Have you ever seen your patient distracted by your clothes or a tattoo, perhaps? Could there be any implications of what you wear, how you come across on the way patients perceive you and your treatment? Will that white coat make any difference to their thinking? If these questions make you curious, read on to find answers.

Statistics first!

A study was published in BMJ Open in May 2018, which aimed at understanding if a physician’s attire can influence the patient in any way and if it impacts the patient experience. By far the largest, it involved a cross-section of patients from across 10 academic hospitals in the USA.

A questionnaire with photos of male and female physicians wearing seven types of attire was prepared and patients were asked to rate the photos in terms of their perception of the physician’s knowledge, trustworthiness, care, approachability and comfort. The responses were measured using a standard instrument and the outcomes were recorded as under:

• 53% respondents admitted that a physician’s attire was important to them during consultation
• More than 33% agreed that the attire did influence the level of satisfaction with respect to care
• Of all forms of attire, formal attire with a white coat had the highest rating

The study concluded that the expectations and perceptions of patients highly depend upon the physician’s attire and the same varies by context and region. Hence, through this study, BMJ reported that highly nuanced policies pertaining to dress code for physicians can improve the level of patient satisfaction with care.

In an article published in NEJM Catalyst in July 2016, Griffin Myers from Oak Street Health points out an evidence-based conclusion for a physician’s dress code. He states that literature for internal medicine, dermatology and family medicine, all suggest that patients lean towards a professional attire, which would mean business casuals, with or without a tie and with a white coat.

MAMC Journal of Medical Science published a study for India in August 2018, titled 'Patients Preference for Doctor Attire in an Outpatient Department of a Government Hospital in New Delhi, India'. The study was aimed at identifying the preferences of patients for selected doctor attire in outpatient department (OPD) setting of a government hospital.

A qualitative research was done with patients from a specific demographic group, for select department visited, for the use of aprons or white doctor coat by the attending doctor. The results were as under:

• Close to 72% of the patients preferred to see their doctor wearing his or her coat
• About 27% of the patients showed indifference towards the white coat, although,
• 42.3% of the patients wanted to see a male doctor dressed in a professional formal attire and 40.9% of the patients wanted the male doctor in a professional informal attire
• As for female doctors, 38.7% of patients preferred a professional formal attire and 37.5% of them preferred professional informal attire

The report concluded that doctors wearing casuals was not preferred by patients. The majority of patients in OPD preferred to see their doctor formally dressed, with an apron on. Clearly, this is an important note for practicing clinicians and hospitals for reviewing their dress code policies.

But what about body art? Where does that stand in the matter of dress code?

A study published in BMJ’s Emergency Medicine in August 2018 reported patients’ indifference to tattoos and body piercings on physicians and no impact on their perception of a physician’s competence, professionalism, the ability to provide care, approachability, trustworthiness or reliability. These results were reflected for more than 75% of the time, in all domains that were assessed for the study.

It is possible that the patients were either open-minded about body art, considering it is quite a common thing to see on many adults these days, or perhaps, they themselves had been sporting one of the forms of body art.