When I was a resident the expected dress code was white pants and a white lab coat provided by the hospital. That worked well for parents, however, it was sometimes scary to my pediatric patients so I tended to dress in a less threatening manner.
At a conference of all of the directors of the pediatric training programs in New England, during the question and answer session I asked my director an embarrassing question. The title of the conference was the Current and Future of Pediatrics. Knowing that he was a misogynist, I asked him what the current and future was of women in pediatrics.
Before he went into his answer that a woman’s place is in the home, he had a preface. He said to me, “Anthony, I would ask you to turn in your whites in the morning but I know you wouldn’t care because you won’t wear them anyway.”
Physician dress is important to many patients. It affects their trust in the physician and their satisfaction. However, it also affects other areas including how much knowledge they think the physician has, how approachable they think the physician is and how caring they think the physician is.
One would then think it would be easy to decide what a physician would wear. Unfortunately, like most things, it is not that easy.
For example, most patients prefer a white coat to scrubs. You would think that was the case in all geographic areas, however, patient preferences actually vary by geographic area. They also vary by patient age, patient sex, level of education and the type of care setting. For example, scrubs are much more acceptable in an ED or OR setting.
In addition, scrubs get washed more frequently than white coats, therefore, scrubs are less likely to carry bacteria. According to a physician survey, white coats were washed an average of every 12 days while scrubs were washed on an average of every one to two days.
That being said, nothing is completely immune from bacteria, therefore, they both carry bacteria to some degree. It is logical that the bacteria they carry are the ones found on physicians’ hands. In addition, those bacteria tend to be antibiotic resistant.
For this reason some places are using scrubs impregnated with antimicrobial substances. That is helpful. One related issue is that laundering practices vary in their degree of bacterial decontamination.
There are two take home points here. The first is that patients have certain expectations about how physicians should dress. When those expectations are met the patient is more likely to leave the visit satisfied and compliant. The second is that the expectations that patients have might not always be the healthiest from an infection standpoint.
I still don’t wear whites. My feeling is that I put on clean clothes before I go to the office so they are less likely to have bacterial contamination. Since I only have five more office days before I retire, I guess it doesn’t really matter whether or not I turn in my whites in the morning.