CORR Insights®: Orthopaedic Physician Attire Influences Patient Perceptions in an Urban Inpatient Setting.

Abstract

While preferences and knowledge have changed over time, the role of uniforms and even clothing colors remains important for all vocations [7]. Indeed, one’s personal presentation is a modifiable component of a first impression [3]. From the military, to the clergy, to the physician wearing scrubs on daytime television, society still has expectations regarding the appearance of professionals. However, unlike many other vocations, doctors have historically adopted a uniform that was not only culturally appropriate, but also functional. The traditional role of the physician uniform has been to promote the eradication of disease and minimize its spread through the best current evidence. From the plague doctor’s protective suit and beak filled with herbs and straw, to advancements like sterile gloves, scrubs, and masks; form has followed function in terms of the physician uniform. Physician attire must facilitate (or at least not impair) best medical practices, allow for the physical demands of our field, and mitigate (or at least not worsen) disease propagation. Physician attire must also meet patients’ social expectations, which may be culture-bound, and may change over time. And although we cannot control patients’ biases with respect to physician age, ethnicity, or gender, we should promote a uniform that conveys professionalism. The ideal physician uniform should seek to offset any biases patients may have, and help identify the individual as a physician, and not a nurse, medical student, or hospital administrator. Research conducted in an urban outpatient orthopaedic setting [4] suggests that patients have expectations regarding how doctors should present themselves; specifically, it appears that in that setting, patients prefer orthopaedic surgeons to wear either a white coat or scrubs. The current study by Jennings and colleagues [5] extends what we know on this topic; it found that in the inpatient setting, patients preferred both male and female orthopaedic surgeons to wear a white coat with scrubs or white coat with business attire most frequently, then, respectively, ranked scrubs alone, business attire, and least preferred casual attire. Prior work by Jennings and colleagues [4] studied patient preferences for orthopaedic surgeons in the outpatient setting. At that time, they did note some variations in patient preference based on the sex of the surgeon, with male physicians preferred to be in a white coat over business attire. However, there was no difference in confidence ranking of male surgeons in scrubs alone versus a white coat over business attire, and no differences in any category between scrubs alone and business attire. For women surgeons, there was an equal preference for a white coat over business attire or scrubs alone, and scrubs alone evoked a greater rating of confidence than business attire. Regardless of gender, patients still disliked surgeons in casual attire. This CORR Insights is a commentary on the article “Orthopaedic Physician Attire Influences Patient Perceptions in an Urban Inpatient Setting” by Jennings and colleagues available at: DOI: 10.1097/CORR. 0000000000000822. The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. R. Justin Mistovich MD, MBA (✉), Case Western Reserve University School of Medicine, Department of Orthopaedic Surgery, 11100 Euclid Ave., Cleveland, OH, 44106, USA, Email: justin@mistovich.net