Patient attitudes to surgeons' attire in an outpatient clinic setting: substance over style

Bedtime negotiations: Unravelling normative complexity in hospital-based prevention

This study explores how actors deal with normative complexity in the design and implementation of practices of preventative care. Previous studies have identified conflicting (e)valuations of prevention within health care at large, but little empirical research describes how these conflicts are resolved in day-to-day interactions. Zooming in on the work of a single actor, our ethnographic study describes a Dutch psychiatrist developing a novel type of hospital bed that provides preventative psychiatric care for women in the post-partum period. Drawing on pragmatic sociology of justification, we construe 'beds'-and the time, people and resources they represent-as points of convergence between conflicting valuations of care. The results show that embedded modes of valuation in a curative hospital setting generate significant normative complexity during implementation. We identify three main strategies through which normative complexity is managed: (a) translating between different modes of valuing prevention, (b) compromising in (material) design of care beds and (c) transcending embedded valuations through moral appeals. By showing the normative complexity of prevention in practice, our study highlights the need for a diverse and situated accounting for preventative care.

Patients' Impression of Health Care Providers' Attire in the Emergency Department

Background The level of patient satisfaction and, ultimately, the assessment of the quality of care are greatly influenced by physicians' capacity to leave a positive impression on patients during provider-patient interactions. The way doctors dress affects how people view their care. There have been few studies on the impact of doctors' attire on patient confidence and trust. The objective of this study is to assess patients' preferences concerning specific cultural attire and its influence on patients' trust, compliance, and perceptions of the quality of care in the emergency department. Methods A cross-sectional study was performed using the survey methodology for patients in emergency departments. Participants completed a written survey after reviewing doctors' portraits in different dress styles. Respondents were asked questions about the importance of the health service providers' attire in the emergency department on the patient's perception. The Statistical Package for Social Sciences version 21 (SPSS; IBM Inc., Armonk, New York) was used to perform the analysis after the data were entered into Microsoft Excel 2016 (Microsoft, Redmond, Washington). The categorical analysis was performed using the Chi-squared test to explore for relationships between the results and various variables. Result A self-administered questionnaire was completed by 395 patients; two responses were excluded for lack of completeness of the answers in it: 33.8%) were males (66.2%) were females (56.7%) were married (73.8%) completed university education (44.8%) were employed and (74.5%) with excellent health conditions. The questionnaire was devoted to the local setting, with pictures of the health care provider (male and female), in different types of doctor's attire included. Respondents overwhelmingly prefer male emergency physicians to dress in medical scrub (50%, p=.0001) and prefer female emergency physicians to dress in a medical scrub with a white coat (68.7%, p=.0001).  Conclusion First impressions based on a physician's appearance serve as the foundation for assumptions about trust, confidence, and competency, particularly in circumstances when patients or family members do not already have a relationship with the provider.

Assessment of the Influence of Physicians' Attire on Surgical Patients' Perception. Across-Sectional Study in Aabet Hospital, AddisAbeba, Ethiopia, 2021

BACKGROUND

In Ethiopia, physicians commonly wear formal attire, surgical scrubs, casual attire, or business attire during patient care, but there is no evidence to show which attire is preferred within the patients. So this study aims to assess the influence of physicians' attire on patients' perceptions.

METHODOLOGY

After ethical approval, a cross-sectional study was conducted with written informed consent; data were collected and checked for its completeness, later entered into SPSS version 25 for statistical analysis. Descriptive statistics was presented with frequency, percentage, tables, graphs, and texts based on the nature of the data. All the four attires were compared using the Friedman test and pair wise comparisons were conducted with Bonferroni correction for multiple comparisons, and Mann-Whitney U-test was used to know the preferred attire on patients' perception about physicians' skill, with 95% confidence and a p-value of less than 0.05 were considered as statistically significant.

RESULTS

In this study, out of the total respondents 66.7% are males and 71.9%, 50.3% of the respondents were degree or diploma holders, and aged 18-34 years respectively. Among participants' 77.1% and 55.9% preferred formal attire and surgical scrub respectively. For male surgeons, formal attire and surgical scrub have an equal preference in surgical patients (p<0.001), but business and casual attire have no statistically significant difference. The patients' preference in male formal physician attire in surgeon's confidence, willingness to discuss confidential information and safeties of the surgeon were 76.2%, 75.7%, and 70.5% respectively, and for female surgeons, formal attire on surgical patients' confidence in the surgeon, safety, and willingness to discuss confidential information were 74.9%, 73.8%, and 71.8% respectively.

CONCLUSION

Physician attire is one of the important factors that inspire surgical patient confidence, smartness, surgical skill, discussion of confidential information, and caring ability in physicians. Formal attire and surgical scrub were the most preferred physician's outfits.

Telemedicine During COVID-19 Pandemic: Endocrine Surgery Patient Perspective

Introduction

In response to the COVID-19 pandemic, many medical providers have turned to telemedicine as an alternative method to provide ambulatory patient care. Perspectives of endocrine surgery patients regarding this mode of healthcare delivery remains unclear. The purpose of this study is to evaluate the opinions and perspectives of endocrine surgery patients regarding telemedicine.

Methods

The first 100 adult patients who had their initial telemedicine appointment with two endocrine surgeons were contacted at the conclusion of their visit. The survey administered assessed satisfaction with telemedicine, the provider, and whether attire or video background played a role in their perception of the quality of care received using a 5-point Likert scale. Differences in responses between new and returning patients were also evaluated.

Results

Telemedicine endocrine surgery patients stated excellent satisfaction with their visit (4.89 out of 5) and their provider (4.96 out of 5). Although there was less consensus that telemedicine was equivalent to in-person or face-to-face clinic visits (4.15 out of 5), patients would recommend a telemedicine visit to others and most agreed that this modality made it easier to obtain healthcare (4.7 out of 5). Attire of the provider and video background did not influence patient opinion in regard to the quality of care they received. Returning patients were more likely to be satisfied with this modality (4.94 versus 4.73, P = 0.02) compared to new patients.

Conclusions

This study shows that telemedicine does not compromise patient satisfaction or healthcare delivery for patients and is a viable clinic option for endocrine surgery.

What Should I Wear to Clinic? A National Survey of Pediatric Orthopaedic Patients and Parents

BACKGROUND

A number of factors have been shown to affect how surgeons are subjectively viewed, including their appearance in clinic. Patient preference for pediatric orthopaedic surgeon attire has not previously been studied, nor has its influence on initial perception of the surgeon.

METHODS

At 5 pediatric regional sites across the United States, parents and patients presenting to the pediatric orthopaedic clinic were given anonymous surveys showing 8 photos of surgeons in different clinical dress including in business or scrub dress, each with or without white coat (WC). Subjects reported their demographics, single preferred photo, rated characteristics of the surgeons in each photo on a 5-point Likert scale, and answered specific questions on scrubs and WCs. The first consecutively completed 100 parent and 100 patient surveys were included from each site.

RESULTS

One thousand surveys were collected from patients (500) and parents (500). The majority felt a surgeon's clinical dress would not affect how they are cared for (83%), and that it was ok to wear scrubs in clinic (90%). Overall, WC was preferred to those without no matter the age, but there was no difference between scrub and business choices. Of those stating a preference, woman in business and WC (24%) and woman in scrubs and WC (21%) were most selected, with the only geographic difference being the midwest's preference for man in business and WC. Females were more likely to prefer women photographs (P<0.0001).

CONCLUSIONS

In general, pediatric orthopaedic patients and parents do not have a strong specific preference toward what their surgeon wears to clinic, including whether or not we are dressed in scrubs, but some initial biases exist. When asked to choose, the traditional WC worn over any attire is preferred, and female patients and parents uncover a preference for a surgeon of their own sex.

LEVEL OF EVIDENCE

Level III.

Telehealth in an Orthopedic Sports Medicine Clinic: The First 100 Patients

Background: Orthopedic specialties have begun to embrace telehealth as an alternative to in-person visits. We have not found studies assessing telehealth in sports medicine. Our goal is to evaluate patient perception of telehealth in an orthopedic sports medicine practice. Methods: Institutional review board (IRB) approval was obtained. The first 100 patients 18 years and older who had their initial videoconference telehealth appointment with our sports medicine providers from March to April 2020 were contacted at the conclusion of their visit. Surveys assessed satisfaction with telehealth, the provider, and whether attire played a role in their perception of the quality of the telehealth visit. Results: Patients on average stated excellent satisfaction with their visit (4.76 out of 5) and their provider (4.98 out of 5). Patients slightly disagreed with the notion that telehealth is equivalent to in-person provider visits (2.95 out of 5). This did not affect their perception to telehealth itself. It did not discourage patients from recommending telehealth or their provider to future patients. Patients overall felt that attire of the provider does not influence their opinion as to the standard of care they received. Returning patients versus new patient visits were more likely to recommend telehealth to others (4.83 vs. 4.56, p = 0.04). The responses from both groups were overwhelmingly positive. Conclusion: Telehealth is a viable clinic option in an orthopedic sports medicine clinic. Patients who have seen providers in-person previously are more likely to recommend telehealth versus new patients. New patients were satisfied with their telehealth experience. Level of Evidence: IV.

Patient Perception of Physician Attire in a Military Ophthalmology Clinic

Introduction

The purpose of this study is to investigate patient preferences of physician attire in an outpatient military ophthalmology clinic to determine how these preferences affect patients’ perceptions of physician competence and their overall clinical experience.

Materials and methods

This study is a prospective survey administered to patients at the ophthalmology clinic at Brooke Army Medical Center. USA. Patients who were willing to participate in a volunteer survey were included in this study. Demographic information and survey questions were utilized in this study along with words and pictures for patients to select a preference in physician attire in the clinic setting (scrubs, military uniform, or civilian professional attire) and surgical setting (surgical cap or a surgical bouffant). The survey asks patients if physician attire impacts patient confidence in physician abilities (yes or no) and if surgeon attire impacts the likelihood of the patient taking the surgeon’s advice (yes or no).

Results

The demographic distribution includes 57-77 years old participants (53%), females (61%), retirees (49%), and dependent spouses (40%). The racial distribution includes 46% - Caucasian, 20% - African American, 22% - Hispanic, 6 - % Asian, and 6% - other. Most patient appointment types were established follow-up (77%) with only 12% new and 11% walk-in. The survey results (N=308) indicate that most patients (64%) did not have a preference in physician clinical attire, while 22% preferred scrubs, 11% preferred military uniform, and 3% preferred civilian attire. Most patients (66%) did not have a preference for surgical headwear, while 27% preferred the surgical cap, and 7% preferred the surgical bouffant. Only 9% of the patients surveyed indicated that physician attire impacted their confidence in their physician’s ability, and 12% reported that attire impacted the likelihood of taking advice.

Conclusions

Most patients in an outpatient military ophthalmology clinic do not have a preference for physician attire or surgical headwear when surveyed. The majority of patients did not feel physician attire impacted their perception of physician's ability or their likelihood of taking advice. When indicating a preference, patients tended to prefer scrubs to outpatient civilian attire or military attire and trended towards preferring surgical cap over surgical bouffant for headwear.

How to dress up in Neuro-urology department?

INTRODUCTION

To examine patient preferences and perceptions regarding physician dress code in a neuro-urology department.

MATERIAL

A questionnaire presenting with different physician dress codes was submitted to patients in a neuro-urology department: casual outfit with white coat, scrubs and scrubs with white coat. Respondents selected their ideal dress code and mentioned if any dress code shock them. Respondents' general opinions regarding physician attire, its importance and relation with patient satisfaction were collected.

RESULTS

163 questionnaires were completed. The three physician attires were chosen equally by the respondents. 71.4% of the respondents felt comfortable with the three attires. When an attire appeared to be offending, the casual attire with white coat was mentioned in 68.2%. 52.5% of the patients reported that the way their doctor dressed was important to them. 36.3% of respondents reported that physician attire influenced how confident they felt about the care they received. Male respondents preferred scrubs with white coat (44.0%) while female respondents preferred casual attire with white coat (42.0%), P=0.02. Neither the age, nor the reason of the consult, the knowledge of the department, the presence of neurological disease, the occupational category and the education level of the patient had an influence on the preference for one specific physician attire.

CONCLUSION

Physician attire in neuro-urology may influence the way that patients perceive care. Physicians must not be restricted to one particular attire in neuro-urology department. However since almost 20% of the patients feel uncomfortable with the casual attire and white coat, it should be avoided.

LEVEL OF EVIDENCE

4.

The Effect of an Orthopedic Hand Surgeon's Attire on Patient Confidence and Trust

Background: Multiple studies have concluded that patients are more likely to understand and trust physicians who dress in more formal attire (shirt and tie) as opposed to casual attire (t-shirts and jeans). The white coat has repeatedly been reported as a major source of trust and confidence in a patient's eyes. Methods: This study explores the effect an orthopedic hand surgeon's attire has on a patient's perception of their surgeon's clinical values. All patients 18 years of age and older who visited our orthopedic hand surgeon's suburban outpatient practice were asked to participate in our survey-based study. Results: Ninety-seven surveys were completed and included. A majority of our responders are female (n = 59, 60.8%), Caucasian (n = 83, 85.6%) between the ages of 55 and 74 years (n = 40, 41.2%), currently employed (n = 59, 60.8%) with private health insurance (n = 69, 71.1%), and married (n = 64, 66.0%). Patients rated male and female hand surgeons wearing a white coat highest using the Likert scale and when asked about their perceived clinical qualities. Patients consistently poorly rated their surgeons wearing casual attire. Patients did note that the white coat, or any specific attire, was not necessary during the initial encounter to build a strong patient-surgeon relationship. Finally, goatees and beards do not positively or negatively impact a surgeon's patient-constructed image. Conclusions: Combining strong clinical skills with appropriate clinical attire highlighted by the physician wearing a white coat appears to be an effective way to enhance patient satisfaction while ultimately gaining the trust and respect needed to properly care for patients.

The contribution of patients' presurgery perceptions of surgeon attributes to the experience of trust and pain during third molar surgery

Background:

Patients' feeling of trust in their surgeon may modulate the experience of pain during surgery. However, factors that contribute to patients' experience of trust during surgery remain underexamined. The current study examined the contribution of patients' impressions of surgeons' warmth and competence to their experience of trust and pain during wisdom tooth extractions.

Methods:

Patients (N = 135, 47% female) scheduled for a wisdom tooth extraction reported their current distress and impressions of their surgeon's warmth and competence after a brief introduction to their surgeon immediately before surgery. Immediately after their surgery, patients reported their experience of trust (feeling safe and in good hands) and pain during surgery. Path analyses modeled perceptions of surgeon warmth, competence, and their interaction as predictors of patients' experiences of trust and pain during surgery.

Results:

Higher perceived surgeon competence, but not warmth, predicted the experience of higher trust and lower pain during surgery. Perceived competence interacted with perceived warmth such that the competence–trust relationship was only significant at moderate to high levels of perceived surgeon warmth and failed to reach significance at lower levels of perceived surgeon warmth.

Conclusion:

These results indicate that patients feel greater trust in surgeons who are perceived as higher in competence and warmth, underscoring the importance of impression management in surgical care.

Clients' attitudes toward veterinarians' attire in the small animal emergency medicine setting

OBJECTIVE To determine how veterinarians' attire affected clients' perceptions and trust in the small animal emergency medicine setting. DESIGN Cross-sectional study. SAMPLE 154 clients of a 24-hour small animal emergency clinic in a rural location. PROCEDURES A survey was administered to clients in the waiting room over a 1-month period to elicit their impressions of veterinarians' attire in various clinical scenarios and whether that attire would affect their perceptions. Respondents completed the survey after examining photographs of 1 male and 1 female veterinarian in 5 styles of attire (business, professional, surgical, clinical, and smart casual). RESULTS 83 (53.9%) respondents were female, and 71 (46.1%) were male; age was evenly distributed. Across all clinical scenarios, the most common response was no preference regarding the way a male or female veterinarian was dressed and that this attire would have no effect on the respondents' trust in their veterinarian. Most respondents were indifferent or preferred that their veterinarians not wear neckties and white coats. Twenty-six percent (40/154) of respondents indicated that they believed their veterinarian's attire would influence their opinion of the quality of care their pet received. CONCLUSIONS AND CLINICAL RELEVANCE In this small animal emergency medicine setting, most clients indicated no preference regarding their veterinarian's attire, yet approximately one-fourth indicated this attire would influence their perception of the quality of care their pet received. Further studies are warranted in other practice settings and locations to determine whether these findings are generalizable or unique to this particular setting.

Patient’s Preference on Neurosurgeon’s Attire and Appearance: A Single Center Study in Korea Cross-Sectional Study

Objective

This study was performed to assess neurosurgery patients' preference for surgeon's attire and appearance in the hospital.

Methods

A total of 100 patients were investigated using a questionnaire comprising 13 questions. We first asked patients about neurosurgeon's appearance including accessories, hair color, mustache, and beard. Then, based on their preferences, they were asked to rank a series of photographs which illustrated a variety of neurosurgeon attires worn by a doctor.

Results

Professional attire with white coat was the most ideal for patients compared to any other attire (preference scale 5.28 ± 1.24), and there was a significant preference gap between wearing a white coat and not wearing a white coat (p <0.01). Patients expressed a preference for neurosurgeon's shoes (30%) but the majority of the respondents answered that it does not matter which shoes their neurosurgeon wears (43%). Furthermore, the patients did not have any preferences regarding accessories, dyeing, and mustache or beard (58%, 67%, and 51%, respectively), and they did not have negative view towards doctor wearing accessories (71.7%) and growing mustache or beard (71.6%).

Conclusion

The patients in this study preferred professional attire along with a white coat compared to any other form of outfit. This result is similar to those of many other studies conducted in other departments or other countries. However, patients did not have a strong negative view on accessories, dyeing, and facial hair. With regard to medical training, patients did not show a preference for their neurosurgeon's educational background.

Patients' perceptions and preferences of oral and maxillofacial surgeons in a university dental hospital

Purpose

There is a lack of information regarding the dental patient's point of view of oral and maxillofacial surgeons (OMFSs). The aim of this study was to evaluate the perceptions and preferences of a group of university dental hospital patients for OMFSs.

Materials and methods

This study was based on patients' self-assessment using a questionnaire. A total of 530 patients were enrolled for the study. The patients' preferences regarding the surgeons' age, gender, religion, race and experience were determined and compared statistically.

Results

A total of 506 questionnaires were considered as complete and used in the analysis. Female patients preferred female practitioner more than male patients did (p=0.002), but no significant difference was found between male and female patients regarding preference for the age (p=0.464), ethnicity (p=0.926) and religion (p=0.261) of the OMFS. The educational status of the patients did not have an effect on the gender preference for the OMFS (p=0.114); however, educational status significantly affected the preferences for the ethnicity and religion of the practitioners (p=0.001).

Conclusion

Today patient expectations and perceptions take place in post graduate education programs. In this study we determined a wide range of different factors for choosing an OMFS. The diversity of these factors may affect the quality of the health service and thus must be considered in determining the content of oral and maxillofacial curriculum.

Patients' preferences regarding age, sex, and attire of orthodontists

INTRODUCTION

We investigated whether patients in different age groups are influenced by the age, sex, and attire of an orthodontist.

METHODS

The opinions of 360 patients regarding 4 orthodontists and 3 types of attire (from photos) were investigated using a questionnaire. Patients were classified as children (8-11 years; n = 120; group 1), adolescents (12-17 years; n = 120; group 2), and young adults (18-25 years; n = 120; group 3). The chi-square test was used to evaluate age- and sex-based preferences for orthodontists and attire types, and a statistical test of proportion (significance level, 5%) was used for multiple comparisons.

RESULTS

Young female orthodontists were preferred (41.1%). A white coat was the preferred attire (48.1%), followed by social clothing (31.7%) and a thematic pediatric coat (19.7%). Groups 1 and 2 preferred a young female orthodontist, whereas group 3 had no apparent age and sex preferences. Regarding attire, group 1 preferred social clothing, whereas groups 2 and 3 preferred a white coat.

CONCLUSIONS

Patients of all ages consider appearance to be an important factor when choosing an orthodontist. The participants largely preferred younger professionals who dressed in white coats, because this type of attire was considered clean and hygienic.

Evaluation of owners' attitudes towards veterinarian attire in the small animal specialty setting in North America

Previous studies in human medicine have found that patients prefer their doctors to be more formally attired, and that this influences their trust and confidence in their physician. The purpose of this study was to evaluate how veterinarians' attire affected owners' impressions and trust in the small animal specialty medicine setting. A questionnaire based study conducted during a 2-month period at an urban based small animal private practice specialty hospital. Respondents completed a written survey after reviewing pictures of the same male and female veterinarian in five different dress styles. Respondents were asked for their preference for male and female veterinarian attire in different clinical scenarios and whether it would affect their willingness to discuss sensitive issues. Two hundred and thirty-eight questionnaires were completed during the study period with 76.1% of respondents being female. Female respondents did not have a preference to how a male or female veterinarian was attired with the attire examples provided. However, male respondents tended to have fairly equal response rates between no preference and preferring a male veterinarian to be in either clinical or professional attire. Male owners either had no preference or preferred their male veterinarian to be attired in clinical or professional attire and had no preference or preferred their female veterinarian to be clinical attire. Most respondents do not feel it is necessary for a veterinarian to wear a white coat or neck ties and most do not feel it is inappropriate for a veterinarian to wear blue jeans, have coloured hair, or have visible tattoos.

Patients' attitudes regarding characteristics of physicians in ophthalmology

Objective

This retrospective cross-sectional study was performed to assess patient perceptions and attitudes towards physicians’ physical appearance and education in the Vitreoretinal Specialist clinic setting. 295 consecutive patients from Retina Consultants of Alabama, a Vitreoretinal Specialty practice at UAB Hospital, completed a questionnaire assessing preferences regarding physicians’ appearance and education. The main outcome measure was to determine if physical attributes and education are factors in patient preference for their Vitreoretinal Specialist.

Results

There were no significant desirable or undesirable physical characteristics for a Vitreoretinal Specialist in a clinical setting. However, the data indicated trends in patient preferences for Vitreoretinal Specialist attire [209 (71%) of 295 patients prefer casual dress], physical appearance [212 (72%) and 240 (81%) of 295 patients had no preference with regards to long hair and facial hair], and medical education [171 (58%) of 298 patients preferred their Specialist to be involved in research and education]. Gender, race, and age were not significantly associated with patients’ perceptions toward the Vitreoretinal Specialist’s physical appearance and education. In conclusion, Vitreoretinal Specialist’s clothing and physical attributes do not significantly influence patients’ opinion of the care they receive, although patients prefer their Specialist to be involved in research and continuing education.

Physicians' attire. Parents preferences in a tertiary hospital

OBJECTIVES

To assess Saudi mother's preferences regarding Saudi children's physicians' attire, and its influence on the parents' level of trust and confidence. Methods: A cross-sectional survey was conducted from January to April 2014. Our sample comprised mothers of pediatric patients in both inpatient and outpatient settings at National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. Mothers answered multiple questions, including their preferences regarding male and female pediatric physicians' attire, their preferences regarding their children's physician's gender, and the impact of physician's appearance on mothers' confidence. Results: There were 259 female participants. Of all caregivers, 51.4% were 32-years-old or younger. Of those, 170 (65.6%) were educated (had completed high school or higher). Forty-four percent preferred that male physicians wear scrubs, while 5.4% preferred formal attire (tie, shirt, and trousers) and 27.8% preferred Saudi national attire (Thobe and shemagh). Most caregivers (57.9%) preferred that female physicians wear long skirts. Most caregivers (87.6%) preferred physicians to wear a white coat. Most (89.2%) believed that a physician's appearance is very important. Conclusion: Gender of the treating physician is insignificant to mothers. However, the level of trust in a physician is related to his/her external appearance. Most mothers prefer their children's physicians to wear scrubs.

Understanding the role of physician attire on patient perceptions: a systematic review of the literature--targeting attire to improve likelihood of rapport (TAILOR) investigators

OBJECTIVES

Despite a growing body of literature, uncertainty regarding the influence of physician dress on patients' perceptions exists. Therefore, we performed a systematic review to examine the influence of physician attire on patient perceptions including trust, satisfaction and confidence.

SETTING, PARTICIPANTS, INTERVENTIONS AND OUTCOMES

We searched MEDLINE, Embase, Biosis Previews and Conference Papers Index. Studies that: (1) involved participants ≥18 years of age; (2) evaluated physician attire; and (3) reported patient perceptions related to attire were included. Two authors determined study eligibility. Studies were categorised by country of origin, clinical discipline (eg, internal medicine, surgery), context (inpatient vs outpatient) and occurrence of a clinical encounter when soliciting opinions regarding attire. Studies were assessed using the Downs and Black Scale risk of bias scale. Owing to clinical and methodological heterogeneity, meta-analyses were not attempted.

RESULTS

Of 1040 citations, 30 studies involving 11 533 patients met eligibility criteria. Included studies featured patients from 14 countries. General medicine, procedural (eg, general surgery and obstetrics), clinic, emergency departments and hospital settings were represented. Preferences or positive influence of physician attire on patient perceptions were reported in 21 of the 30 studies (70%). Formal attire and white coats with other attire not specified was preferred in 18 of 30 studies (60%). Preference for formal attire and white coats was more prevalent among older patients and studies conducted in Europe and Asia. Four of seven studies involving procedural specialties reported either no preference for attire or a preference for scrubs; four of five studies in intensive care and emergency settings also found no attire preference. Only 3 of 12 studies that surveyed patients after a clinical encounter concluded that attire influenced patient perceptions.

CONCLUSIONS

Although patients often prefer formal physician attire, perceptions of attire are influenced by age, locale, setting and context of care. Policy-based interventions that target such factors appear necessary.

Patients' attitudes toward the attire of male physicians: a single-center study in Saudi Arabia

BACKGROUND AND OBJECTIVES

The doctor-patient relationship has been influenced by the appearance of physicians, and there is an association between a physician's physical appearance and the patients' initial perceptions of physician competence. This study aims to explore patients' preferences toward the attire of a male physician, and to examine if a physician's choice of uniform influences the degree of trust, confidence, and follow-up care among respondents.

DESIGN AND SETTINGS

A cross-sectional survey conducted among patients of the Alwazarat family medicine center in Riyadh, Saudi Arabia.

PATIENTS AND METHODS

A self-administered questionnaire was completed by 300 patients (50% were male and 83.6% had received a secondary education; the mean age was 33.4 [10.1] years) in the Alwazarat family medicine center in Riyadh. The questionnaire was also customized for the local setting with the inclusion of photos of a male doctor in Saudi Arabian national costume, and 3 other dress styles (Western dress with white coat, scrubs with white coat, and scrubs only).

RESULTS

Overall, across all questions regarding physician dress style preferences, participants significantly preferred Western dress (39.9%, P < .001), followed by Saudi national dress (26.3%), a scrub suit with a white coat (22.3%), and scrubs only (11.5%). Respondents reported that they were more likely to follow medical advice and would return for follow-up care if a physician wore Western dress. They were significantly more willing to share their social, sexual, and psychological problems with a physician wearing Saudi national dress (P < .001). The importance of a physician's appearance was ranked significantly higher by older patients (P=.002).

CONCLUSION

Respondents were more likely to favor a physician wearing Western attire with a white coat. However, Saudi national dress, followed by Western dress, is the preferred attire when physicians are dealing with social, sexual, and psychological problems.

Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis

This article uses a Bourdieusian framework to understand the importance of clothing norms for symbolizing and reproducing social, as well as professional, hierarchy in hospitals. Using data from participant observation, it examines how a complex yet informal dress code has emerged at a community hospital in the Northeastern United States, in a setting where very few formal guidelines exist on how to dress. By conceptualizing professionals as holders of various types of capital (economic, cultural, and symbolic), this article expands previous research which considered clothing only as a marker of professional identity. The findings demonstrate (1) how clothing norms are used in subtle, but purposeful, ways to reflect varying degrees of cultural and economic capital and (2) how these complex norms also reflect professional boundaries in medical authority (symbolic capital), which is important during critical moments where clothing can quickly signal who can take control. The discussion borrows Bourdieu's concepts of habitus and field to explain why subordinates subscribe to these clothing norms, in the absence of a formal organizational dress code.

Perceptions of patients, physicians, and Medical students on physicians' appearance

OBJECTIVE

To investigate the impressions made by different styles of dress and appearance adopted by physicians on patients, medical students and other physicians in Brazil.

METHODS

Two hundred fifty nine patients, 119 students, and 99 physicians answered questions related to a panel of male and female physicians' pictures covering the following styles: white clothing; white coat; formal, informal, and casual garments; and surgical scrubs. They also reported their level of discomfort with a list of 20 items for professional appearance of both genders.

RESULTS

Most of the answers of the volunteers involved using white clothes or white coat, and in many situations the percentages of preference referred for these styles were close. Physicians and students preferred physicians wearing surgical scrubs for emergency visits, and doctors with informal style for discussing psychological problems with male professionals. Patients most often chose white clothing in response to questions. Regarding male professionals, all three groups reported high degree of discomfort for the use of shorts and bermuda shorts, multiple rings, facial piercing, sandals, extravagant hair color, long hair, and earrings. For females, high levels of discomfort were reported to shorts, blouses exposing the belly, facial piercing, multiple rings, extravagant hair color, and heavy makeup.

CONCLUSION

Brazilian patients, physicians, and medical students form a better initial impression of physicians using clothing traditionally associated with the profession and exhibiting more conventional appearance. The use of entirely white garments appears to be a satisfactory option in this country.