White coat in primary care: what do patients think today?
QUESTIONS UNDER STUDY: Patient preference for their doctor’s attire can influence their assessment of the quality of care. Most patients prefer specialists and hospital-based physicians to wear white coats, but evidence from general practitioner (GP) practices is lacking. We aimed to assess patient preference for GPs to wear white coats in Switzerland.
METHODS: We conducted a cross-sectional survey in the canton of Geneva, Switzerland, in 2011. The survey was part of a larger study on patient expectations from their GP. A random sample of 75 GPs was contacted by post and 23 agreed to participate. They were asked to recruit between 50 and 100 consecutive patients coming to the practice for a scheduled consultation. Patients were asked to complete a questionnaire on their expectations from the GP, including whether they preferred their GP to wear a white coat or not.
RESULTS: 1,637 patients agreed to participate (participation rate: 97%, women: 63%, mean age: 64 years). Overall, wearing a white coat was considered important by only 34% of participants. In multivariate analyses, older patients, those of Italian background and patients consulting uncertified GPs and/or GPs wearing a white coat were more likely to consider white coats as being important.
CONCLUSIONS: These findings suggest that white coats are no longer considered a powerful symbol for a large majority of patients visiting GPs. However, GPs may wish to adjust their attire to meet the expectations of their more conservative patients.
- Landry M, Dornelles AC, Hayek G, Deichmann RE. Patient Preferences for Doctor Attire: The White Coat’s Place in the Medical Profession. Ochsner J. 2013;13(3):334–42.
- Gooden BR, Smith MJ, Tattersall SJ, Stockler MR. Hospitalised patients’ views on doctors and white coats. Med J Aust. 2001;175(4):219–22.
- Harnett PR. Should doctors wear white coats? Med J Aust. 2001;174(7):343–4.
- Gonzalez Del Rey JA, Paul RI. Preferences of parents for pediatric emergency physicians’ attire. Pediatr Emerg Care. 1995;11(6):361–4.
- Hennessy N, Harrison DA, Aitkenhead AR. The effect of the anaesthetist’s attire on patient attitudes. The influence of dress on patient perception of the anaesthetist’s prestige. Anaesthesia. 1993;48(3):219–22.
- Anvik T. Doctors in a white coat – what do patients think and what do doctors do? Scand J Prim Health Care. 1990;8(2):91–4.
- McKinstry B, Wang JX. Putting on the style: what patients think of the way their doctor dresses. Br J Gen Pract. 1991;41(348):270, 275–8.
- Chung H, Lee H, Chang D-S, Kim H-S, Lee H, Park H-J, et al. Doctor’s attire influences perceived empathy in the patient-doctor relationship. Patient Educ Couns. 2012;89(3):387–91.
- Ikusaka M, Kamegai M, Sunaga T, Narita N, Kobayashi H, Yonenami K, et al. Patients’ attitude toward consultations by a physician without a white coat in Japan. Intern Med Tokyo Jpn. 1999;38(7):533–6.
- Rehman SU, Nietert PJ, Cope DW, Kilpatrick AO. What to wear today? Effect of doctor’s attire on the trust and confidence of patients. Am J Med. 2005;118(11):1279–86.
- Nair BR, Attia JR, Mears SR, Hitchcock KI. Evidence-based physicians’ dressing: a crossover trial. Med J Aust. 2002;177(11–12):681–2.
- Chang D-S, Lee H, Lee H, Park H-J, Chae Y. What to wear when practicing oriental medicine: patients’ preferences for doctors’ attire. J Altern Complement Med. 2011;17(8):763–7.
- Banu A, Anand M, Nagi N. White coats as a vehicle for bacterial dissemination. J Clin Diagn Res. 2012;6(8):1381–4.
- Treakle AM, Thom KA, Furuno JP, Strauss SM, Harris AD, Perencevich EN. Bacterial contamination of health care workers’ white coats. Am J Infect Control. 2009;37(2):101–5.
- Loh W, Ng VV, Holton J. Bacterial flora on the white coats of medical students. J Hosp Infect. 2000;45(1):65–8.
- Adams G, Gulliford MC, Ukoumunne OC, Eldridge S, Chinn S, Campbell MJ. Patterns of intra-cluster correlation from primary care research to inform study design and analysis. J Clin Epidemiol. 2004;57(8):785–94.
- Douse J, Derrett-Smith E, Dheda K, Dilworth JP. Should doctors wear white coats? Postgrad Med J. 2004;80(943):284–6.
- Dunn JJ, Lee TH, Percelay JM, Fitz JG, Goldman L. Patient and house officer attitudes on physician attire and etiquette. JAMA. 1987;257(1):65–8.
- Bianchi MT. Desiderata or dogma: what the evidence reveals about physician attire. J Gen Intern Med. 2008;23(5):641–3.
- Gjerdingen DK, Simpson DE, Titus SL. Patients’ and physicians’ attitudes regarding the physician’s professional appearance. Arch Intern Med. 1987;147(7):1209–12.
- Keenum AJ, Wallace LS, Stevens ARB. Patients’ attitudes regarding physical characteristics of family practice physicians. South Med J. 2003;96(12):1190–4.
- Menahem S, Shvartzman P. Is our appearance important to our patients? Fam Pract. 1998;15(5):391–7.
- Hueston WJ, Carek SM. Patients’ preference for physician attire: a survey of patients in family medicine training practices. Fam Med. 2011;43(9):643–7.
- Sotgiu G, Nieddu P, Mameli L, Sorrentino E, Pirina P, Porcu A, et al. Evidence for preferences of Italian patients for physician attire. Patient Prefer Adherence. 2012;6:361–7.