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Abstract
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.
- health policy
- quality in health care
- infection control
- public health
- qualitative research
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors Conception and design of the work: CMP and SS. Acquisition of the data: VC, JJJ, LK and CMP. Analysis and interpretation of the data, drafting and critical revision of the manuscript for important intellectual content, accountable for all aspects of the work and approval of the final manuscript: AC, VC, JJJ, LK, CMP, SS and AS.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Ethics approval The study was reviewed and deemed exempt from regulation by the University of Michigan Institutional Review Board (HUM00085305).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Additional unpublished data are not publicly available.
Collaborators Dr Rachel Thompson, Dr Rajesh Patel, Dr Gabrielle Berger, Dr Daniel Cabrera, Dr Nancy Dawson, Dr MaryAnn S. Hedges, Dr Talawnda Bragg, Scarlett Shader Anaiah Massey, Aditya Yelamanchi and Sabian Taylor contributed by collecting data at their respective sites, PhD assisted with the design of the survey instrument and statistical analysis plan assisted with the design of the survey instrument.
Author note The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.