It is March, and madness seems to be in the air. As this piece is being typed, The University of South Carolina has just advanced into the final four of the NCAA basketball tournament – which is, of course, big news here in South Carolina. Also, I sit in my office, wearing extremely bright red scrubs (below). Why, you might ask? Well, let’s just say that my team lost, and there are consequences for losing.
 Considering my current attire, it is particularly ironic that this morning I came upon a recently published article from the researchers at the University of Michigan. They have reported upon perceptions of physicians based on their attire. The paper, published in British Medical Journal Open, was based upon a comprehensive review of 30 studies on physician attire involving 11,533 adult patients in 14 countries.
Upon analysis of the available data, the researchers found that people prefer their physicians to dress on the formal side – and definitely not in casual wear. Doctors of either gender, in suits or a white coat, are more likely to inspire trust and confidence. Twenty-one of the 30 studies found that patients expressed clear preferences about what they felt doctors should wear or said that physician attire affected their perceptions of a physician. In 18 of those studies, formal attire or a white coat was the preferred attire. Interestingly, patients’ interacting with physicians in emergency, surgical or critical care scenarios demonstrated less bias towards formal clothing. Researchers discovered that in four of the seven studies that involved surgery patients, they reported that attire choice didn’t matter or that scrubs were preferred.
This data suggests that a “one-size-fits-all” approach to physician attire does not adequately cover patient perceptions, which ultimately directs a patient’s sense of satisfaction. This sense of patient satisfaction is of increasing consequence as CG-CAPS and H-CAPS Scores become increasingly influential in how hospitals and physicians are paid by CMS. Clearly, the influence that a patient’s sensitivity toward a clinician’s attire as a generalized marker of that clinician’s overall knowledge, caring, and professionalism will become increasingly important.
Currently, the authors are preparing to launch their own international study of the impact of physician clothing choices, under the name “Targeting Attire to Improve Likelihood of Rapport” or TAILOR. In this prospective study, the researchers hope to quantify how patients’ views of physicians change based on what they’re wearing and where they’re providing care. The team will also evaluate how attire might affect patients’ trust in a clinician’s plan of care.
Throughout my training and into clinical practice, I have observed – and participated – in a variety of different means of dressing to go to work in the hospital. I have had attending physicians opine on the merits of formal clinic clothes as the most appropriate clinician attire. Still others have advocated scrubs as we are an increasingly surgical specialty. Interestingly, in reviewing this article, it seems that we, as podiatric surgeons, would best fit somewhere in the middle – between formal clinic attire and scrubs. Personally, I try to wear more formal clinic clothes (bow-tie, white coat, etc) during my clinical days and scrubs on OR days. However, it doesn’t always work out that way. There will certainly be regional and cultural differences which further impact the patient’s perceptions of clinician attire. It is important to consider these factors as you face yourself in the mirror every morning. As for me, today, I’m not sure what my patient’s will think of my red scrubs – when in doubt a subtly placed “Go Carolina” will probably smooth any ruffled feathers.
I would encourage you to share your experiences and insights on the e-Talk on this topic at PRESENT Podiatry — We love hearing from you. Follow the link and take our poll regarding the clothes that you favor in the clinic setting.
All opinions expressed are my own and do not necessarily reflect those of my employer.
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