Clinical research study
What to wear today? Effect of doctor’s attire on the trust and confidence of patients

https://doi.org/10.1016/j.amjmed.2005.04.026Get rights and content

Abstract

Purpose

There are very few studies about the impact of physicians’ attire on patients’ confidence and trust. The objective of this study was to determine whether the way a doctor dresses is an important factor in the degree of trust and confidence among respondents.

Methods

A cross-sectional descriptive study using survey methodology was conducted of patients and visitors in the waiting room of an internal medicine outpatient clinic. Respondents completed a written survey after reviewing pictures of physicians in four different dress styles. Respondents were asked questions related to their preference for physician dress as well as their trust and willingness to discuss sensitive issues.

Results

Four hundred respondents with a mean age of 52.4 years were enrolled; 54% were men, 58% were white, 38% were African-American, and 43% had greater than a high school diploma. On all questions regarding physician dress style preferences, respondents significantly favored the professional attire with white coat (76.3%, P <.0001), followed by surgical scrubs (10.2%), business dress (8.8%), and casual dress (4.7%). Their trust and confidence was significantly associated with their preference for professional dress (P <.0001). Respondents also reported that they were significantly more willing to share their social, sexual, and psychological problems with the physician who is professionally dressed (P <.0001). The importance of physician’s appearance was ranked similarly between male and female respondents (P = .54); however, female physicians’ dress appeared to be significantly more important to respondents than male physicians’ dress (P <.001).

Conclusion

Respondents overwhelmingly favor physicians in professional attire with a white coat. Wearing professional dress (ie, a white coat with more formal attire) while providing patient care by physicians may favorably influence trust and confidence-building in the medical encounter.

Section snippets

Methods

Subjects were administered a survey to assess the self-expressed degree of patient trust, confidence in physicians, and adherence to prescribed regimens. The study used a randomized cross-sectional design, which made use of survey methodology. Before the administration of the surveys to the study subjects, the survey’s reliability and validity were tested. Two researchers familiar with instrument development and clinical research assessed the questionnaire’s content validity. After a slight

Results

Characteristics of study participants are listed in Table 1. Of the 400 respondents, 54% were white and 38% were African-American. Table 2 demonstrates that, in response to each of the preference questions about physician attire, there is a clear choice among respondents for professional attire. The chi-squared tests indicated that the preference patterns were all highly significantly different from an equal preference among the 4 various styles of dress. On average, across all preference

Discussion

In our study, respondents overwhelmingly favor professional attire with white coats for physicians. Our study results are similar to many other studies conducted worldwide in a variety of settings, except that none of the studies were conducted in the internal medicine outpatient setting.28, 29, 30, 31, 32, 33, 34, 35 Our study indicated that professional attire was associated with greater patient self-reported trust and confidence. This is similar to findings reported by McNaughton-Filion and

Conclusion

Patients and visitors to an internal medicine clinic in this study were overwhelmingly in favor of doctors wearing professional dress, ie, more formal attire with a white coat. We recommend that general internists consider wearing more formal attire with a white coat during patient care encounters, because it may favorably influence trust and confidence-building in the medical encounter. This is particularly important if this attire results in better adherence and thus positive health outcomes.

Acknowledgment

We thank Scott Stewart, MD; Sarah Melissa Mahoney, MD; Jerome Simmons, and Erica Hanesworth, Pharm D for modeling for photographs. We thank Mary Nashed, MB, and M. Hadi Ali Baig, MBBS, for assistance with logistics of the study. We are also thankful to John C. Baroody of Medical Media of Ralph H. Johnson V.A. Medical Center for his help in photographing our models.

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    This work was supported in part by Department of Veterans Affairs Research Services.

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