Evidence-based Attire Part 1

I am going to write a 2 part series on what we should wear as physicians. I was inspired to do this when my resident said he has received an email declaring all male physicians must wear ties. I mostly have abandoned tie wearing as they are hot, uncomfortable and I just can’t find matching ties to many of the shirts I want to wear and don’t want to commit a fashion faux pas. I also perceived them to be an infection risk (I will address this in part 2 of this series). When I don’t wear a tie I wear my white coat. When I wear a tie I often forgo the white coat. What do patients think about this?

I felt it important to try to review a smattering of the literature on the topic. I admit I didn’t do a full literature review because the importance of this is just not worth the time. I did randomly select from the studies I did find so as not to only support my biased opinion that patients don’t really care what we wear.

There is a fair amount of literature on this topic in both the medical and dental world. Many of the studies included pictures like the following for patients to critique and give their opinion of the physicians depicted. They were often asked about the professionalism of the attire and their desirability of certain aspects of dress.

I didn’t find a dress option I really had hoped to find information on: white coat but no tie.

What do patient’s think about how we dress?

Below are some selected figures from studies showing these results. This first table shows that wearing a tie was fairly desirable but not as desirable as a name tag and white coat.

This is from a study of anesthesiologists (https://goo.gl/kTKUoM)

The figure below was from a study of anesthesiologist. It included 110 patients. You can see that wearing a tie was felt to be important by about 25-30% of them. Wearing a name tag and white coat was more important.

Another from a study of anesthesiologists (https://goo.gl/5fMh7k)

The figure below suggests that wearing a ties led to greater patient comfort in dealing with the doctor. Interestingly, not wearing a tie has the same ranking as wearing a white coat in patient’s comfort of dealing with a doctor dressed in such a way.

Finally, the table below shows patients in this study mostly disagreed that ties were important and didn’t even feel white coats were all that important. They felt is was most important for doctors to act professionally.

So, there you have it. White coats and name tags seem to be the most important. It helps patients identify us as doctors and we are perceived to be more professional in the white coat. Ties have mixed results. I am still undecided as to how I feel about this. I used to love wearing ties…now not so much. I think I will make my decision after I review the infection risk data. Stay tuned for that installment which will be coming soon.

What do you think?