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