Patients are more likely to have trust and confidence in doctors who are wearing either suits or white coats, compared to those in casual attire, according to a new analysis by the University of Michigan Health System.
The exception is during an emergency situation, however, in which case clothes don’t seem to matter very much.
The researchers also found that age and culture makes a difference in how a person feels about a doctor’s attire. In general, Europeans and Asians of any age, and Americans over age 50, trusted a formally dressed doctor more, while Americans in Generation X and Y tended to be more accepting of casually dressed doctors.
Lead author Christopher Petrilli, M.D., an internal medicine resident at the University of Michigan Health System who worked in the sharp-dressed world of investment banking before switching to medicine, says the study grew out of his conversations with senior physicians, including senior author Vineet Chopra, M.D., M.Sc., and co-author Sanjay Saint, M.D., M.P.H.
“As physicians, we want to make sure that we’re dressing in a way that reflects a level of professionalism and also mindful of patients’ preferences,” said Petrilli.
“Many studies have looked at various aspects of physician attire, so we wanted to look across this body of literature to find common threads. But at the same time, we found a lack of detailed guidance from top hospitals to their physicians about how to dress.”
The findings were compiled from a comprehensive international review of 30 studies on physician attire, involving 11,533 adult patients in 14 countries. Overall, 21 of the 30 studies showed that patients had 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.
In four of the seven studies that involved surgery patients, however, attire choice didn’t matter or scrubs were preferred. The was also true in four of five studies that involved patients receiving emergency care or intensive care.
“In order to better tailor physician attire to patient preferences and improve available evidence, we would recommend that health care systems capture the ‘voice of the customer’ in individual care locations, such as intensive care units and emergency departments,” said Chopra.
The team is currently preparing to launch their own international study on the impact of physician clothing choices, under the name “Targeting Attire to Improve Likelihood of Rapport” or TAILOR.
They want to find out whether patients’ views of physicians change based on what they’re wearing or where they’re providing care. The team will also investigate how clothing might affect patients’ trust in what that doctor says or recommends.
The upcoming study will survey patients in outpatient general medicine and specialty clinic waiting rooms and inpatient medical units. Hospitals in three countries have signed on to participate, making it the largest such study of its kind.
While pediatric patients and their parents will not be included, the researchers note that this is another area ripe for research.
“Everything is supposed to be evidence-based in medicine,” said Petrilli. “With this review and our new study, we can provide compelling evidence to influence the way physicians dress.”
The analysis is published in the journal British Medical Journal Open.