Article Text
Abstract
Objective The patient–physician relationship impacts patients’ experiences and health outcomes. Physician attire is a form of nonverbal communication that influences this relationship. Prior studies examining attire preferences suffered from heterogeneous measurement and limited context. We thus performed a multicentre, cross-sectional study using a standardised survey instrument to compare patient preferences for physician dress in international settings.
Setting 20 hospitals and healthcare practices in Italy, Japan, Switzerland and the USA.
Participants Convenience sample of 9171 adult patients receiving care in academic hospitals, general medicine clinics, specialty clinics and ophthalmology practices.
Primary and secondary outcome measures The survey was randomised and included photographs of a male or female physician dressed in assorted forms of attire. The primary outcome measure was attire preference, comprised of composite ratings across five domains: how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the respondent felt. Secondary outcome measures included variation in preferences by country, physician type and respondent characteristics.
Results The highest rated forms of attire differed by country, although each most preferred attire with white coat. Low ratings were conferred on attire extremes (casual and business suit). Preferences were more uniform for certain physician types. For example, among all respondents, scrubs garnered the highest rating for emergency department physicians (44.2%) and surgeons (42.4%). However, attire preferences diverged for primary care and hospital physicians. All types of formal attire were more strongly preferred in the USA than elsewhere. Respondent age influenced preferences in Japan and the USA only.
Conclusions Patients across a myriad of geographies, settings and demographics harbour specific preferences for physician attire. Some preferences are nearly universal, whereas others vary substantially. As a one-size-fits-all dress policy is unlikely to reflect patient desires and expectations, a tailored approach should be sought that attempts to match attire to clinical context.
- GENERAL MEDICINE (see Internal Medicine)
- Health policy
- Protocols & guidelines
- Physician attire
- dress
- clothing
- uniform
- patient preferences
- patient-physician relationship
- nonverbal communication
Data availability statement
No data are available.
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Footnotes
Twitter @nate_houchens, @PetrilliMD, @yasuharutokuda
Contributors Conception and design of the work: SS, CP and VC. Acquisition of the data: SS, CP, LK, VC, MZ, HS, AK, and KK. Analysis and interpretation of the data: NH, SS, CP, LK, DR, LDL, MZ, HS, KK, AK, YT, CF, GV, SF and VC. Drafting of the manuscript: NH, CP, LK, DR, and VC. Critical revision of the manuscript for important intellectual content: NH, SS, CP, LK, DR, LDl, MZ, HS, KK, AK, YT, CF, GV, SF and VC. Accountable for all aspects of the work: NH, SS, CP, LK, DR, LDL, MZ, HS, KK, AK, YT, CF, GV, SF and VC. Approval of the final manuscript: NH, SS, CP, LK, DR, LDL, MZ, HS, KK, AK, YT, CF, GV, SF and VC. Guarantor: NH.
Funding This work was partially supported by a Swiss National Science Foundation grant (32 003B_149474; PI, HS). Several investigators (SS, HS, MZ, VC and LDL) received extramural funding for salary support. All authors had full access to all the data in the study and accept responsibility for the decision to submit for publication.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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