Looks do matter—patients claim what doctors wear is important

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No white coat? Patients may prefer it?

According to a study published in BMJ Open, just over half of patients think what a doctor wears is important and more than a third claim that their doctor’s attire influences the satisfaction they have with the care that they receive.

In the study, Christopher Petrilli (University of Michigan Medical School, Ann Arbor, USA) and colleagues asked 4,000 patients (from clinics and hospitals from 10 major medical centres) to look at pictures of male and female physicians in seven different forms of attire, and to think of them in both inpatient and outpatient clinical settings. For each photo, patients had to rate the providers on how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the attire made the patient feel. The options were:

  • Casual: Short-sleeved collared shirt and jeans with tennis shoes, with or without white coat
  • Scrubs: Blue short-sleeved scrub top and trousers, with or without white coat
  • Formal: Light blue long-sleeved dress shirt and navy blue suit trousers, with or without white coat, with black leather shoes with one-inch heels for women and black leather shoes for men, and a dark blue tie for men
  • Business suit: Navy blue jacket and pants with the same dress shirt, tie and shoes as in the “formal” option, no white coat
  • Formal attire with a white coat got the highest score on the composite of five measures, and was especially popular with people over age 65. It was followed by scrubs with a white coat, and formal attire without a white coat.

Overall, just over half said that what physicians wear is important to them and more than one-third said that what a doctor wears influences their satisfaction with their care. When asked directly what they thought their own doctors should wear, 44% said the formal attire with white coat, and 26% said scrubs with a white coat. When asked what they would prefer surgeons and emergency physicians wear, scrubs alone got 34% of the vote, followed by scrubs with a white coat with 23%.

The results were largely the same for physicians of either gender—except for male surgeons. Patients tended to prefer that male surgeons go with formal wear, without a white coat.

Additionally, 62% agreed or strongly agreed that when seeing patients in the hospital, doctors should wear a white coat, and 55% said the same for doctors seeing patients in an office setting. The percentage preferring a white coat fell to 44% for emergency physicians.

Though the surveys were conducted during business hours on weekdays, the researchers asked patients what they thought doctors should wear when seeing patients on weekends. In this case, 44% said the short-sleeved outfit with jeans was appropriate, though 56% were neutral or disapproved of such a look even on weekends.

Petrilli comments: “Professional dress on Wall Street, law and nearly every other industry is relatively clear—and it typically mirrors what applicants would wear to their job interview. In medicine, the dress code is quite heterogeneous, but as physicians we should make sure that our attire reflects a certain level of professionalism that is also mindful of patients’ preferences.”

Based on their findings, Petrilli et al are calling for more hospitals, health systems and practice groups to look at their dress standards for physicians, or create them if they do not already have one.

“Patients appear to care about attire and may expect to see their doctor in certain ways. Which may explain why even white lab coats received a high rating for ‘approachability’—patients may see a white coat similar to a physician’s ‘uniform’ and may similarly also expect formal attire in most settings. Patients don’t always have the opportunity to choose their doctor. In this era of appropriately increased focus on patient centredness and satisfaction, physician attire may be an important, easily modifiable component of the patient care experience,” says Petrilli.

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