fantasty

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What to wear today? Effect of doctor’s attire on the trust and confidence of patients

Shakaib U. Rehman, MD,a,Paul J. Nietert, PhD,Dennis W. Cope, MD,
Anne Osborne Kilpatrick, DPA

The American Journal of Medicine (2005) 118, 1279-1286

ABSTRACT
PURPOSE: There are very few studies about the impact of physicians’ attire on patients’ confidence and trust. The objective of this study was to determine whether the way a doctor dresses is an important factor in the degree of trust and confidence among respondents.
METHODS: A cross-sectional descriptive study using survey methodology was conducted of patients and visitors in the waiting room of an internal medicine outpatient clinic. Respondents completed a written survey after reviewing pictures of physicians in four different dress styles. Respondents were asked questions related to their preference for physician dress as well as their trust and willingness to discuss sensitive issues.
RESULTS: Four hundred respondents with a mean age of 52.4 years were enrolled; 54% were men, 58% were white, 38% were African-American, and 43% had greater than a high school diploma. On all questions regarding physician dress style preferences, respondents significantly favored the professional attire with white coat (76.3%, P <.0001), followed by surgical scrubs (10.2%), business dress (8.8%), and casual dress (4.7%). Their trust and confidence was significantly associated with their preference for professional dress (P <.0001). Respondents also reported that they were significantly more willing to share their social, sexual, and psychological problems with the physician who is professionally dressed (P <.0001). The importance of physician’s appearance was ranked similarly between male and
female respondents (P = .54); however, female physicians’ dress appeared to be significantly more important to respondents than male physicians’ dress (P < .001).
CONCLUSION: Respondents overwhelmingly favor physicians in professional attire with a white coat. Wearing professional dress (ie, a white coat with more formal attire) while providing patient care by physicians may favorably influence trust and confidence-building in the medical encounter.
 

Southpawz

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Link to full article?

[edit]

It doesn't really matter over here in Ireland, as they'll probably kick you out of the hospital if you wern't dressed appropriately (shirt + tie + white coat for guys) ... at least they do for students :luck:
 
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f_w

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It illustrates the problem that n=1 doesn't make research. They surveyed patients in 1 waiting room (of a physician who probably wears a white coat).

If you surveyed the patients in a rural FPs office, 90% would point to the doc in corduroys and flannel shirt as the 'most trustworthy'. If you surveyed the waiting room of a oncologic surgeon, they would point to the guy in scrubs.
 

BaylorGuy

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f_w said:
It illustrates the problem that n=1 doesn't make research. They surveyed patients in 1 waiting room (of a physician who probably wears a white coat).

If you surveyed the patients in a rural FPs office, 90% would point to the doc in corduroys and flannel shirt as the 'most trustworthy. If you surveyed the waiting room of a oncologic surgeon, they would point to the guy in scrubs.
I'd have to agree here...while the research does show some insight into what dress is most important on a physician, there are a number of limitations directly and indirectly related to using only 1 internal medicine outpatient clinic. (hospital, urban setting, rural setting, not internal medicine, etc.). However, good study overall...needs to be taken further
 

Bobblehead

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Interesting study. A couple of points:

1. It was conducted in a VA. By their own admission the female respondents may not be patients. Anyone that's worked in a VA understands why (mostly male patients, especially among the older vets although there are more female patients nowadays). Non-scientifically I can tell you that VA patients do not behave like non-VA patients. Something about the military enables them to not only tolerate a lot more pathology but also put up with a lot more bureaucratic runaround than others.

2. The locale was in South Carolina. There is a question of generalizability beyond that particular state or region of the country. The authors admitted this limitation in their discussion.

3. It was done in an internal medicine outpatient setting. This result may or may not be generalizable to subspecialty practices where you are sent from your PCP to someone for a subspecialty referral.

3. There was no business casual option (slacks, shirt, no tie) with or without a white coat which would seem a much more reasonable choice than jeans and a T-shirt or a short skirt.

4. It would have been interesting to have performed a repeat survey comparing how the responses varied and adjusting for the attire of the physician the respondent actually saw although this would have likely made the study much more difficult. It would also require a degree of physician cooperation in their attire.
 

DW3843

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the VA in question smells kind of funny.

If you've ever been to a VA you know exactly what I'm talking about
 

Samoa

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I'm sorry, I stopped reading at "cross-sectional descriptive study using survey methodology." Let me know when there's a real study out there.
 

Pollicis

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At my school, there is a strict dress code, however, there seems to be very little enforcement of this rule. For the most part, it's the women who are problematic (it's hard for a male to screw up a shirt and tie), but I often see women wearing very questionable attire (ie: are you going to a nightclub or to a hospital) with very little or no consequence. I wonder how things are at other schools?
 

MeowMix

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I think we should all dress as Mexican med students do: white pants, white shirt, white coat. All the way through med school and residency.

Try keeping that outfit clean for more than 5 minutes...
 

f_w

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white pants, white shirt, white coat. All the way through med school and residency.

Try keeping that outfit clean for more than 5 minutes...
That is the point of the all white uniform. Whites will show if you don't wash them, also you can cook or bleach them to reduce bacterial contamination.

This is actually the tradition I trained in. On the floors you were expected to wear white pants (the junior people often wore a pair of Levis) a short sleeved white shirt or Tee, a freshly laundered labcoat and white shoes. If you went into the OR, you had to change into OR provided scrubs and clogs which in turn could not leave the OR section of the hospital. Yes it was a pain and I still have a big stack of white higher quality Tees sitting in my closet to show for it.
 

medgirl20

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f_w said:
That is the point of the all white uniform. Whites will show if you don't wash them, also you can cook or bleach them to reduce bacterial contamination.

This is actually the tradition I trained in. On the floors you were expected to wear white pants (the junior people often wore a pair of Levis) a short sleeved white shirt or Tee, a freshly laundered labcoat and white shoes. If you went into the OR, you had to change into OR provided scrubs and clogs which in turn could not leave the OR section of the hospital. Yes it was a pain and I still have a big stack of white higher quality Tees sitting in my closet to show for it.

Same in Croatia everyone upto and including the chief of surgery wears white trousers a white t-shirt, white lab coat (short) and white socks with white clogs.
 

Mike59

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Research also shows that patient compliance SUCKS across the board.

Why should we give a rats-ass about people's opinions about our appearance when they don't follow through with our advice anyway....
 

skiz knot

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f_w said:
It illustrates the problem that n=1 doesn't make research. They surveyed patients in 1 waiting room (of a physician who probably wears a white coat).

If you surveyed the patients in a rural FPs office, 90% would point to the doc in corduroys and flannel shirt as the 'most trustworthy'. If you surveyed the waiting room of a oncologic surgeon, they would point to the guy in scrubs.
**anecdotal evidence warning**

Couple of the docs that work with us at my school say just the opposite, the kind of docs that still do house calls to rural customers. They have said that their patients "expect" their doctor to dress in a certain way, i.e. professional attire.

Haven't done any looking into the matter, but it seems to make sense.

Also, When I lived in an extremely rural area (population 5168 in a 3,340 mi² area, the physicians all dressed in traditional professional attire.
 

Furrball2

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f_w said:
It illustrates the problem that n=1 doesn't make research. They surveyed patients in 1 waiting room (of a physician who probably wears a white coat).

If you surveyed the patients in a rural FPs office, 90% would point to the doc in corduroys and flannel shirt as the 'most trustworthy'. If you surveyed the waiting room of a oncologic surgeon, they would point to the guy in scrubs.
I greew up in rural New England, FPs wore a shirt and tie at work. I went to med school in the Pacific NW. Rural FPs I worked with wore shirts and ties to work.

Why do people entering a profession fight the need to look like a professional?
 

Rendar5

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because wearing ties and tight collars can be very uncomfortable for some people. which is why i prefer to wear really nice shirts w/o ties.
 

UCSBMed1

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Rendar5 said:
because wearing ties and tight collars can be very uncomfortable for some people. which is why i prefer to wear really nice shirts w/o ties.
Simple solution: buy shirts with looser neck circumferences. :)
 

Whodathunkit

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Mike59 said:
Research also shows that patient compliance SUCKS across the board.

Why should we give a rats-ass about people's opinions about our appearance when they don't follow through with our advice anyway....

:laugh:

It's funny because it's true.
 

f_w

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I greew up in rural New England, FPs wore a shirt and tie at work. I went to med school in the Pacific NW. Rural FPs I worked with wore shirts and ties to work.
Well, I guess that is the thing with anecdotal knowledge. A couple of rural FPs I know in the midwest go for the flannel shirt and corduroys (maybe the shirt and tie is a coasty thing).
 
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