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How does physician attire influence patient perception?

White coat, business suit, scrubs, or a casual look?

Many physicians are faced with this choice every day as they decide how to dress, although they may not be aware how that choice affects patients' perceptions of their professionalism or competence.

A new study in JAMA Internal Medicine that surveyed 337 family members of patients in three Canadian intensive care units (ICUs) offers some answers.

When asked to select their preferred physician from a panel of photographs, survey respondents "strongly favored" doctors who wore "traditional attire" with a white coat, according to the study's researchers.

"Physicians in traditional dress were seen as most knowledgeable and most honest," the researchers wrote.

When participants were asked to select the best physician overall, 52% selected doctors wearing traditional attire with a white coat, followed by scrubs (24%), suit (13%), and casual attire (11%).

A separate questionnaire that those same family members answered provides an interesting contrast to those numbers. That questionnaire found that just 32% of participants believe wearing a white coat is important for physicians.

In an accompanying editorial to the piece, another set of authors wrote that the disparity between the numbers suggests that patients and their family members have a subconscious preference, not necessarily for white coats, but for attire that identifies a physician as a health professional.

"The photograph ratings suggest that 'professional dress' really means something that specifically identifies the person as a health professional, since scrubs (less formal, more identifying) outperformed the business suit (more formal, less identifying) on all measures," the editorial stated.

Despite the study's focus on physician attire's effect on patient perception, the editorial authors noted that appearance isn't everything. Good communication and respectful behavior are likely to outweigh dress in terms of importance to patients, they said.

Nonetheless, the study's results provide doctors with a reason to pause and think for a moment when they're getting dressed for the day.

"As professionals, it is important to be aware that patients and families may be affected by our appearance and attire," the editorial stated. "In the absence of compelling reasons to wear nonprofessional attire, physicians should consider patient preferences in the interest of fostering comfort and trust."


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