By Faye Reiff-Pasarew By Faye Reiff-Pasarew June 29 at 6:00 AM

Faye Reiff-Pasarew is an assistant professor of hospital medicine, director of the humanism in medicine program and unit medical director at the Icahn School of Medicine at Mount Sinai.

Sweetheart, youre too young to understand, my patient a man in his 60s, someone accustomed to commanding a room barked at me from his hospital bed. Medical problems had recently upended his life, and he was having a hard time adjusting. I cant believe I have to talk about this stuff to a young girl.

I hear it all the time. Though Im 34 and have been an attending physician for several years, after nearly a decade of medical training, patients routinely ask how old I am, tell me I look like a baby and, most infuriating, call me cute or adorable, as if I were a preschooler playing dress-up. A few have even asked to be seen by a real doctor instead of a girl. Its an experience thats not unique to me but familiar to many other young women in the profession. And while young men may similarly struggle to prove themselves as doctors, theyre never called sweetie.

Yes, its condescending and annoying. But this is not about being thin-skinned. My job is to provide the best possible careand to do that, I need my patients trust. Caring for them depends on their confidence in me.

Every time a doctor walks into a room, they have a professional obligation to overcome potential misgivings. I care for people whove been admitted to the hospital because something has just gone very wrong as an internist specializing in hospital medicine, I deal with everything from heart attacks to potentially life-threatening infections and they need medical interventions right away. I dont have the luxury of time during multiple office visits to earn their trust. Any delay can be dangerous. We cant afford nor can our patients for our recommendations to be taken with a grain of salt.

[Telling women to apologize less isnt about empowerment. Its about shame.]

Case in point: Last year on a flight from Detroit to Minneapolis, a passenger became unresponsive, and flight attendants called for medical help. But according to passenger Tamika Cross, a young African American obstetrician, when she offered to assist, she was told: Oh no sweetie put [your] hand down, and we are looking for actual physicians or nurses. Eventually, another doctor, an older white man, was allowed to help. Cross said she was waved off because she didnt fit the flight attendants description of a doctor.

The problem here apart from race and gender stereotyping is that when a physician treats a patient in an emergency, every minute counts. And it raises the question: what did even the presumably short delay cost the sick passenger? If the older white male doctor hadnt been on board, would Dr. Cross have been permitted to try to save the passengers life?

Just last week, a woman at a medical facility in Canada was recorded saying, Can I see a doctor please thats white, that doesnt have brown teeth, that speaks English? The video went viral and the episode, appropriately, prompted outrage, but women and people of color in the medical profession arent shocked.

These patient biases have been well documented, and are unfortunately reinforced by the healthcare system. Even though studies have shown that female providers produce lower mortality rates among older patients and are more patient-centered than men, our effectiveness is not reflected in patient satisfaction scores that wind up influencing doctor compensation: Female doctors earn 74 percent of what male physicians do. Even in the relatively new field of hospital medicine, which skews younger and closer to even on gender, women are still underrepresented in leadership positions and scholarship.

Physicians today are encouraged to navigate these difficult interactions with humility and empathy sit at the bedside, listen without interrupting and avoid giving orders. At the same time, female doctors are encouraged to exude confidence and assertiveness, to demand the respect were not always initially given. This is a tricky balance. If my patient calls me nurse, I have to clarify my role, refocus the conversation on the medical situation and yet not undermining our delicate rapport.

Ive focused my career on trying to foster humanism in medicine. That includes using poetry to teach medical students about diagnosing cancer; podcasting about art and illness; creating resources for caregivers and inviting patients to speak at grand rounds. Ive come of age influenced by narrative medicine, engaging with patients through their stories. But my belief in embracing patient perspectives sometimes runs up against my sense of social justice. When patients belittle me, even unintentionally, I grapple with respecting their narrative and maintaining respect for myself.

[The word adulting is gross. Its also sexist.]

Should I, and other women physicians, continue our patient-centered approach and hope the arc of history bends towards gender equity? Or do we have to train ourselves to project confidence in a way that doesnt threaten male patients or undermine our inclination to be less authoritative than our medical predecessors? Either way, we need to ask our institutions medical schools, hospitals and private practice groups to stand behind us, acknowledge the realities we face and work with us to find solutions. That might mean featuring female doctors in ad campaigns; providing sufficient gender-neutral parental leave so young women are not disadvantaged at the start of their careers; or tailoring the medical school curriculum to include practical strategies for female physicians to respond to demeaning language and to communicate with both confidence and empathy.

What it definitely means is that patients should understand that our ability to effectively direct their treatment is in their interest.

The day after my sexagenarian patient decried having to deal with a young girl, he introduced me to his wife as the young nurse. I briefly corrected him, introduced myself again as his physician and then sat and listened to his story because, ultimately, that is my job. I tried to understand how this unexpected illness had led to his feeling a loss of control and vulnerability. I saw how that might make him feel defensive. I cant brush aside demeaning language, but I can understand what motivates it. I can find a way to empathize with patients who are suffering, even when they offend me. And, hopefully, I may eventually change my patients ideas about what a real doctor is.

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I'm a young, female doctor. Calling me 'sweetie' won't help me save your life. - Washington Post