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Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA
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  • Published on:
    Advice that has stood the Test of Time

    In their manuscript, Petrilli et al. reference an abundance of literature showing that bacteria and other pathogens can be isolated from physician attire, including items that are typically not laundered after a single use, such as white coats and neckties. Despite this, they claim an absence of literature linking said contamination to source or transmission of disease. I caution the authors not to dismiss lower levels of evidence for clinical studies, such as case series. In his essay, which was later published in The New England Quarterly Journal of Medicine and Surgery, Oliver Wendell Holmes Sr. describes what can be interpreted as a clinical demonstration of early germ theory related to the contagiousness of postpartum infections and subsequent maternal death.(1) Holmes references multiple cases where physicians performing obstetrical duties in clothes worn in the care of (or performance of autopsy on) patients who succumbed to puerperal fever, would have similar outcomes on future patients with whom they came in contact. He references a similar case report published by Brodie in the Lancet where a provider, after destroying his entire wardrobe, had no recurrent cases of puerperal peritonitis.(2) He finishes with a list of recommendations, which instructs physicians to change “every article of dress” after post-mortem contact with patients who died of puerperal fever. In the absence of convincing evidence refuting the now common sense nature of Holmes’ recommendat...

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    Conflict of Interest:
    None declared.
  • Published on:
    President & Medical Director - Golden State MD Health & Wellness A Professional Corporation
    • Ahimsa P Sumchai MD, Sports Medicine/Emergency Medicine/Fitness & Nutrition Golden State MD Health & Wellness

    As an African American female physician and practice owner with a 37 year professional history I fully concur with the findings of this article. I have commented on other writings on Doximity around the issues of professional attire and efforts to restrict wearing white coats. As a practice owner with locations in San Francisco and Sacramento I travel weekly by Amtrak and this experiences reinforces my opinion that professional attire for a physician can improve patient and public interactions. In the course of my career I have experienced numerous incidents in which I was demeaned, harassed or disrespected as a physician because of my race and gender in areas dominated traditionally by white males. I have authored numerous writings about my experience as the first African American female to train in neurological surgery in the University of California system and my experiences as a flight physician and post doctoral fellow for Stanford Life Flight. I have been mistaken for a custodian, a "girl" and on a good day a pediatrician in my years of training. My white coat and my professional attire make all the difference in the world in how patients relate to me. When I appear without it I am called Miss or Ms. When I have it on I am called Doctor.I will never give up wearing my white coat!

    Conflict of Interest:
    None declared.