In many cases, casual attire works when dealing with patients

“The study helped to point out that there’s a redefinition of professional attire,” says Meghan W. Thomas, M.D., a resident in dermatology at the University of North Carolina at Chapel Hill. She collaborated with Dean S. Morrell, M.D., professor of dermatology and director of residency programs, to examine perceptions of physician attire.

“Physicians have more leeway than do professionals in the corporate world. Patients perceive ‘business casual’ attire - a dress shirt and trousers but no tie - as professional enough. You don’t lose any ground in their view of your appearance, and may gain some points in approachability,” Dr. Thomas says.

Dr. Thomas

Such attire may be seen as more approachable because it is ubiquitous in a variety of business settings, Dr. Thomas says. The way physicians and staff members treat patients’ calls and concerns remains critical, however.

Attire perceptions

Dr. Thomas and co-investigators analyzed the results of a confidential questionnaire given to patients seen in the adult dermatology clinic and to parents of children seen in the pediatric dermatology clinic.

Among the 454 respondents, 248 were parents of pediatric patients and 176 were adult patients. The questionnaire asked about dermatologists’ attire generally and whether the physician should wear a white coat and whether a male physician should wear a tie.

Among parents, 27 percent preferred that dermatologists treating adults wear a white coat, and 21 percent preferred that the male physician treating adult patients wear a tie.

Fewer thought that these appearances were important in a pediatric setting; 26 percent wanted a pediatric dermatologist to wear a white coat, while 15 percent wanted the physician to wear a necktie.

Among those seen in the adult clinic, more conservative attire won out some of the time. More than half (54 percent) preferred that a dermatologist seeing adults wear a white coat, but only 18 percent preferred a tie.

The adult patients also responded to their preferences for dermatologists seeing children. In that setting, 50 percent preferred that the physician wear a white coat and 19 percent wanted the physician to wear a tie.

Across the ages

The respondents varied by age in their responses. Only 33 percent of those younger than age 50 preferred the white coat in the adult setting, compared to 30 percent in the pediatric setting. Among those at least 50 years old, 55 percent wanted the white coat in the adult setting, compared to 51 percent in the pediatric setting. In both age groups, the tie was less important.

Among younger respondents, 18 percent and 16 percent preferred a tie in the adult and pediatric settings, respectively. Among older respondents, 24 percent preferred a tie in the adult setting, as did 14 percent in the pediatric setting.

“You still have to balance approachability with professionalism,” Dr. Thomas says. “And although women have broader options, there are limitations. The bottom line is that you can establish professionalism with more versatility in attire.”

Dr. Thomas stresses that attire is only a minor feature of approachability; the overall picture is most important. This includes courtesy of office staff, the way physicians answer patients, the promptness in which return phone calls, and the basic physician-patient relationship. Many of the survey comments highlighted interaction, knowledge and treatment as having the most impact on trust, the researchers found.

Match expectations

“Think about the type of patients who come to your office,” Dr. Thomas says. “If you have a practice with predominantly older patients, they will anticipate more conservative dress.”

Regardless of anything else, however, the white coat will still work, she says. “It’s a symbol of our profession. This is true even in Europe and Asia. The symbol is universal. It helps patients differentiate the physician and lends a hand to anything you’re wearing.”

As with any other issues regarding appearance, attire is rarely a deal-breaker, especially with established patients. With new patients, however, appearance contributes to the first impression. DT