients and how our patients perceive us as medical professionals. Use this knowledge to your advantage to make each of your patients more willing and happy participants in the successful outcomes of their treatment plans.

   Dr. Kirby is an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. He is in private practice in Sacramento, Calif.

   Dr. McCord retired in December 2008 from practice at the Centralia Medical Center in Centralia, Wash.

Kevin A. Kirby, DPM
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