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Why We Trust Doctors More When They Wear a White Coat

... and the problem with black coats (or no coat).

Key points

  • A recent study showed an association between a physician’s attire and patient confidence in them.
  • Patients prefer doctors to wear professional attire or scrubs, depending on the location of the interaction.
  • Patients view blue scrubs most favorably, while they identify black scrubs as the most negative.

The patient-physician relationship is a key component of healthcare and is based on a patient's perception of their physician's knowledge, level of caring, trust, and loyalty. While many physicians may overlook the importance of what they wear to work each day, a growing body of evidence shows that this decision may have a big impact on how they are perceived.

A recent study showed an association between a physician’s attire and patient confidence in them and the patient’s ability to perceive clinician trustworthiness, intelligence, and empathy. To explore this impact, it is important to review the role of professional attire versus surgical scrubs, the presence or absence of a white coat, and the location of the interaction, as these are all significant factors.

Historically, physicians have gravitated towards professional attire and surgical scrubs as the main dress category. One study found that respondents favored professional attire more than scrubs, followed by business, and lastly, casual dress. Patients are more likely to trust and have confidence in their physicians if they wear white coats. They reported being more willing to share social, sexual, and psychological problems with a professionally dressed physician. Adding a white coat was clearly favored when comparing professional dress with or without a white coat. These findings support the notion that physicians' attire should reflect a higher level of professionalism and devotion to their practice which is appreciated by patients and portrayed by the white coat.

When it comes to the perception of scrubs, it is clear that the color matters. One study asked patients to identify the male and female they most strongly identified with the profession of a surgeon and then to rank the most and least knowledgeable, skilled, trustworthy, and caring male and female clinicians. Patients most frequently chose green for surgeons, followed by blue for both sexes. They most commonly identified black scrubs with each negative characteristic, including being the least knowledgeable, skilled, trustworthy, and caring.

Patients most commonly identified male and female clinicians in blue scrubs as the most caring. These observations align with findings in color psychology which show that green represents feelings of healing, nature, and high quality, and blue represents loyalty, competence, and trust. At the same time, black can evoke fear, darkness, and death. Of note, five respondents in this study stated that the black scrubs looked deathlike or like a mortician’s uniform.

Important differences have been highlighted when examining physician attire preferences by care setting. Patients preferred professional attire with white coats for interactions with primary care and hospital physicians. Conversely, scrubs were rated highest for emergency room physicians and surgeons in another study. In both emergency and surgery settings, the preference for scrubs alone followed scrubs with white coats. The coat preference could be related to the cleanliness and hygiene of the coat, given the possible exposure to various bodily fluids in the emergency department and operating room.

These findings overwhelmingly show that patients prefer physicians in professional attire with white coats. Interestingly, for surgeons and emergency medicine doctors, scrubs alone are the preferred dress by patients. For physicians, wearing professional dress or scrubs based on these clinical locations may favorably influence trust and confidence-building in the medical encounter.

It’s important to point out that no studies have shown a relationship between the quality of care received and a physician's attire so while these subconscious relationships are important, they do not need to play an integral role when choosing your physician.

Facebook/LinkedIn image: Monkey Business Images/Shutterstock

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