Physicians' Attire: What Do Patients Think?

Greek physician Hippocrates believed doctors should be “clean in person, [and] well-dressed.”

However, the way surgeons should dress has been debated for centuries, and in particular, what patients perceive when they see how their surgeons dress is an open question.

A team of researchers from Temple University in Philadelphia, PA, attempted to determine how surgeons’ attire affected their patients’ perception of certain qualities. They were interested in patients' opinions about the surgeon's intelligence, confidence, and trustworthiness.

They conducted their study in an urban orthopedic hospital.

The study researchers asked 100 patients awaiting surgery to complete a questionnaire on a computer. Eighty-five patients responded. The majority of respondents was 35 to 54 years old and had private or state-funded insurance.

In the first survey section, the researchers showed respondents a white male or female surgeon dressed in 4 different outfits: casual, scrubs, business, and a white coat over business wear; gender and outfit were randomly assigned.

In the second section, the researchers showed respondents all four images and asked them to rank the surgeons from highest to lowest in terms of confidence. The third section asked for personal information about each patient.

For both male and female surgeons, respondents disliked casual clothing. When respondents viewed male surgeons, they rated white coats higher than business attire in the categories of confidence, intelligence, surgical skill, trust, ability to discuss confidential information, and safety. Respondents also preferred the white coat to casual attire.

When they viewed female surgeons, they rated the white coat and scrubs the same. However, in four of seven categories, respondents preferred the white coat to business attire.

Despite different preferences depending on the surgeon’s gender, these results demonstrated that overall, respondents preferred the white coat in 4 categories (confidence, safety, trust, and intelligence). Patients also believed the surgery will progress smoothly and will more readily discuss personal information when the surgeon wears a white coat.

Some hospitals in the United Kingdom have adopted a “bare below the elbow” policy to prevent spread of infection. This research suggests surgeons should dress in scrubs when following this policy.

The results of this study appear online on in Clinical Orthopaedics and Related Research, a publication of The Association of Bone and Joint Surgeons.