Original contribution
Patient attitudes toward emergency physician attire

https://doi.org/10.1016/j.jemermed.2004.12.014Get rights and content

Abstract

Previous studies have suggested that Emergency Department (ED) patient satisfaction is unaffected by physician attire. We conducted a before-and-after trial to test this hypothesis. A convenience sample of ED patients was surveyed during a 2-week period. In the first week, emergency physicians wore white coats and formal attire. In the second week, the same physicians wore scrubs. Patients were asked to indicate on a 100-mm visual analog scale (VAS) their ratings of physician appearance, satisfaction, and professionalism. The primary outcome was the difference in VAS scores between the two dress styles. There were 111 patients surveyed. There were no significant differences between patients’ evaluation of appearance (Δ = −.68 mm VAS, 95% confidence interval [CI] −5.5 to 4.1), satisfaction (Δ = .83 mm VAS, 95% CI −3.0 to 4.6), or professionalism (Δ = −.46 mm VAS, 95% CI −3.6 to 2.6) between the two dress styles. Emergency physician attire does not affect patient satisfaction.

Introduction

Physician attire has evolved over the years, and what is considered to be proper physician dress has been often debated. Past studies concerning patients’ preferences of physician attire have been limited to studies of preference by photographs or clinic/inpatient settings (1, 2, 3, 4, 5, 6, 7, 8, 9). To our knowledge, only one study, from the United Kingdom, has specifically examined the influence of physician dress on Emergency Department (ED) patients’ evaluations of physician performance (10). Boon and Wardrope found that ED patients did not have a preference between formal clothes and scrubs. In an uncontrolled pilot study, we found that our patients also do not have a preference in emergency physician attire in our clinical setting, an urban ED in the United States (11). There was little difference in patient evaluations of physician appearance, satisfaction, or professionalism between the two dress styles (Δ = 3 mm VAS, 95% CI −3 to 9; Δ = 2 mm VAS, 95% CI −3 to 7, Δ =0 mm VAS, 95% CI −5 to 5, respectively). We now follow up our preliminary study with a controlled trial to determine if patient preferences are influenced by physician attire.

Section snippets

Methods

We surveyed adult patients at an urban ED in a teaching hospital. Surveys were administered by trained research assistants who were available for 6 days a week, 24 h a day, over a 2-week period. The assistants were involved in multiple studies and enrolled a convenience sample of patients for this study. All patients aged 18 years and older were asked by the research assistant to consent to participate in the study at the completion of their care in the ED. Patients who were intoxicated, had an

Results

One hundred eleven patients were surveyed, 56 in the formal attire group and 55 in the scrubs group. The demographics of the study group are summarized in Table 1. There were no differences between patients’ evaluations of appearance, satisfaction, or professionalism between the two groups (Table 2). There were no differences in preference of attire based on patient age, gender, race, physician gender, or physician race (Table 3). There was poor correlation between ratings on physician

Discussion

Patient evaluations of satisfaction, physician appearance, and physician professionalism were not affected by physician attire. In fact, the scores between the two types of dress styles were nearly identical. Both formal attire and scrubs seem to be acceptable to our ED patients.

In past studies when patients were shown photographs or asked which items of dress were preferred, they generally favored a formal style of dress (1, 2, 3, 4, 5, 8, 9, 12). However, in studies where patients were

References (13)

There are more references available in the full text version of this article.

Cited by (0)

Original Contributions is coordinated by John Marx, md, of Carolinas Medical Center, Charlotte, North Carolina

View full text