Patient Perception of Physician Attire Before and After Disclosure of the Risks of Microbial Contamination

Authors

  • Enoch C. T. So Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Faraday H. F. Fung Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Joshua K. H. Yeung Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Lilian H. Y. Chow Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Julio S. H. Kwok Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Ruby L. Y. Lam Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Tommy C. Y. So Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Faye S. M. Yu Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Dana Vackova School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong.
  • Gilberto K. K. Leung Centre of Education and Training, Department of Surgery, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong.

DOI:

https://doi.org/10.5195/ijms.2013.216

Keywords:

Clothing, Cross Infection, Patient Preference, Patient Safety

Abstract

Background: The white coat is traditionally considered to be the appropriate attire for physicians but it may also be contaminated with microbes and act as a potential source of infection. We aimed to study patients’ acceptance of physicians’ attire, their underlying reasons, and their reactions to an educational intervention with regards to the risks of contamination.

Methods: We conducted a voluntary ques­tionnaire survey at a university teaching hospital in Hong Kong from February to July 2012. 262 patient-responses from adult inpatients and outpatients across various specialties were analysed.

Results: White coats were highly favoured (90.8%) when compared with scrubs (22.1%), smart casual (7.6%) and formal (7.3%) wears. ’Professional image’ and ‘ease of identification’ were the main attributes of the white coat. Most patients (92.2%) would prefer doctors washing their white coats every few days, whilst 80.9% believed that doctors were actually doing so. After patients were informed of the potential risk of microbial contamination, white coats remained as the most favoured attire (66.4%), but with scrubs doubling in popularity (45.8%). Smart casual (9.2%) and formal attire (4.6%) remain the least accepted.

Conclusion: Despite cross-infections being a significant concern within the healthcare environments, patients’ predominant acceptance and perceived attributes towards the white coat were maintained after an educational intervention on the risks of microbial contamination.

Metrics

Metrics Loading ...

Author Biography

Enoch C. T. So, Li Ka Shing Faculty of Medicine, The University of Hong Kong.

Enoch So is a final year medical student of a 5-year pro­gram at the University of Hong Kong. He holds a Bachelor degree in Bioin­formatics (Hons 1) and is a University Medalist in Bioinformatics at the Uni­versity of New South Wales, Australia.

References

1. Jones VA. The white coat: why not follow suit? JAMA. 1999;281(5):478.
2. Blumhagen DW. The doctor’s white coat: the image of the physician in modern America. Ann Intern Med. 1979;91(1):111-116.
3. Huber SJ. The white coat ceremony: a contemporary medical ritual. J Med Ethics. 2003;29(6):364-6.
4. Loh W, Ng VV, Holton J. Bacterial flora on the white coats of medical stu¬dents. J Hosp Infect. 2000;45(1):65-8.
5. Wong D, Nye K, Hollis P. Microbial flora on doctors’ white coats. BMJ. 1991;303(6817):1602-04.
6. 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.
7. Kerr C. Ditch that white coat. CMAJ. 2008;178(11):1127
8. Bond L, Clamp PJ, Gray, K, Van Dam V. Patients’ perceptions of doctors’ clothing: should we really be ‘bare below the elbow’? J Laryngol Otol. 2010;124(9):963-6
9. Henderson J. The endangered white coat. Clin Infect Dis. 2010; 50(7):1073-4.
10. Gherardi G, Cameron J, West A, Crossley M. Are we dressed to impress? A descriptive survey assessing patients’ preference of doctors’ attire in the hospital setting. Clin Med. 2009;9(6):519-24.
11. 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(13):1279-86.
12. Yamada Y, Takahashi O, Ohde S, Deshpande GA, Fukui T. Patients’ Prefe¬rences for Doctors’ Attire in Japan. Inter Med. 2010;49(16):1521-26.
13. Cha A, Hecht BR, Nelson K, Hopkins MP. Resident physician attire: Does it make a difference to our patients? Am J Obstet Gynecol. 2004;190(5):1484-8
14. Gjerdingen DK, Simpson DE, Titus SL. Patients’ and physicians’ attitu¬des regarding the physician’s professional appearance. Arch Intern Med. 1987;147(7):1209-12
15. Chang DS, Lee H, Lee H, Park HJ, Chae Y. What to wear when practicing oriental medicine: patients’ preferences for doctors’ attire. J Altern Complem Med. 2011;17(8):763-67
16. 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.
17. Lill MM, Wilkinson TJ. Judging a book by its cover: descriptive survey of patients’ preferences for doctors’ appearance and mode of address. BMJ. 2005;331(7531):1524-7.
18. Shelton CL, Raistrick C, Warburton K, Siddiqui KH. Can changes in clinical attire reduce likelihood of cross-infection without jeopardising the doctor-pa-tient relationship? J Hosp Infect. 2010;74(1):22-9.
19. Hueston WJ, Carek, SM. Patients’ preference for physician attire: a survey of patients in family medicine training practices. Fam Med. 2011;43(11):643-7.
20. Wilson JA, Loveday HP, Hoffman PN, Pratt RJ. Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England). J Hosp Infect. 2007;66(4):301-7.
21. Loveday HP, Wilson JA, Hoffman PN, Pratt RJ. Public perception and the social and microbiological significance of uniforms in the prevention and control of healthcare-associated infections: an evidence review. Brit J Infect Cont. 2007;8(4):10-21.

Downloads

Published

2013-12-31

How to Cite

So, E. C. T., Fung, F. H. F., Yeung, J. K. H., Chow, L. H. Y., Kwok, J. S. H., Lam, R. L. Y., So, T. C. Y., Yu, F. S. M., Vackova, D., & Leung, G. K. K. (2013). Patient Perception of Physician Attire Before and After Disclosure of the Risks of Microbial Contamination. International Journal of Medical Students, 1(3), 109–114. https://doi.org/10.5195/ijms.2013.216

Issue

Vol. 1 No. 3 (2013)

Section

Original Article

Categories

License

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
    2. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
    3. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
    4. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
    5. The Author represents and warrants that:
      1. the Work is the Author’s original work;
      2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
      3. the Work is not pending review or under consideration by another publisher;
      4. the Work has not previously been published;
      5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
      6. the Work contains no libel, invasion of privacy, or other unlawful matter.
    6. The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Enforcement of copyright

The IJMS takes the protection of copyright very seriously.

If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.

If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org

 

Infringing material

If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org