Ditch the white coat? How doctors should dress if they want patients' respect

Keep scrubs to ED, OR settings, patients say

Research suggests that patients prefer their physicians change their outfits based on the setting of their conversation or experience, Vineet Chopra and Sanjay Saint write in The Conversation.

Attire not top-of-mind for most docs

Although doctors are taught to steer clear of judging a patient upon first meeting to avoid biased opinions or incorrect diagnoses, they rarely think about patients' first impressions of them, according to Chopra, an assistant professor of internal medicine at the University of Michigan (UM), and Saint, a UM internal medicine professor.

An informal survey of medical students at UM found that more than 50% believed that how a doctor dresses could influence patients' opinions of him or her. But just two of the 30 students surveyed said they thought about their dress when caring for patients.

Moreover, many hospitals do not have stringent guidelines on what doctors should wear—only recommending a "professional" dress code, often without actually defining what constitutes such dress.  

Patients prefer setting-dependent dress

Chopra and Saint recently conducted a review of more than 30 studies examining how patients viewed physicians' attire.

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Twenty-one studies found patients had a strong general opinion about what physicians wore, while in 18 of the studies, patients strongly preferred their doctors dress in formal clothing and wear a white coat. 

Specifically, the review yielded three main findings:

  • Older patients and those from Europe or Asia reported higher patient satisfaction when their physicians dressed in formal attire;
  • Patients tend to prefer their physicians wear scrubs in the more "hands-on" settings of the ICU, ED, and OR;  and
  • Patients generally viewed doctors who wore scrubs in doctors' offices or outpatient settings unfavorably.

And a recent MedPage Today survey of more than 2,000 patients and doctors found that more than 60% of respondents believed doctors should wear white coats. Just 30% of doctors said they had no opinion on physician attire, or preferred that their doctors wear scrubs or dress casually.

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What to wear

According to Chopra and Saint, there is no "one size fits all" solution for doctor dress, given that the context for patient interactions plays such a significant role. The researchers have launched a more comprehensive study on physician dress code to better determine what patients want when it comes to what doctors wear.

Until those results are in, Chopra and Saint recommend men dress in formal attire with long-sleeved shirts and ties and women don business professional attire in non-ED and non-OR settings. They also contend this attire should be worn even on weekends and non-typical business hours when physicians are working, as "patients and their expectations remain unchanged, regardless of hour or day."

And, they conclude, "regardless of the occasion, flip-flops, showy jewelry, or jeans simply don't belong in a hospital" (Chopra/Saint, The Conversation, 7/2).

The takeaway: Research suggests patients see formal attire as appropriate dress for physicians working in doctors' offices and outpatient settings, and say scrubs should be saved for the OR, ED, and ICU.


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