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Hospitalised patients’ view on doctors and white coats
Abstract
To determine hospitalised patients' feelings, perceptions and attitudes towards doctors and how these are affected by whether or not doctors wear a white coat.
Cross-sectional questionnaire survey.
The medical and surgical wards of two Sydney teaching hospitals, on one day in January 1999.
154 of 200 consecutive patients (77%).
The effects of white-coat-wearing on patients' feelings and ability to communicate and on their perceptions of the doctor; why patients think doctors wear white coats and their preferences for the wearing of white coats and doctors' attire in general; and patients' rating of the importance of these effects and preferences.
Patients reported that white-coat-wearing improved all aspects of the patient-doctor interaction, and that when doctors wore white coats they seemed more hygienic, professional, authoritative and scientific. The more important that patients considered an aspect, the greater the positive effect associated with wearing a white coat. From a list of doctors' reasons for wearing white coats, patients thought that doctors wore white coats because it made them seem more professional, hygienic, authoritative, scientific, competent, knowledgeable and approachable. 36% of the patients preferred doctors to wear white coats, 19% preferred them not to wear white coats and 45% did not mind.
Patients reported feeling more confident and better able to communicate with doctors who wore white coats. The recognition, symbolism and formality afforded by a white coat may enhance communication and facilitate the doctor-patient relationship.
... Though patients generally agree that some specialists and/ or hospital-based physicians, such as oncologists, ophthal-mologists, surgeons, anaesthesiologists and emergency doctors, should wear a white coat during the consultation [1][2][3][4][5], its place in primary care medicine is a heavily debated topic. Indeed, conflicting evidence exists about how patients would like their primary care physicians (GPs) to dress [6,7]. ...
... Indeed, conflicting evidence exists about how patients would like their primary care physicians (GPs) to dress [6,7]. However, this issue may be considered as important, because doctors' appearance can affect perceptions of the quality of medical care received and influence trust, confidence and the patient-doctor relationship, which could lead to better adherence and, as a result, better health outcomes [2,[7][8][9][10][11]. Some patients probably perceive doctors wearing a white coat as not only more competent, professional, scientific and trustworthy, but also more hygienic and knowledgeable, mainly in hospital settings [2,12]. ...
... However, this issue may be considered as important, because doctors' appearance can affect perceptions of the quality of medical care received and influence trust, confidence and the patient-doctor relationship, which could lead to better adherence and, as a result, better health outcomes [2,[7][8][9][10][11]. Some patients probably perceive doctors wearing a white coat as not only more competent, professional, scientific and trustworthy, but also more hygienic and knowledgeable, mainly in hospital settings [2,12]. On the other hand, some patients may feel more comfortable with doctors not dressed in a white coat, since formal attire may interfere with an effective patient-doctor communication and relationship [2]. ...
Patient preference for their doctor's attire can influence their assessment of the quality of care. Most patients prefer specialists and hospital-based physicians to wear white coats, but evidence from general practitioner (GP) practices is lacking. We aimed to assess patient preference for GPs to wear white coats in Switzerland.
We conducted a cross-sectional survey in the canton of Geneva, Switzerland, in 2011. The survey was part of a larger study on patient expectations from their GP. A random sample of 75 GPs was contacted by post and 23 agreed to participate. They were asked to recruit between 50 and 100 consecutive patients coming to the practice for a scheduled consultation. Patients were asked to complete a questionnaire on their expectations from the GP, including whether they preferred their GP to wear a white coat or not.
1,637 patients agreed to participate (participation rate: 97%, women: 63%, mean age: 64 years). Overall, wearing a white coat was considered important by only 34% of participants. In multivariate analyses, older patients, those of Italian background and patients consulting uncertified GPs and/or GPs wearing a white coat were more likely to consider white coats as being important.
These findings suggest that white coats are no longer considered a powerful symbol for a large majority of patients visiting GPs. However, GPs may wish to adjust their attire to meet the expectations of their more conservative patients.
... 3 To patients, the white coat is preferred due to ease of identification, 4,5 tradition, 4 apparent hygiene, 1,4,6 perceived competence, and seeming more knowledgeable 1,6-9 and professional in appearance. [4][5][6]8 This affinity for a physician who wears a white coat is even greater in those patients and doctors of advanced age. 4,10 However, the practicality, 4 comfort, 4 and even hygiene 4,11-15 of doing such has been called into question throughout recurrent study and paneling of physicians. ...
... Respondents agreed that physician attire influences their overall satisfaction levels. 2 These findings possibly stem from both conscious and unconscious biases and preferences for specific physician attire across a variety of clinical settings. 6,8,[26][27][28][29][30]9,[19][20][21][22][23][24][25] The preference of the majority of future U.S. physicians to not wear a white coat could have an effect on overall physician hygiene. A systematic review of 72 individual studies by Haun et al. demonstrated that white coats are susceptible to contamination with several infectious and antibiotic-resistant organisms including methicillin-resistant staphylococcus aureus (MRSA), enterococcus species, Clostridium difficile, and other gram-negative rods that are frequently implicated as cause for hospital-acquired infections. ...
... T he ability to form a trusting, honest relationship is important to any doctor-patient relationship. 1,2 This may be even more important in veterinary medicine than in human medicine because of veterinarians' reliance on clients for information regarding history, clinical signs, and environmental factors that may be important for diagnosing an animal's medical condition. ...
... However, such preferences for white-coat attire in particular can vary on the basis of medical specialty as well as by geographic location. 2,13,23,24 Surprisingly, most of the companion animalowning clients who were surveyed in the present study were neutral on almost all aspects of outward appearance of veterinarians, including tattoos, dyed hair, and facial piercings. On the contrary, a study 11 in human medicine revealed that facial piercings, tattoos, and male physicians wearing earrings were the most common physical attributes identified that caused patients to be less confident in their physician. ...
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.
... Namun, temuan ini berbeda dari hasil penelitian lain yang menemukan bahwaparapasien kurang menyukai jas putih. 10,11 Pentingnya peraturan mengenai pakaian yang tepat dan menggunakan pakaian pelindung untuk melindungi pasiendanpenyediaperawatankesehatan sehingga terhindar dari penularan penyakit menular di klinik gigi. Hal ini juga penting untuk meneliti bagaimana pasien memandang pakaian pelindung tertentudanuntukmengevaluasi apakah penggunaan pakaian tertentu meningkatkan atau menurunkan kepuasan pasien dengan perawatan. ...
... Dokter gigi dapat menenangkan kecemasan pasien anak-anak, dengan menjelaskan tujuanperangkatpelindungtersebut. 10,12 Untuk membuat perubahan berdampak positif dan penyesuaian yang akan membuat kunjungan ke dokter gigi lebih menarik, adalah penting untuk memahami apa yang anak lihat sebagai aspek yang tidak menyenangkan tentang kunjungan ke dokter gigi.Anak-anakmenyimpulkan injeksi dan ekstraksi gigi sebagai hal yang paling menakutkan dan simbol rasa takut dari dunia kedokteran gigi. Temuan dari penelitian ini serupa denganhasil penelitianlainyang menekankan kebutuhan untuk hanya menggunakan instrumen yang diperlukan selama perawatan dan penggunaantekniktell-show-doselama pengobatan. ...
Management of child behavior begins when the children enters the dental environment and continues until they leaveit. Fear of dentist and dental treatment have been considered a major hindrance to provide a quality dental services.Establish a friendly relationship with children is important for dentist to combat patient’s fears and to deliver effectiveand efficient treatment. The aim of this study was to assess children’s feelings and attitudes toward their dentist inHalimah Dg. Sikati Dental Hospital. A questionnaire designed to evaluate children’s attitudes and preferences towarddentists was completed by 45 children (29 females, 19 males) who attended the hospital. It showed 80% of the subjectreported that they had been to the dentist before; 84.4% report liked their visit, and 8.9% were afraid. A 93,3% of thechildren preferred their dentist to wear a white coat, while 80% preferred them to wear a mask, 82.2% preferred tobe treated by a female dentist, while 77,8% reported that their sibling had a pleasant perception. 80% of the childrenpreferred that their dentist wear the formal attire. Fear of local anesthesia and tooth extraction were the most commonreasons cited for not liking dental treatment. It was concluded that children have strong perceptions and preferences regarding their dentists.
... The white coat (combined with formal wear or scrubs), was the preferred attire in all circumstances . Many previous studies across specialties and across the world have shown a preference among patients for doctors who wear white coats [1,[3][4][5][7][8][9][10]. While some patients prefer the white coat for its ability to inspire confidence and ease commu- nication [7,11] others feel it is an important means of identification distinct from the name tag [1] . ...
... The white coat (combined with formal wear or scrubs), was the preferred attire in all circumstances . Many previous studies across specialties and across the world have shown a preference among patients for doctors who wear white coats [1,[3][4][5][7][8][9][10]. While some patients prefer the white coat for its ability to inspire confidence and ease commu- nication [7,11] others feel it is an important means of identification distinct from the name tag [1] . Patients in our study cohort felt the surgeon's wearing white coats appeared more experienced and caring overall, a finding which has been shown in previous stud- ies [10][11][12]. ...
Background: Physician attire is an important factor in the patient’s first impression of their doctor. The purpose of this study is to determine how different forms of attire impact patient perceptions of their physicians within our orthopaedic clinics.
Methods: A survey was distributed to new patients visiting an orthopedic surgery clinic within a 9 month span at a Canadian outpatient hospital. Each participant also received either a male or female photo sheet depicting 6 different forms of physician attire: Surgical scrubs and white coat, surgical scrubs alone, formal wear with white coat, formal wear alone, business suit and casual wear. Demographic data and general questions related to surgeon’s attire as well as specific questions pertaining to the pictures provided were collected.
Results: 100 patients responded to the survey. Most respondents agreed that physician attire was important and they expected their surgeon to be dressed professionally. Respondents felt strongly that there was an association between how a physician dressed and their perceived ability to dispense care. There was a significant preference for the surgeons wearing a white coat. The least favored surgeon attire overall was casual wear.
Discussion: The results from our survey identify the importance of surgeon’s attire in the patient’s perception of their surgeon as a health care provider. Attire was identified as influencing patient confidence and possible likelihood of compliance/follow-up. Conclusion: We have identified the white coat as being an important adjunct to the surgeon’s attire that embodies professionalism and inspires confidence in a surgeon.
... Studies have shown that wearing a white coast is associated with patient trust and confidence in their physician as well as their willingness to disclose personal matters to their physicians (Wear 1998). Additionally, patients describe doctors who wear their white coast as being more hygienic, professional, authoritative, and scientific (Gooden et al. 2001). Doctor talk is another important element of the culture of medicine. ...
... However, this finding differs from other studies that found that patients were less favorable towards the white coat. [18,19] However, around 84.2% of parents prefer dental assistant with tied hair and around 80.2% of parents prefer them with all buttons closed in the apron. This is also in agreement with studies related to adults in medical literature, where the authors concluded that parents felt that this attire portrayed the qualities of cleanliness, professionalism, and authority. ...
Background: Professional appearance contributes to first impression. Attire and appearance could be subject to cultural sensitivity. Moreover, they also could be perceived differently according to gender and pediatric practice. Attires have to be less intimidating and child friendly in pediatric dentistry. Parents harbor conscious and unconscious biases when it comes to the clinical demeanor of dental staff in a hospital. Dental staff needs to focus on their attire which would help in building quick rapport and trust in children and parents. This study portrays the perceptions of parents towards the dental staff in pediatric department in a hospital. Aims and objective: To assess parental attitudes towards dental assistant attire, to find out effect of positive changes that would make children and their parents more comfortable. Methodology: Data was collected using a validated questionnaire from 101 parents attending the Department of Pediatric Dentistry. Results: This study revealed that parents place a great deal of emphasis on dental staff attire. Parents mainly favored formal attire as they believed in "targeted attire to improve likelihood of rapport" (TAILOR). Parent's ranked multicolored apron with buttons closed with the name tags on the left side. They preferred the male assistants to be clean shaven and females to have tied hair and groomed nails with minimal accessories. 89% of the parents felt that assistants could play the role of oral educators. Conclusion: The results obtained from this study can help dental staff decide what is appropriate to wear in pediatric dental clinic so as to minimize anxiety and improve delivery of health care. Professionalism is multi-factorial and is vital in engendering a way of comfort and confidence during treatment. The nonverbal communication attributed to an attire/appearance can play a major role in the child-dentist relationship. Making small changes in one's appearance can have a big impact on decreasing the anxiety levels of the child.
... Therefore, the white coat cemented itself as an elemental part of medical profession during the 20 th century. It has become evident that white coat helped creating a more conducive environment for doctor-patient relationship and patients perceived such doctors to be more distinguishable, sanitary and professional [4,5] . It has been documented that patients prefer their doctors to wear name tags [6,7,8] . ...
Objective: To understand patient’s predisposition for physician’s apparel Methodology: Using a cross-sectional study design, a total of 96 participants were approached at Mayo Hospital, Lahore. An interview based pre-tested semi structured questionnaire consisting of both open and close ended questions was used for data collection. Data was analyzed using SPSS version 26 Results: Out of 96 patients, 48(50%) were male and 48(50%) were female. Out of these 78.1% believed that doctor’s dress is important to them. 63.5% of patients preferred name tag and 84.4% preferred whitecoat. The most desired apparel for male physician was western attire with white coat (53.1%) and national attire with white coat for female doctors (54.2%) Conclusion: This study accentuated the patients’ predisposition for physician’s apparel which can lead to better rapport and ultimately improved healthcare services. Keywords: physician apparel, patient preference, attire
... Sağlık sektöründe hekimin yeri, hekimin hastaya bakışı, hekim hasta ilişkileri yavaş fakat sürekli olarak değişmekte; buna bağlı olarak hastanın bakış açısına, değerlerine, hekimlerden beklentilerine verilen önem de giderek artmaktadır. Hekim ve sağlık kuruluşunu merkeze alıp ona göre düzenlenen eski sağlık hizmet sunumu artık hastanın merkeze alındığı, onun istek ve ihtiyaçlarına göre düzenlenen sağlık hizmet sunumuna dönüşmektedir (15). Tüm dünyada bu eğilim varken, sağlık kuruluşları kendilerini buna göre düzenlerken, Türkiye' de özel hastaneler hariç bu konuların henüz olması gerektiği kadar üzerinde durulmadığı görülmektedir. ...
ZET Amaç: Çalışmanın amacı İstanbul' da bulunan bir üniversite hastanesinin değişik birimlerinden hizmet alan erişkin hastaların kadın ve erkek hekimlerin kıyafetlerine ilişkin tercihlerinin araştırılması ve söz konusu tercihler üzerinde rol oynayan faktörlerin belirlenmesidir. Gereç ve Yöntem: Çalışmaya katılan hastalarla görüşme ve anket formu uygulaması 280 hastaya (%46.9) klinik servislerde, 219 hastaya (%36.7) polikliniklerde ve 98 hastaya (%16.4) acil servis ünitelerinde olmak üzere toplam 597 hasta üzerinde gerçekleştirilmiştir. Erişkin hastaların, hekimlerin kıyafetlerine ilişkin tercihlerini araştırmak için Likert Ölçeği kullanılarak anket oluşturulmuştur. Hastalara değişik hastane kıyafetleri taşıyan kadın veya erkek hekimlerin fotoğrafları gösterilerek, hastalardan bu fotoğraflar arasından seçim yapmaları istenmiştir. Verilerin analizi için frekans dağılımlarından, bağımsız gruplar t testinden ve Friedman testinden yararlanılmıştır. Bulgular: Hastaların yaş, hizmet alınan birim, eğitim ve cinsiyet gruplarına göre kadın ve erkek hekimlerin kıyafetlerine ilişkin tercih düzeyleri farklılaşmaktadır. Ayrıca tercih nedenleri ile kıyafet türü arasında da anlamlı fark bulunmaktadır. Sonuç: Hastaların kadın ve erkek hekimler için en çok tercih ettiği kıyafet beyaz vizit önlüğüdür. Ancak beyaz vizit önlüğünü tercih eden hastalar saygınlık, profesyonellik ve temizlik unsurlarını önemserken; güven ve rahatlatıcılık unsurlarını önemseme eğilimleri daha düşüktür. ABSTRACT Objective: The aim of the study is to investigate the preferences of female and male physicians' clothes of adult patients who receive service from different units of a university hospital in Istanbul and to determine the factors that play a role in these preferences. Materials and Methods: Questionnaires and interviews were conducted with a total of 597 patients participating in the study; 280 patients (46.9%) in clinical services, 219 patients (36.7%) in outpatient clinics and 98 patients (16.4%) in emergency units. A questionnaire was created using the Likert Scale to investigate the preferences of adult patients regarding their physicians' clothing. Photographs of male and female physicians wearing different hospital uniforms were shown to the patients and the patients were asked to choose from these photographs which ones they preferred. Frequency distributions, independent groups t test and the Friedman test were used to analyze the data. Results: The preference levels for the clothes of female and male physicians differ according to the age, service unit, education and gender groups of the patients. In addition, there is a significant difference between the reasons for preference and the type of clothing. Conclusion: The most preferred attire for male and female physicians is a white coat. However, while patients who prefer a white coat care about dignity, professionalism and cleanliness. The patients tend to care less about trust and comfort.
... No obstante de lo anterior, pacientes y médicos de diferentes culturas y edades [21,36] prefieren ser atendidos o atender de bata blanca [37][38][39][40], sobre todo si se luce inexperto [16,41]. Sin embargo, cuando se explica el riesgo infeccioso inherente, dicha preferencia cae significativamente [42], es decir, para la mayoría el riesgo infeccioso de la bata supera su eventual fuerza simbólica. ...
La bata blanca, símbolo de la Medicina moderna, ha entrado tal vez en su ocaso definitivo tras la pandemia por COVID-19, ya que en contra de los motivos que originaron y popularizaron su uso, no solo no sirve para la protección personal sino que fácilmente se convierte en vector de infección cruzada y resistencia microbiana. A la mancha indeleble en la profesión que ha ocasionado el mercado de la salud, se ha sumado el comportamiento no ético de colegas, para quienes el lucro personal supera su vocación de servicio, desvirtuando la pulcritud y limpieza del ejercicio que la bata encarna. A pesar de lo anterior, algunas facultades de Medicina se niegan a ello, iniciando a sus estudiantes en el apostolado con las ceremonias de su entrega. Es posible que la cultura de su uso retorne cuando cuente con detectores de contaminación, que rechace las partículas contaminantes y que le permita mantenerse “estéril” pero, principalmente, cuando represente la humildad y el servicio social de la Medicina. Este dilema de portarla deberá resolverse tras ajustar algunas variables culturales en los diferentes escenarios, en la posibilidad de que a través de ese atavío se permita potenciar la relación médico paciente que promocione una función sanadora, como elemento utilitario. Llegará el momento en el que por nuestras genuinas actitudes, los trabajadores de la salud seamos vistos “de blanco” porque, parafraseando, intentamos curar y salvar unas cuantas veces, escuchando con compasión y empatía a nuestros congéneres muchas veces y acompañarlos y consolarlos siempre.
... Patients consider physicians who wear white coats to be more hygienic, professional, authoritative, and scientific. 2 Patient preference for physicians to wear white coats has been reported in various countries. Conversely, some studies show that white coats increase patients' tension, 3 and cause hypertension 4 and bacterial transmission. ...
Many studies have examined the impression made on patients by physicians' attire. Regardless of practice location, many patients express most confidence in physicians who wear white coats. The number of physicians in Japan who choose not to wear white coats in practice has been increasing, particularly in primary care settings. However, very few studies have examined physician preference for attire. To clarify Japanese general practitioners' preference for attire by practice setting, we conducted a survey of physician preferences and reasons for attire selection. Subjects were 794 general practitioners certified by the Japan Primary Care Association and recruited from a mailing list. We conducted a web-based questionnaire survey. Physicians were asked to choose one of four different dress styles (semi-formal, white coat, scrubs, and casual) for different practice settings and state the reasons for selection. The response rate was 19.3% (n = 153; men 112). Most subjects chose white coats as usual attire for hospital practice (52%), mainly because of custom and professionalism. In contrast, most subjects chose non-white coats for clinics (59%) and home care (hospital-provided, 58%; clinic-provided, 71%). More subjects chose casual dress for clinic and home care practice, mainly to appear empathic. Most subjects chose white coats as the most appropriate hospital attire (54%), mainly because of patient perceptions of this attire being professional. Most subjects considered non-white coat attire more appropriate for clinic and home care practice. The findings indicate that general practitioners choose their clothes depending on practice location.
... However, this finding is different from other studies, which found that patients have less preference for the white coat. [22,23] Münevveroglu et al. reported 76.5% of the children like their dentist to wear a colored coat instead of a white one. [18] Another factor may minimize the anxiety of children during the dental visit. ...
... 14 Regardless of geographic location or specialty, older patients have consistently preferred formal physician attire with professional dress and a white coat. [15][16][17] One possible explanation is that older patients have more traditional views on professionalism likely influencing their preference for a traditional white coat. In an editorial from 1973, the chairman of the Division of Plastic Surgery at Duke commented on the changing appearance of medical students: ''It seems to me that there has been a rather cataclysmic rejection by them of our traditions of what student doctor should look like . . . the unique purpose of the medical school is to transform a young layman into a mature physician: if he is to be one, his future patients have the right to expect that he look and act like one. ...
Background
The authors sought to investigate patient preferences on physician and medical student attire in the outpatient otolaryngology setting.
Methods
A prospective sample of 50 (23 males, 27 females) patients presenting to an otolaryngology clinic in a North American teaching hospital, Boston, MA, were included. Patients were seen by a researcher wearing a white coat and either (1) a shirt and tie or (2) surgical scrubs, then completed a Likert-style survey evaluating feelings of trust, comfort, and professionalism. Statistical significance was set at α = 0.05.
Results
Most patients (82%, 41/50) believed that attire was important. Men and older patients were significantly more likely to believe attire was important ( P = .01 and .005, respectively). Patients were significantly more comfortable when seen by a provider wearing a shirt and tie compared to scrubs ( U = 109.5, P = .021); however, there was no difference in feelings of trust or professionalism ( P = .5* and .6*, respectively).
Conclusions
Physician attire is important for patients presenting to otolaryngology clinic. Patients favored a white coat with a shirt and tie. Level of Evidence: NA.
... This being said, the type of attire wore by physicians may improve a patients ease of communication, encourage the doctor-patient relationship 8 further as well as identifying physicians from lay persons in critically, clinical situations. 9 On the other hand, the white coat could increase the risk of spreading nosocomial infections, even if it is a indirect infection. 10 The sleeves and pockets of such white coats could be a reservoir of bacteria. ...
Objective: To determine Thai, outpatients’ preference and attitudes towards various styles of a physicians’ attire, whilst they were on duty at Songklanagarind Hospital, within Songkhla province, Thailand.
Material and Method: A cross-sectional study was conducted at Songklanagarind Hospital, Songkhla, Thailand; during the periods of January to March, 2015. Outpatients, who visited and were waiting to see their doctor, were approached by simply, convenience randomization. Demographic characteristics of participants along with their preference on attire were collected by using a self-rating questionnaire enclosed with 3 various styles of attire pictures.
Results: Most patients preferred both male and female physicians, who wore white coats (70.0%), while they were on duty, either during weekdays or over the weekend. Similarly, the patients stated that they trusted physicians, who wore white coats (92.2%), more than those in a style of formal attire, (7.5%) or casual clothing (0.3%) during the weekday due to; a sense of professionalism and knowledge. Although, most patients also preferred physicians wearing white coats over the weekend and holiday periods (50.4%) they could accept a form of smart, casual dress, (45.0%) more so than a style of formal attire (4.7%).
Conclusion: Most patients preferred and tended to trust physicians, who wore white coats during both official and non-official times.
... Other studies also highlighted that caregivers thought that white coat made the doctors more hygienic, scientific, skillful, well-informed and made them feel safer. [19,20] In the history of the white coat, the term hygiene was not really mentioned. The white coat may have emerged in terms of science's crave to satisfy medicine and it was a kind of recognition feature for medical staff in the hospital. ...
... Likewise, patients rated images of doctor with apron higher than those of casual attire in measures for comfort and perception of competence. [23],[24] The current available evidence has not conclusively linked white coats with increased infection rates. However, 2007 dress code guidelines in England were issued banning white coats and barebelow-the-elbow policy for all workers in the hospitals; however, detailed scrutiny on the risk of infection transmission and objections eventually led to revision of these guidelines in 2010. ...
Objective: To assess patients preference for preselected doctor attire in outpatient department (OPD) setting of a government hospital. Materials and Methods: An anonymous, predesigned, pretested, semistructured interview schedule was administered to adult (>18 years) ambulatory coherent patients. The brief questionnaire captured selected sociodemographic details of patients, department visited, and use of aprons (white coat) by attending doctor observed and desired practice. To the item—“Was your attending doctor in OPD wearing apron (white coat)?”, the possible response was yes/no. For the item—“Would you like to see your attending doctor wearing apron (white coat)?”, again the possible answer was yes/no. When a patient responded to this item as “no,” we further explored their reason for the same. The patients were shown four colored pictures each for male and female doctor in different dress. They were probed regarding their preference that they would like to see their attending doctor to be wearing. These attires were labeled as 1 = cool casual, 2 = casual, 3 = professional informal, and 4 = professional formal. Result: The mean age of 547 patients was 35.34 (±12.81) years; 322 (58.9%) were males. Out of 547 patients, nearly 395 (72.2%) wanted (desired) to see their attending doctor to be wearing apron; however, only 256 (46.8%) reported that attending doctors were actually wearing the apron in the outpatient department. Only 152 (27.7%) patients responded that it does not matter to them whether attending doctor was wearing white coat (apron) or not. Majority of patients preferred male doctor to be wearing professional formal (42.3%) and professional informal (40.9%) attire, whereas for female doctor, also majority preferred professional formal (38.7%) and professional informal (37.5%), respectively. Casuals were the least preferred attire. Conclusion: It is reiterated that majority of patients in our OPD setting preferred formal attire of attending doctor with apron, a clear and loud message for future physician in training.
... La elección del uso de delantal blanco y vestimenta formal puede deberse a la percepción de limpieza y en su rol como símbolo médico que lo diferencia de otros funcionarios 3,4,14,18 . Sin embargo, otros reportes demuestran que los pacientes confían en sus médicos independiente de la forma en que este se vista, incluso si ésta no les gusta 10,11 . ...
Background:
The formal appearance of health care professionals may influence their trustworthiness.
Aim:
To determine the effect of the orthopedic surgeon's attire on patients' perceptions of credibility and reliability of professionals.
Material and methods:
In a cross-sectional design, 351 patients (mean age 43 ± 17 years, 62% males) from the Department of Orthopedics and Traumatology of a Chilean regional hospital in southem of Chile were chosen to complete a questionnaire of attire preferences, in which five photographs with male and female orthopedic surgeons appeared (executive, formal attire, informal attire, scrubs and casual clothing). The influence of attire in the perception of physicians' trustworthiness to resolve medical situations was analyzed.
Results:
Forty four percent of patients had no physician gender predilection (p = 0.32). Forty three percent of male and 38% of female patients preferred the use of formal attire. In situations of credibility or confidence, all patients chose mostly the use of white coats with formal attire by professionals. The probability of choosing an orthopedic surgeon with a formal attire was significantly higher among patients who considered the attire and appearance of the professional to be very important (Odds ratio = 3.74; p < 0.01).
Conclusions:
Patients prefer orthopedic surgeons wearing white coats and formal attire, which improves credibility of these professionals to correctly solve medical situations.
... Whereas when comparing the results to medical specialists like psychiatrists and pediatrics, it has been observed that they do not wear white coats because their patients find them threatening and thus interfere in their relationship with the patients. The views of pediatricians may reflect the findings of a study by Barrett and Booth who found children regard formally dressed doctors as competent but not friendly, and those casually dressed as friendly but not competent (13). ...
... This study attempted to understand the preferences of patients and doctors toward the different types of dress codes doctors choose for the various clinical scenarios encountered in a variety of locations. Two Australian studies in 2001 by Harnett (1) and Gooden et al (2) suggested that 36%-59% of patients preferred junior doctors to wear white coats for easier identification, hygienic purposes and as a symbol of professionalism. Conversely, other studies (3,4) suggested that, from a patient's perspective, the doctor's attire does not correlate with estimates of the clinician's courteousness, concern or professionalism. ...
A doctor's attire is vital for both a positive first impression and the overall healthcare experience of patients. We attempted to understand patients' and doctors' perceptions and preferences regarding six types of dress codes used by doctors in different situations and locations. A total of 87 patients and 46 doctors participated in the study. Separate sets of questionnaires, that included four demographic questions and 14 survey questions, were given to the patient and doctor groups. Most patients preferred doctors dressed formally in white coats irrespective of scenarios or locations whereas majority of doctors preferred formal attire without white coats. Both groups preferred operation theatre attire in the emergency department. Findings confirmed that patients perceived doctors as more trustworthy, responsible, authoritative, confident, knowledgeable and caring in white coats. There is a need to educate the public regarding the reasons for change in doctor's traditional dress codes.
... Rehman et al reported that 76.3% of patients in USA favored the use of professional attire, including a white coat. 2 Dunn et al 15 observed that 59% of oncology patients preferred white coat as a physicians attire also Harnett 16 found that 65% of inpatients preferred their physicians to wear white coats. Gooden et al 17 observed that 48% and 36% of patients and inpatients, respectively preferred their physicians to wear white coats. ...
... Birçok çalışmada hastalar hekimlerinin beyaz önlük giymesini yeğlemiştir. 1,3,4 Hastaların hekimlerde yarı resmi bir giyim tarzını resmi giyim tarzına veya beyaz önlüğe yeğlediklerini bildiren 2 veya hekimin giyim biçiminin hastalar tarafından önemli bulunmadığını belirten 5 çalışmalar da vardır. Psikiyatri kliniğinde yatan hastalarda yapılan bir çalışmada da şık görünüm ve beyaz önlük hastalar tarafından ilk sırada yeğlenmiştir. ...
Objective: First impression carries significance in interpersonal relations. Establishing a relationship also forms the basis of the treatment process which will be conducted by the patient and the physician together. Physicians' clothing has been suggested to create major differences in physician-patient relationship. In this study, it was aimed to investigate the clothing style of psychiatrists preferred by psychiatrists and psychiatric patients and their opinion about its possible effects on physician-patient relationship. Methods: Consecutive 150 patients who applied to psychiatry outpatient clinic and 100 psychiatrists were included in the study. At first, sociodemographic data form was completed. Then, the pictures of different clothing styles were shown to participants and a questionnaire about its possible effects on physician-patient relationship was applied. Results: Mean age of the patients was 39.3±2.8 (range 19-79 years), 73 (48.7%) patients were female, 77 (51.3%) patients were male. Diagnoses of 40 (26.7%) patients were psychotic disorders, 52 (34.7%) were affective disorders, 31 (20.7%) were anxiety disorders and 27 (18.0%) patients were diagnosed with other disorders. Mean age of the psychiatrists was 32.4±8.2 (range 24-59 years), 52 (52.0%) psychiatrists were female, 48 (48.0%) psychiatrists were male. Mean duration of practicing medicine was 7.7±8.2 years, and mean duration of practicing psychiatry was 6.2±7.2 years. The number of psychiatry residents was 68 (68.0%), and the number of psychiatrists was 32 (32.0%). It was found that psychiatrists attached more importance to physician's clothing compared to patient group (p<0.01). Patients’ first choice was white coat for both male (54.7% n=82) and female (50.0% n=75) psychiatrists. While psychiatrists’ first choice was casual wear (56.0% n=56) for male psychiatrists and semi-formal wear (52.0%, n=52) for female psychiatrists. Only five (5.0%) psychiatrists preferred white coat for both male and female psychiatrists. Conclusion: Although psychi-atric patients do not attach importance to psychiatrist’s clothing style as psychiatrists, they prefer that psychiatrists wear white coats. Therefore wearing white coat may positively affect physician-patient relationship and may help the physician to create a good impression. © 2016, Cukurova University, Faculty of Medicine. All rights reserved.
... 8,9,13 However, this finding differs from other studies where patients had least preference toward the white coat. 14,15 Pediatric dentists wearing white coat must be concerned by the fact that 28% of children in this study reported that they disliked their dentist white coat and another 30% preferred the non-white coat attires for their dentist to wear. Parents in this study showed similar preference (42%) in traditional attire as reported by previous studies. ...
Background:
Before arrival into doctor's clinic, child might have acquired an impression of a clinical environment and doctor's appearance. Different kind of doctor's attire may evoke different reactions. By understanding children and parent's perception and preferences about dentist's attire, a suitable dress code could be adopted to establish good rapport with children.
Aim:
To evaluate children and parental perceptions and preferences towards dentist attire.
Materials and methods:
A questionnaire designed with series of photographs of male and female dental students in different attires was responded by 150 parents aged 29 to 63 years and 150 children aged 9 to 13 years.
Results:
Seventy percent of children participants (n = 104) and 42% of parents participants (n = 63) favored the traditional white coat attire. However, 58% parents (n = 87) significantly preferred non-white coat attires in comparison to 30% of children (n = 46) (χ(2) = 21.61, p < 0.001). No statistical significant difference was noted among the children and the parents, both favoring the use of protective wear (χ(2) = 0.99 p > 0.05), no-significant association was found between parents and children response to white coat (χ(2) = 0.39, p = 0.53). A highly significant difference was found between the male participants, who favored the male dentist and female participants preferring the female dentist (χ(2) = 47.16, p < 0.001).
Conclusion:
Our study attempted to rule out the stereotyped concept of 'white coat fear' among children, both children and parents favored traditional white coat attire, contrary to popular misconception 'white coat syndrome'. However, use of child friendly attires could be useful in anxious children for better practice management. How to cite this article: Ellore VPK, Mohammed M, Taranath M, Ramagoni NK, Kumar V, Gunjalli G. Children and Parent's Attitude and Preferences of Dentist's Attire in Pediatric Dental Practice. Int J Clin Pediatr Dent 2015;8(2):102-107.
... Her ikisinin işbirliği ile bu konunun ele alınması gerekmektedir. Hastayla daha iyi bir iletişim kurulabilmesi ve güvenin sağlanmasında doktorun tıbbi bilgisi, dış görünüşü, konuşma şekli, tutum ve davranışları önemlidir.5678910 Bu durum bizim hastalarımız için irdelendiğinde, düşük eğitim seviyeli grupta hastaların hiçbiri doktorunun onlar için güzel ve farklı giyinmesini istemezken , yüksek tahsilli hastalarda evet oranı %61 olup aradaki bu fark istatistiksel olarak anlamlı bulunmuştur (p<0.05). ...
... 5 Results differ from an Australian study showing the majority of patients are indifferent about what their doctor wears, which reflects that opinions differ depending on region. 6 When asked to choose between the pictured options of dress, white coats were the preferred option, with smart dress next and smart casual the least popular, coinciding with a study by Gallagher et al. 7 The first phase of the study showed that medical students in white coats elicited higher trust and confidence in patients than the smart or smart casual forms of dress; the findings are similar to a Glasgow study on doctors by Dover S. 8 White coats were shown not to be seen as intimidating or make patients feel uncomfortable compared to other form of dress. This shows the idea that white coats are intimidating, such as that in white coat hypertension, 9 is not a significant factor in the context of the Orthopaedic OPD. ...
Introduction: Currently, medical students are not given specific guidance on how to dress. This allows them to wear what they interpret as appropriate, which may not always be optimal. Many studies have shown that a doctor’s attire can greatly affect the consultation; however, no studies have been carried out investigating patient responses to medical student attire.
Methods: A two-phase patient questionnaire was conducted. Phase 1 surveyed 60 patients, who were given questionnaires based on pictures of medical students in various clothing styles: with a white coat, without a white coat but smartly dressed, and without a white coat dressed smart casual. This was followed by a second live phase where 50 patients were seen by medical students dressed with or without white coats and were asked to complete a survey assessing their response to the student and consultation based solely on their dress.
Results: Patients favour medical students wearing white coats. In our questionnaire based study (phase 1), white coats scored highest in trust and confidence (p
... Gooden y colaboradores [15], en 2001, tras un estudio en 200 pacientes, encontraron que la bata blanca mejora todos los aspectos de la interacción médico-paciente, y que además de ser utilizada como una barrera de protección, se constituye en un signo de autoridad y respeto. ...
El currículo de medicina de la Pontificia Universidad Javeriana, sede Cali, ha querido retomar e implementar diversas iniciativas y símbolos dentro de un “programa de profesionalismo” que busca promover valores éticos, morales y humanistas en los estudiantes de medicina. La ceremonia de imposición de la bata blanca hace parte de este programa y constituye uno de los símbolos que se ha querido incorporar. Objetivo: Revisar los antecedentes de la ceremonia de imposición de bata blanca en contraste con el significado que se le ha atribuido en la Facultad de Ciencias de la Salud de la Pontificia Universidad Javeriana. Materiales y métodos: Revisión sistemática en las bases bibliográficas de Pubmed, ScienceDirect, Hinari, SciELO y Google Schoolar, mediante el descriptor white coat ceremony para contrastar las experiencias reportadas en la literatura sobre dicha ceremonia con la experiencia de la Pontificia Universidad Javeriana. Resultados: Dado que l a bata blanca es un símbolo ampliamente reconocido de la profesión médica por la humanidad, su ceremonia de imposición se constituye en un acto que exhorta a los estudiantes de medicina hacia el cumplimiento de las mismas obligaciones de los médicos desde su proceso de formación. Conclusión: L a ceremonia de imposición de la bata blanca se constituye en un acto simbólico de transición que enmarca el paso de los estudiantes del ciclo fundamental al profesional y que en la Facultad de Ciencias de la Salud de la Pontificia Universidad Javeriana de Cali pretende exaltar los valores humanos esenciales de la medicina.
... A review of the literature, including two dermatology studies, indicates that patients prefer their physicians to wear white coats, not only for identification purposes but to build trust and confidence. [1][2][3][4][5][6][7] This preference holds stable whether studies have addressed general practitioners, 1-4 specialists, 5 or dermatologists specifically. 6,7 A study in which subjects were shown digital photographs of doctors with or without white coats found that subjects perceived the doctors wearing white coats to have greater authority, to be more friendly and to be more attractive. ...
Physicians wearing white coats are per-ceived as having more authority, being more friendly and being more attractive than those not wearing white coats, and patients report that they prefer their dermatologist to wear a white coat. The aim of the study was to deter-mine the prevalence of dermatologists wearing white coats on practice websites. We searched Google for dermatology practice websites in six states representing distinct geographic regions in the United States. The first one hundred search results were evaluated, and photographs of dermatologists on these web-sites were examined for the presence or absence of white coats. Most (77%) of derma-tologists did not wear white coats. The highest prevalence was in the eastern states of Massachusetts and South Carolina, with 29% and 39%, respectively. Colorado had the lowest rate at 13%. Rates were essentially equal when segmented by gender. Although patients report that they prefer their dermatologist to wear a white coat, dermatologists often do not wear a white coat on their practice websites.
... The majority of patients does not mind the doctors' dress and only one fifth of them dislike doctors wearing white coats (3). Several reasons are in favour of wearing a white coat uniform (4). ...
Background:
The dress code for surgeons has evolved over time from formal suit-and-tie to crisp white coat, and currently to various forms of smart-casual attire; however, there is no stipulated or rigid uniform guideline. It is important to explore and discuss the various forms of attire in relation to patients' ideals and perceptions of a surgeon.
Methods:
An observational study in the form of a paper-based questionnaire was carried out at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), Chris Hani Baragwanath Academic Hospital (CHBAH) and Wits Donald Gordon Medical Centre (WDGMC). Seven questions (Q1-Q7) were posed with various dress categories to select from in each question, namely: formal, smart, smart-casual and scrubs. Descriptive analysis of the survey responses, and the determination of the association between survey responses and a) hospital, b) gender, c) age group was performed. Fisher's exact test was used where the requirements for the chi-square test could not be met. Attire groups with n < 15 were not analysed. The strength of the associations was measured by Cramer's V and the phi coefficient respectively. Data analysis was carried out using SAS v9.4 for Windows. A 5% significance level was used.
Results:
A total of 387 questionnaires were filled out with a total of 376 fully completed and eligible samples in consenting participants of 18 years and older. In all seven questions, scrubs were the preferred attire. Overall, for Q1-Q5 and Q7, after scrubs, smart was the next most popular attire. For Q6, after scrubs, smart, smart-casual and formal were all popular, indicating some leeway on weekends and public holidays. There was a significant association between each of the responses to the question and hospital (p < 0.0001). At CHBAH, patients preferred scrubs more and smart attire less, compared to CMJAH and WDGMC. At CMJAH, preference for formal attire was greater when compared to the other two hospitals.
Conclusion:
Overall, patients preferred their surgeons to be dressed in scrubs as this attire easily identified surgeons and instilled confidence in the wearer.
Background:
In a health-care setup, interpersonal communication plays a pivotal role in the attainment of professional outcomes. Dressing is an indirect mode of communication. Since ancient times, it is assumed that doctor's clothing have a positive effect on the minds of patients. This survey evaluates the perception of interns from dental sciences regarding the impact of dressing on professional performance at workplace.
Materials and methods:
A self-designed questionnaire was distributed among a batch of interns who were willing to participate in the survey. Seventy-six interns returned the responses which were complete without any duplication. All the survey forms were scrutinized and the data were collated. Qualitative analysis of the assembled data was performed to evaluate intern's perception about the association between dressing and professional performance at workplace.
Results:
Results of the survey demonstrated that 81.6% of the participants dress up to work as per their temperament. About 65.8% of the participants believed that dental professionals should choose formal wear for workplace settings. Majority of the participants, i.e., 67.1%, believed that dressing affects perception on personality traits such as dignity and character of a professional. A wide number of interns perceived that dressing alters the behavior of self, patients, and colleagues (55.3%, 71.1%, and 68.4%, respectively). The result of this survey also showed a positive correlation between dressing and professional traits such as confidence, responsibility, and efficiency (75.0%, 63.2%, and 63.2%, respectively). Notably, 55.3% opined against enforcing a dress code for dental institutions/dental offices.
Conclusion:
The result of the study represents the positive influence of dressing on professional performance at workplace in dentistry as perceived by interns from the faculty of dental sciences.
Background: From the late 1960s, physician's appearance has been actively studied in the West, and until the early twenty-first century, patients tended to prefer “formal dress” attire along with white coats for physicians. However, people’s attitudes today toward dress code has not been clarified while it may have changed.
Objective: This study aimed to investigate the acceptability of dress codes from the patient’s perspective to suggest the future of dress codes.
Methods: Outpatients and their families in a university hospital and small-to medium-sized hospital were surveyed. We inquired which of the different styles of white coats and different colors of scrubs were most desirable for male and female physicians. We used Scheffet’s pair-comparison method to show the rankings.
Results: Patients and their families expected their physicians to wear white coats rather than scrubs. Furthermore, the more traditional and formal dress code was preferred. The least preferred color of scrubs was yellow.
Conclusion: The study found that patient’s preference for a traditional, conservative appearance has not changed over time. It did not match today's perspective on infection prevention. Although, both perspectives, patient preferences and infection prevention are important for education and gaining patient trust.
Although increasingly disputed, the white coat uniform is ubiquitous in geriatric care, which may reflect a phenomenon called medicalisation of ageing. This narrative review is the first attempt at integrating several theoretical approaches, such as the “white coat effect” and “enclothed cognition”, in order to gain a comprehensive understanding of the use of this clothing item. Based on extensive empirical evidence, we will examine the consequences of wearing a uniform, not only on patients (in this case, older patients) and healthcare professionals, but also on their relationship. The white coat has powerful symbolic functions for healthcare professionals and is still preferred by older adults. However, the negative repercussions of wearing a uniform require us to question its use, particularly in environments where older persons live, such as nursing homes.
Objectives
To understand the influence of the white coat on patient satisfaction, opinions about medical clothing, perception about confidence, empathy and medical knowledge and the satisfaction and comfort level of physicians in consultation.
Setting
An interventional study was conducted with a representative sample of the population attending primary care in central Portugal.
Participants
The sample was composed by 286 patients divided into two groups exposed or not to a doctor wearing a white coat. The first and last patients in consultation every day for 10 consecutive days were included.
Interventions
Every other day the volunteer physicians consulted with or without the use of a white coat. At the end of the consultation, a questionnaire was distributed to the patient with simple questions with a Likert scale response, the Portuguese version of the ‘Trust in physician’ scale and the Jefferson Scale of Patient Perceptions of Physician Empathy - Portuguese Version (JSPPPE-VP scale). A questionnaire was also distributed to the physician.
Outcomes
Planned and measured primary outcomes were patient satisfaction, trust and perception about empathy and secondary outcomes were opinion about medical clothing, satisfaction and comfort level of physicians in consultation.
Results
The sample was homogeneous in terms of sociodemographic variables. There were no statistically significant differences between the groups in terms of satisfaction, trust, empathy and knowledge perceived by the patients. There were differences in the opinion of the patients about the white coat, and when the physician was wearing the white coat this group of patients tended to think that this was the only acceptable attire for the physician (p<0.001). But when the family physician was in consultation without the white coat, this group of patients tended to agree that communication was easier (p=0.001).
Conclusions
There was no significant impact of the white coat in patient satisfaction, empathy and confidence in the family physician.
Trial registration number
ClinicalTrials.gov ID number: NCT03965416 .
Background
Physician attire has been shown to impact patients’ perceptions of their provider with regards to professionalism, competency, and trustworthiness in various surgical subspecialties, except in plastic and reconstructive surgery.
Objectives
This study aims to address this knowledge gap and obtain objective information regarding patients’ preferences.
Methods
A survey was distributed to adult, English-speaking participants in the U.S. using Amazon MTurk platform from February 2020 to December 2020. Participants were asked to evaluate six attires (scrubs, scrubs w/ white coat, formal attire, formal attire w/ white coat, casual, casual w/ white coat) in terms of professionalism, competency, and trustworthiness for male and female plastic surgeons during their first encounter in clinic using a 5-point Likert scale.
Results
A total of 316 responses were obtained, which consists of 43.4% men and 56.6% women. Mean age of participants was 53.2 years. The highest scores across all metrics of professionalism, competency, trustworthiness, willingness to share information, confidence in the provider, and confidence in surgical outcomes were given to the formal attire with white coat group with average scores of 4.85, 4.71, 4.69, 4.73, 4.79, 4.72, respectively. The lowest scores across all metrics belonged to the casual attire group with scores of 3.36, 3.29, 3.31, 3.39, 3.29, 3.20, respectively. Patients preferred formal attires for young plastic surgeons (p=0.039).
Conclusions
Our study suggests that physician attire impacts patients’ perception of plastic surgeons with regards to their professionalism, competency, and trustworthiness. White coats continue to remain a powerful entity in clinical settings given that attires with white coats were consistently ranked higher.
Research in social psychology demonstrates that physical environmental factors – or “artifacts” such as provider clothing and office décor – can influence health outcomes. However, the role of artifacts in augmenting or diminishing health outcomes is under-explored in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts may carry significant potential in informing how placebo effects can be maximized, and nocebo effects minimized in clinical settings. We discuss the potential mechanisms, including classical conditioning, response expectancy, and mindsets, by which artifacts might enhance or diminish these effects. Next, we propose testable hypotheses to investigate how placebo and nocebo effects might be elicited by artifacts in care settings, and conclude by providing innovative research designs to advance this novel research agendum.
Background:
Prior research suggests that physician attire has an important effect on patient perceptions, and can influence the patient-physician relationship. Previous studies have established the effect of specialty, location, and setting on patient preferences for physician attire, and the importance of these preferences and perceptions on both the physician-patient relationship and first impressions. To date, no studies have examined the influence of attire in the inpatient orthopaedic surgery setting on these perceptions.
Questions/purposes:
(1) Do differences in orthopaedic physician attire influence patient confidence in their surgeon, perception of trustworthiness, safety, how caring their physician is, how smart their surgeon is, how well the surgery would go, and how willing they are to discuss personal information with the surgeon? (2) Do patients perceive physicians who are men and women differently with respect to those endpoints?
Methods:
Ninety-three of 110 patients undergoing orthopaedic surgery at an urban academic medical center participated in a three-part survey. In the first part, each patient was randomly presented 10 images of both men and women surgeons, each dressed in five different outfits: business attire (BA), a white coat over business attire (WB), scrubs alone (SA), a white coat over scrubs (WS), and casual attire (CA). Respondents rated each image on a five-point Likert scale regarding how confident, trustworthy, safe, caring, and smart the surgeon appeared, how well the surgery would go, and the patient's willingness to discuss personal information with the surgeon. In the second part, the respondent ranked all images, by gender, from the most to least confident based on attire.
Results:
Pair-wise comparisons for women surgeons demonstrated no difference in patient preference between white coat over business attire compared with white coat over scrubs or scrubs alone, though each was preferable to business attire and casual attire (WS versus WB: mean difference [MD], 0.1 ± 0.6; 95% CI, 0.0-0.2; p = 1.0; WS versus SA: MD, 0.2 ± 0.7; 95% CI, 0-0.3; p = 0.7; WB versus SA: 0.1 ± 0.9; 95% CI, -0.1 to 0.2; p = 1.0). The same results were found when rating the surgeon's perceived intelligence, skill, trust, confidentiality, caring, and safety. In the pair-wise comparisons for male surgeons, white coat over scrubs was not preferred to white coat over business attire, scrubs alone, or business attire (WS versus WB: MD, -0.1 ± 0.6; 95% CI, 0-0.1; p = 1.0; WS versus SA: MD, 0 ± 0.4; 95% CI, -0.2 to 0; p = 1.0; WS versus BA: MD, 0.2 ± 0.8; 95% CI, 0-0.4; p = 0.6). WB and SA were not different (MD, 0.0 ± 0.6; 95% CI, -0.1 to 0.2; p = 1.0), though both were preferred to BA and CA (WB versus BA: MD, 0.3 ± 0.8; 95% CI, 0.1-0.5; p = 0.02; WB versus CA: 1.0 ± 1.0; 95% CI, 0.8-1.2; p < 0.01). We found no difference between SA and BA (MD, 0.3 ± 0.7; 95% CI, 0.1-0.4; p = 0.06). We found that each was preferred to CA (SA versus CA: 0.9 ± 1.0; 95% CI, 0.7-1.2; p < 0.01; BA versus CA: 0.7 ± 1.0; 95% CI, 0.5-0.9; p < 0.01), with similar results in all other categories. When asked to rank all types of attire, patients preferred WS or WB for both men and women surgeons, followed by SA, BA, and CA.
Conclusions:
Similar to findings in the outpatient orthopaedic setting, in the inpatient setting, we found patients had a moderate overall preference for physicians wearing a white coat, either over scrubs or business attire, and, to some extent, scrubs alone. Respondents did not show any difference in preference based on the gender of the pictured surgeon. For men and women orthopaedic surgeons in the urban inpatient setting, stereotypical physician's attire such as a white coat over either scrubs or business attire, or even scrubs alone may improve numerous components of the patient-physician relationship and should therefore be strongly considered to enhance overall patient care.
Level of evidence:
Level II, therapeutic study.
Personnel in contact with patients or equipment and textiles should always use the hospital’s work attire. It includes anyone handling food, medicines, textile, waste or cleaning tools. By caring, treating, examining and transporting patients, there will be direct contact between own work clothes and the patient’s cloths/bedding or skin. The same is true when working with used patient equipment such as bedpans, toilet chairs, beds and other aids and working in patient rooms, toilets and bathrooms or when handling bedding and bandages, giving physiotherapy, etc. The work uniform is particularly exposed to organic matter and microbes, for example, in ambulances, in emergency services, in restless and anxious patients and children, during sampling and examination/treatment, etc. In acute wards, the staff is often exposed to splashes from patients, especially blood but also vomit, sputum, pus, faeces and urine. This chapter is focused on practical measures to prevent transmission of infections via contaminated staff uniforms.
Introduction : L’optimisation de la relation médecin-malade doit être recherchée par tous les praticiens. Plusieurs facteurs influençant cette relation ont été étudiés mais pas l’aspect vestimentaire du médecin généraliste. Objectifs : Notre étude cherche à étudier l’impact de la tenue vestimentaire du médecin généraliste sur les patients. La confiance du patient envers son médecin et en ses compétences ainsi que l’observance thérapeutique déclarée sont-elles liées à sa tenue? Matériel et Méthode : Il s‘agit d‘une étude quantitative prospective réalisée auprès de 400 personnes issues de la population générale en France en 2016 avec des questionnaires aidés de planches photos homme et femme représentant 4 tenues vestimentaires. Résultats : 56 % des répondants font attention à la tenue de leur médecin généraliste. La tenue de ville (71,5%) est la tenue la plus appropriée et dépasse de peu la blouse blanche (70,4%) (p< 0,05). C’est également la tenue qui met le plus à l’aise les patients (47,8%), devant la blouse blanche (37,3%) et la tenue classique (36,3%) (p<0,05). La blouse blanche rassure le plus (42,7%), devant la tenue de ville (34,7%) et la tenue classique (27,8%). La tenue décontractée est celle qui met le moins en con ance (46,5%) (p<0,05). Pour 87,7% des patients, la tenue vestimentaire n’a pas d’impact sur l’observance thérapeutique contre 12,3% chez qui la tenue vestimentaire peut jouer un rôle dans l’observance thérapeutique (p<0,05). Conclusion : La tenue vestimentaire du médecin généraliste a un impact sur le patient et peut donc influer sur la relation de soins.
Objective
Several large studies have shown that improving the patient experience is associated with higher reported patient satisfaction, increased adherence to treatment and clinical outcomes. Whether physician attire can affect the patient experience—and how this influences satisfaction—is unknown. Therefore, we performed a national, cross-sectional study to examine patient perceptions, expectations and preferences regarding physicians dress.
Setting
10 academic hospitals in the USA.
Participants
Convenience sample of 4062 patients recruited from 1 June 2015 to 31 October 2016.
Primary and secondary outcomes measures
We conducted a questionnaire-based study of patients across 10 academic hospitals in the USA. The questionnaire included photographs of a male and female physician dressed in seven different forms of attire. Patients were asked to rate the provider pictured in various clinical settings. Preference for attire was calculated as the composite of responses across five domains (knowledgeable, trustworthy, caring, approachable and comfortable) via a standardised instrument. Secondary outcome measures included variation in preferences by respondent characteristics (eg, gender), context of care (eg, inpatient vs outpatient) and geographical region.
Results
Of 4062 patient responses, 53% indicated that physician attire was important to them during care. Over one-third agreed that it influenced their satisfaction with care. Compared with all other forms of attire, formal attire with a white coat was most highly rated (p=0.001 vs scrubs with white coat; p<0.001 all other comparisons). Important differences in preferences for attire by clinical context and respondent characteristics were noted. For example, respondents≥65 years preferred formal attire with white coats (p<0.001) while scrubs were most preferred for surgeons.
Conclusions
Patients have important expectations and perceptions for physician dress that vary by context and region. Nuanced policies addressing physician dress code to improve patient satisfaction appear important.
Clothes are important for self-identity, self-confidence, appearance, and social skills. What are the roots of clothing? Is clothing described in the Bible? What are the protective effects of clothing? Adverse Effects? What is the effect of physicians' attire? What are the legal consequences of clothing? Biblical verses were examined and relevant verses relating to clothing were studied closely from a contemporary perspective.
The authors of this Views and Reviews describe the evolution of the role of mental health counseling in infertility care. As the use of assisted reproductive technologies and third-party reproduction has grown, so too has the interest and demand for mental health services. A historical perspective is presented that sets the stage for subsequent discussions of key areas where mental health practitioners are able to contribute to the utility and outcomes of infertile patients as well as those involved in their care. This series of articles stresses the value of more comprehensive integration of mental health support into infertility practice and highlights practical opportunities to do so.
Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10161 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 23-25
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.
A cross-sectional survey conducted among patients of the Alwazarat family medicine center in Riyadh, Saudi Arabia.
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).
Overall, across all questions regarding physician dress style preferences, participants significantly pre.ferred 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).
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.
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.
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.
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.
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.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The practice of wearing white coats, also called laboratory (lab.) coats, by doctors is very common throughout the western world and is also found in the rest of the world. The exact origin of this practice is unclear and its relevance, especially in pediatric practice, is being questioned of late. Objectives: To find out whether the mode of dressing of a pediatrician, especially wearing of white coats, has an influence on the perception of the doctor by parents and/or children in a pediatric ward. Materials and Methods: A structured self-Administered questionnaire was used to collect information from the caregivers of children, (and older children) who were admitted in the hospitals during the study period. Three photographs of a doctor dressed differently (formal dressing with shirt and tie and a white coat, formal dressing with shirt and tie but no white coat and casual dressing with T-shirt upon jeans trousers) were shown to the children and their parents/caregivers and were asked to indicate which of the pictures they would prefer as their child′s doctor. Results: A total of 227 child/caregiver pairs were interviewed. Ninety-four of the children [41.4%] were females whereas133 [58.6%] were males. The preference of the caregivers on the appropriate dress style for doctors was mostly the corporate attire alone was 74 [32.6%]; and with a white coat was 126 [55.5%]. The preference of the children for the corporate look was also 67 [29.4%] and the corporate look with white coat was 88 [38.7%] as the preferred attire for their attending doctor. Conclusions: Our findings suggest a preference for the wearing of white coats by pediatricians, especially among caregivers and older children.
To investigate patients' views and expectations when attending outpatient clinics a questionnaire-based study was performed. The questionnaires asked about appointment systems, continuity of care, staff appearance, chaperons and medical students. Patients wanted fixed appointment times, to see the same doctor on successive visits, for the staff to be formally dressed and to have chaperons during examination. The number of medical students should be restricted especially for women patients. Staff should be sensitive to patients' needs.
Dress styles and forms of address vary among psychiatrists.
A semi-structured interview was administered to a sample of psychiatric in-patients, and a questionnaire was sent to junior and consultant psychiatrists, to identify preferences for dress styles and terms of address.
Forty-nine (71%) of the in-patient sample participated. A preference was found for smart attire and white coats. Of the 69 (80%) doctors returning questionnaires, the majority supported smart dress as the most appropriate attire. Most patients preferred to be called by their first name while addressing doctors by title and surname. Junior doctors preferred to use first names when talking to patients while almost all consultants used title and surname. Doctors of all grades liked to be called by their title and surname.
Paying more attention to the way we present ourselves and interact at work may help to facilitate the therapeutic alliance.
I recently gave a lecture-demonstration to a class of medical students taking clinical physiology (a preclinical course). I wished to present two patients with Graves's disease: in anticipation of the session I requested that white coats be worn by the students. When the class hour had ended, I received, from one of the students, a note that not only graded my performance but included the following comment: "I would like to see the evidence that wearing of white coats by students is of any benefit to patients — isn't your request more to satisfy your own ego?" The following is . . .
The clinician's appearance is often considered a symbol which identifies and defines specific characteristics of the individual. Opinion of both lay and medical personnel on appropriate clothing inclines towards formal dress. Our aim was to assess the effect of the anaesthetist's appearance during a ward visit on the patient's evaluation of either the visit or the anesthetist himself. In our sample of 66 patients we found no evidence that the style of dress (formal: suit and tie, informal: jeans and open-necked shirt) affected that evaluation. However, when 138 patients were asked to rate the desirability of items of clothing for a male hospital doctor they expressed a preference for traditional clothing; a suit was rated as desirable and jeans as one of the four most undesirable items. We conclude that despite the conservatism of expressed opinions, the clothing worn by the anaesthetist is irrelevant to the patient's satisfaction with the visit.
To evaluate perceptions of a pediatrician's attire, 50 children and parents in an outpatient facility were shown five photographs of a female or a male physician dressed differently (formal to informal). A list of positive and negative attributes was presented to the parents and children who were to match each picture to the attributes. Parents had a strong positive preference for the formally dressed female (short white coat and skirt), and the formally dressed male (short white coat and tie). More than 50% of the parents least preferred the most informal attire. Children had no clear preferences for males and preferred the female in the blouse and skirt. Children assigned negative attributes to informal attire but not to the same degree as did their parents. This study demonstrates that parents have stronger preferences than do their children. Although children had no strong positive preferences, they may feel negatively about informal attire.
Thirty-five residents and 77 staff physicians from three residency programs in Minnesota and Wisconsin completed questionnaires about their attitudes toward various components of the physician's appearance. Most participants showed positive responses to traditional physician attire such as white coat, name tag, shirt and tie, dress pants, skirt or dress, nylons, and dress shoes. Negative responses were associated with casual items such as sandals, clogs, athletic shoes, scrub suits, and blue jeans. Cronbach's alpha analysis identified four cohesive appearance scales: traditional male appearance, casual male appearance, traditional female appearance, and casual female appearance. Older physician participants favored a more traditional appearance than did younger physicians, and of the physicians who were 35 years and younger, staff physicians tended to show more conservative views toward professional appearance than did residents.
To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED.
A survey study was conducted to determine patients' preferences for resident physician attire as well as the relationship of physicians' attire to patient satisfaction and perception of the quality of care. Questionnaire responses were obtained from 200 consecutive subjects equally divided among four clinical settings (a hospital-based internal medicine clinic, an emergency room, an internal medicine ward, and a community-based internal medicine clinic) which are maintained by the University of California, Irvine, Medical Center. The questionnaires were administered only to English-speaking patients who had seen a physician on a previous visit. A majority of the patients at the four settings indicated that they had no preference regarding attire (70.5% for male doctors, 66.5% for female doctors): however, 44% of the patients said that neatness of dress was moderately to very important. The aggregate findings were not greatly altered when adjusted for demographic variables such as age, sex, race, occupational status, and education.
Although physician appearance has been a topic of interest to medical historians for more than two centuries, little objective investigation has been made into patients' and physicians' attitudes toward the physician's appearance. This study analyzed responses from 404 patients, residents, and staff physicians regarding their attitudes toward various aspects of the male and female physician's professional appearance. Positive responses from all participants were associated with traditional items of dress such as the dress, shirt and tie, dress shoes, and nylons, and for physician-identifying items such as a white coat and a name tag. Negative responses were associated with casual items such as blue jeans, scrub suits, athletic shoes, clogs, and sport socks. Negative ratings were also associated with overly feminine items such as prominent ruffles and female dangling earrings and such temporarily fashionable items as long hair on men, male earrings, and patterned hose on women. Overall, patients were less discriminating in their attitude toward physician appearance than physicians. Patients rated traditional items less positively and casual items less negatively. This study confirms the importance of the physician's appearance in physician-patient communication.
To study patient preferences on physician attire and etiquette, we interviewed 200 patients on the general medical services of teaching hospitals in Boston and San Francisco. Of these 200 patients, 65% believed physicians should wear a white coat, 27% believed physicians should not wear tennis shoes, 52% believed physicians should not wear blue jeans, 37% believed male physicians should wear neckties, and 34% believed female physicians should wear dresses or skirts. Forty percent of patients wanted physicians to address them by first name, but only 10% of patients wanted to address their physicians by first name. A concurrent mailed survey of 74 medical house staff members at the two hospitals revealed wide variability in physicians' attire and in how patients were addressed at each institution. Thus, many house officers had habits that were less formal than a substantial portion of their patients preferred.
This study evaluates the effect of physician dress and other variables (i.e., sex of physician and patient, age, and type and site of visit) on patient-physician rapport. Three hundred eighty-six teens filled out a questionnaire, at the end of an office visit, which evaluated their attitudes regarding their physician and their preference for physician dress. The physicians alternated between very informal, informal, formal-white coat, and formal-suit/dress styles. Dress style made no statistical difference in patients' attitudes toward their physician. When asked what they preferred their doctor to wear 43% responded "makes no difference," 26% said "white coat," 14% said "pants and shirt," 10% said "jeans and shirt," and 4% said "suit and tie." Female patients were significantly more comfortable (3.6 versus 3.3, p less than 0.01) with female physicians. Male patients did not show a preference for a same-sex physician.
In many accident and emergency (A&E) departments doctors still wear white coats or their ordinary clothes, rather than a type of uniform, which, should it become contaminated, can be changed easily for a clean uniform. Before a change of clothing to a uniform could be considered in an inner-city A&E department, a study was carried out to assess the public's perception towards different styles of dress. Three hundred and twenty-nine questionnaires were returned by minor injury patients requiring a radiograph. The study was carried out over 3 weeks in January 1993. Each week a different style of dress was worn: week 1--white coats, week 2--normal clothing and week 3--theatre greens. The majority of patients thought that style of dress was important but did not alter their attitude towards the A&E medical staff. Therefore, there is no reason why doctors should not wear a more appropriate uniform that can be changed easily when contaminated.
Two groups of adult patients (55 each) were visited pre-operatively by an anaesthetist who was dressed either formally or casually. Their response to this visit, their opinions regarding anaesthetists and their knowledge of anaesthetic work were elicited afterwards by means of a questionnaire. Patients' satisfaction with the anaesthetist and his/her visit was not influenced by dress. The anaesthetist was awarded a high level of prestige and the length of his/her training was recognised to be comparable to that of other professionals; 81.8% of patients thought that anaesthetists held a medical degree but only 35.4% thought that they worked in the intensive care unit. Patients expressed a preference for doctors to wear name tags, white coats and short hair but disapproved of clogs, jeans, trainers and earrings.
To determine if young children have a preference regarding whether physicians do or do not wear a white coat.
One hundred one children, ages four to eight years, and their parents were recruited from the outpatient setting of a pediatric referral center. Two pairs of photographs, the same man with and without a white coat and the same woman with and without a white coat, were shown to the children and their parents, and both were asked which of each pair they would like to have as their or their child's doctor, respectively. Parents filled out a questionnaire rating the appropriateness of various aspects of a physician's attire and appearance.
The children selected the person in the white coat 69% of the time. The parents also selected the white coat more often (66%). On the questionnaire parents identified a name tag as the most appropriate item of dress followed by a white coat. A groomed mustache and groomed beard were also rated favorably. Open-toed sandals, clogs, and shorts were rated negatively, while parents were neutral with respect to hospital greens, blouse and skirt or dress, and shirt and tie.
Physicians may wear a white coat without fear that they are negatively affecting their relationship with their pediatric patients four to eight years of age. The appropriateness of wearing a name tag is confirmed.
The purpose of this study is to evaluate the child's and parents' visual perception of physicians. To do this, 50 children and their parents were asked which physician they preferred, when shown eight pairs of photographs. Four characteristics were tested twice, white coat versus no white coat, smile versus stern face, cartoon posters versus no posters, and standing versus stooping. We found that both children and parents preferred the smiling physician and the physician with cartoon posters on the wall. Surprisingly 54% of children preferred the physician in the white coat, whereas only 35% of parents preferred the white coat. Sixty-eight percent of children also preferred the standing physician compared with only 41% of parents. There was little correlation between the parent's and child's answers. The results did not differ significantly with age, gender, or number of hospitalizations. In conclusion our study did not confirm the popular belief that children are afraid of physicians in white coats, although children did strongly prefer physicians who smiled and those with cartoon posters on the wall.
To know how Japanese patients perceive their physicians without a white coat during consultations.
The patients who visited a university clinic were divided into two groups: those seen by a physician in a white coat (the white-coat group) and those seen by a physician in private clothes (the private-clothes group). Questionnaires were distributed to the patients, which asked the tension and satisfaction of consultations as well as their preference for physician's attire. The answers of the white-coat group were compared with those of the private-clothes group.
The percentage of new patients who felt tense during consultations was greater in the white-coat group (42%) than in the private-clothes group (33%). Seventy-one percent of the patients in the white-coat group preferred physicians in a white coat whereas only 39% preferred so in the private-clothes group (p<0.0001). However, the degree of patients' satisfaction for the consultation showed no statistical difference between the groups. Sixty-nine percent of the patients older than or equal to 70 years preferred a white coat while 52 percent of the patients younger than 70 years preferred so (p=0.002).
Physician's white coats did not influence the satisfaction with the consultations for most Japanese patients in a university clinic, although elderly patients as well as those seen by a physician in a white coat tended to prefer the white coat to the private clothes. Furthermore, practice without a white coat might reduce patients' tension during their first consultation.