Appearance matters: Patients more likely to trust docs wearing white coats

A recent study in BMJ Open affirmed the value of physicians dressing the part, showing patients are more likely to consider them trustworthy and knowledgeable if they are wearing the traditional white coat over formal clothing.

This observation comes from a survey of 4,062 patients across 10 academic hospitals in the U.S. The questionnaire contained photographs of a male and female physician dressed seven different ways, ranging from casual (jeans with a collared shirt and tennis shoes) to a dark business suit.

Respondents were asked to rate the physicians from 1-10 based on their perception of how knowledgeable, trustworthy, caring and approachable the doctors appeared, as well as how comfortable they made the patient feel. Pooling the male and female physician scores, formal attire with a white coat achieved the highest composite rating at 8.1 and the highest individual ratings in every category. Scrubs with a white coat ranked second overall, with a composite score of 7.5.

“Overall, respondents indicated that formal attire with white coats was the most preferred form of physician dress,” wrote the researchers, led by Christopher M. Petrilli, MD, with the University of Michigan Medical School and VA Ann Arbor Healthcare System.

“However, in settings such as surgery or emergency rooms, scrubs with white coats were most preferred. Although variation in preferences by respondent age, gender, education and geography were noted, these findings indicate that most patients have expectations regarding doctor attire, and that a ‘professional’ look matters most. Given the size, methodological rigor and representativeness of these data, policies addressing physician attire should be considered to improve patient satisfaction.”

Even though quality of care is more important than how a physician looks, patient satisfaction is a crucial component of medicine and may ultimately improve outcomes. For example, a patient who trusts and respects a doctor more may be more likely to follow their advice or adhere to the medications they prescribe.

In general, older patients were more likely to prefer formal attire with white coats in hospital settings, while younger patients were more likely to prefer scrubs with white overcoats. Petrilli and colleagues said facilities focusing on geriatric care could use these findings to implement dress codes that match elderly patients’ expectations.

Interestingly, more than half of Northeast patients listed scrubs as the most appropriate attire for surgeons, compared to only a quarter of patients in the South. A greater number of patients in the South and West preferred formal attire plus coats versus respondents in the Northeast and Midwest.

“Hospitals in Southern regions of the USA may wish to endorse formal attire and white coats as their preferred policy,” the authors wrote. “For providers in the emergency room and surgical arenas, such attire may in fact be viewed as out of place—and thus different rules might be necessary. These examples illustrate how policies for specific doctors, settings or patients can be leveraged to focus on patient-centered care.”

The physicians pictured in the questionnaire were both young, white and slender, which may have biased the results, the authors noted. In addition, it’s unclear how a doctor’s interaction with a patient may have changed the patient’s trust and comfort levels, but the findings did highlight how dress may impact first impressions.

“While physician attire cannot replace excellent clinical care, our data suggest that it may influence how patients perceive care and perhaps how willing they are to trust their doctors,” Petrilli et al. wrote. “In an era of patient centeredness and patient satisfaction, physician attire may be an important, modifiable component of patient care.”