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Analysis

Physician Attire: Patients Prefer White Coats

By Christopher Cheney  
   June 13, 2018

New research provides guidance for implementing clinician dress codes at health systems, hospitals, and physician practices.

Physician attire impacts patient satisfaction, with preferences for clinician couture varying by care setting and patient attributes such as age, researchers have found.

"Our work shows that patients care. So, for institutions that don't have a dress code or formal policy for attire, it might be time to consider one," article co-author Vineet Chopra, MD, MSc, of the University of Michigan Medical School and VA Ann Arbor Healthcare System told Healthleaders this week.

Out of 4062 patients surveyed, 53% said physician attire was important to them. The research was published in BMJ Open.

Overall, patients preferred formal attire with a white coat, ranking that ensemble an 8.1 on a scale of 1 to 10. "Our work shows white coats matter the most. I think this is an important takeaway for institutions," Chopra says.

The researchers found that preference for physician attire is influenced by patient attributes and care settings:

  • Female patients preferred scrubs with white coats in emergency room and hospital setting compared to men (41% vs. 31%)
  • In hospitals, patients 65 and older preferred formal attire with white coats more than younger patients (44% vs. 36%)
  • Younger patients preferred scrubs and white coats over formal attire (28% vs. 21%)
  • Patients with a college degree preferred formal attire and white coat for family physicians more than patients without a degree (48% vs. 42%)
  • Patients preferred formal attire with white coat for primary care (44%) and hospital physicians (39%), but scrubs were rated highest for ER physicians (40%) and surgeons (42%)

Patients also had regional differences in their preference for physician attire.

"While formal attire and white coats were preferred across all regions, 50% of respondents in the West and 51% in the South selected this as their preferred option compared with 38% and 40% in the Northeast and Midwest, respectively," the researchers wrote.

The findings on patient preference variation for physician attire indicate that healthcare organizations should take a nuanced approach to dress codes, Chopra says.

"Preferences may vary based on location and context. Institutions may want to consider examining specific areas to understand whether or not more defined dress codes might be indicated."

The research is consistent with common perceptions about professionals, the researchers wrote.

"These findings make intuitive sense: Patients often have notions of how a 'professional' should dress and are more likely to respond positively to those that meet these stereotypes. Strategies targeting physician dress may therefore enhance trust and satisfaction."

The research is based on a questionnaire that included photos of a male and a female physician in seven different sets of attire. Patients were asked to rate the physicians in several clinical settings. The rating system had five domains: knowledgeable, trustworthy, caring, approachable, and comfortable.

Formal attire with white coat scored highest for all five domains.

The research includes several other key data points:

  • In the overall rankings, scrubs with a white coat ranked second to formal attire with white coat. Formal attire without a white coat ranked third.
     
  • In ER and surgery settings, scrubs alone were preferred by 34% of patients followed by scrubs with white coats (23%)
     
  • 36% of patients said physician attire impacted satisfaction with their care
     
  • 55% of respondents said doctors should wear a white coat during office visits with patients

Matching physician attire with patient expectations can improve patient experience, the researchers wrote.

"Providers engaged in care of elderly patients … may consider donning formal attire more so than surgeons or emergency room physicians where scrubs may be more important. Similarly, hospitals in Southern regions of the USA may wish to endorse formal attire and white coats."

The research has policy implications, they wrote.

"Patients appear to care about attire and may expect to see their doctor in certain ways. Hospitals, clinics, emergency departments and ambulatory surgical centers should consider using these data to set dress codes for physicians providing care in these settings."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Physician attire mattered to 53% of patients surveyed

Care settings impact patient preferences

Overall, patients prefer formal attire with white coat


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