Beyond appearance: patient perspectives on the role of physician attire in trust
Abstract
This study examines the role of physician attire in building patient trust compared to other professional behaviors, identifying key attire-related factors that influence this trust. The study consisted of two parts. In the first part, patients and their companions participated in in-depth interviews to identify factors affecting their trust in doctors, including appearance. The findings from these interviews were used to create a survey questionnaire. In the second part of the study, 120 patients and their companions from two teaching hospitals were surveyed about the importance of doctors' attire and professional behaviors identified earlier. Qualitative interviews revealed three trust-building themes: general behavior (honesty and kindness), providing information (about diseases and necessary measures), and appearance (white coat and cleanliness). Quantitatively, 120 participants rated providing information (81%) and honesty (74.2%) as the most important factors in building trust, with appearance rated as very important (40%) but less critical (P < 0.001). White coats were prioritized over hygiene and clothing cleanliness (P < 0.0001), while 37.5% noted that tattoos or bright clothing reduced trust.The findings show that several factors are more important than the type of a doctor's attire in maintaining the patient's trust, and the dress code should prioritize safety and infection prevention.
Xun H, Chen J, Sun AH, Jenny HE, Liang F, Steinberg JP. Public Perceptions of Physician Attire and Professionalism in the US. JAMA Netw Open. 2021;4(7):e2117779.
Kamata K, Kuriyama A, Chopra V, Saint S, Houchens N, Petrilli CM, et al. Patient Preferences for Physician Attire: A Multicenter Study in Japan. J Hosp Med. 2020;15(4):204-10.
Scheive M, Gillis J, 2nd, Gillis S, Legault GL. Patient Perception of Physician Attire in a Military Ophthalmology Clinic. Cureus. 2021;13(1):e12472.
Bahrami M, Memarian M, Tamaddon H, Kharrzi Fard MJ. Survey of dentist’s professional appearances from patients’ point of view at Tehran University of Medical Sciences. Journal of Dental Medicine. 2018;31(2):109-18.
Cohen M, Jeanmonod D, Stankewicz H, Habeeb K, Berrios M, Jeanmonod R. An observational study of patients' attitudes to tattoos and piercings on their physicians: the ART study. Emerg Med J. 2018;35(9):538-43.
Houchens N, Saint S, Petrilli C, Kuhn L, Ratz D, Lott LD, et al. International
patient preferences for physician attire: results from cross-sectional studies in four countries across three continents. BMJ Open. 2022;12(10):e061092.
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.
Marques Caetano Carreira L, Dinis S, Correia A, Pereira A, Belo R, Madanelo I, et al. Does the white coat influence satisfaction, trust and empathy in the doctor-patient relationship in the General and Family Medicine consultation? Interventional study. BMJ Open. 2021;11(12):e031887.
Varnado-Sullivan P, Larzelere M, Solek K, Gupta S, Hatfield JE, Cheema MH, et al. The Impact of Physician Demographic Characteristics on Perceptions of Their Attire. Fam Med. 2019;51(9):737-41.
Aitken SA, Tinning CG, Gupta S, Medlock G, Wood AM, Aitken MA. The importance of the orthopaedic doctors' appearance: a cross-regional questionnaire based study. Surgeon. 2014;12(1):40-6.
Matsuhisa T, Takahashi N, Takahashi K, Yoshikawa Y, Aomatsu M, Sato J, et al. Effect of physician attire on patient perceptions of empathy in Japan: a quasi-randomized controlled trial in primary care. BMC Family Practice. 2021;22.
Brown T, Boyle M, Williams B, Molloy A, Palermo C, McKenna L, et al. Predictors of empathy in health science students. J Allied Health. 2011;40(3):143-9.
Alosaimi MA, Alhamyani AS, Aljuaid AM, Aljuaid AA, Althobaiti LT, Alosaimi FA, et al. Analyzing Factors Influencing Patient Selection of a Surgeon for Elective Surgery in Saudi Arabia: A Questionnaire-Based Survey. Cureus. 2022;14(12):e32124.
Bond L, Clamp P, Gray K, Van Dam V. Patients’ perceptions of doctors' clothing: should we really be “bare below the elbow”? J Laryngol Otol. 2010.
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.
Palazzo S, Hocken DB. Patients' perspectives on how doctors dress. J Hosp Infect. 2010;74(1):30-4.
Shelton CL, Raistrick C, Warburton K, Siddiqui KH. Can changes in clinical attire reduce likelihood of cross-infection without jeopardising the doctor-patient relationship? J Hosp Infect. 2010;74(1):22-9.
Saidun S, Akhmetova E, Awang Abd Rahman A. Muslim Female Healthcare Personnel Dress Code: A Proposed Guideline. International Medical Journal Malaysia. 2018;17:57-70.
Kakemam E, Dargahi H. The health sector evolution plan and the technical efficiency of public hospitals in Iran. Iranian journal of public health. 2019 Sep;48(9):1681.
| Files | ||
| Issue | Vol 18 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jmehm.v18i5.19209 | |
| Keywords | ||
| Professionalism; Professional Behavior; Dress Code; Trust. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
