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What Doctors Wear Matters to Patients

Some patients still like to see a white coat, but the COVID-19 pandemic may have turned the tide toward more casual attire, like scrubs.

Doctor in a white coat

Watch any movie and you can always pick out the doctor because he or she is in a white coat. It’s a longtime custom, but some are asking if it’s still necessary – especially in light of the working conditions doctors experienced during the COVID-19 pandemic.

A recently published journal article looked at two studies – one in 2017 and one in 2022 – and found that patient preference for formal attire, including the doctor’s white coat, dropped following the pandemic. Patients chose from seven different clothing combinations for both female and male doctors.

Casual options included:

  • Business casual dress alone
  • Business casual dress with a white coat
  • Scrubs
  • Scrubs with a white coat

Formal options were:

  • Formal business attire, no suit jacket
  • Formal business attire with a doctor’s white coat
  • Formal business attire plus a suit jacket

More than 300 Mayo Clinic patients at a Jacksonville, Florida, primary care clinic answered the survey and gave preferences for different settings, including a primary care office, emergency room, hospital and surgery. In every category, patient preference increased for casual clothing, like scrubs, and decreased for formal attire like a suit and tie topped by a doctor’s coat.

Patients are most comfortable seeing a casually dressed doctor in the emergency room, where 87% of patients were in favor. About 73% of patients were fine with surgeons wearing casual attire. For other hospital encounters, 56% preferred casual dress for doctors.

But at a primary care office visit, 75% of patients said they still like to see a doctor more formally dressed, sometimes, including the white coat. But even there the preference for formal clothes dropped significantly in 2022 compared to responses in 2017.

A white coat, sometimes with the doctor’s name embroidered on it, can be a helpful visual symbol that communicates who the doctor is in a health care setting that includes nurses, techs and other health care professionals. It’s also practical because it can keep their street clothes clean and has pockets. On the other hand, some say the white coat might be impractical, like during the pandemic when infection controls were especially important. Others say the white coat might make too much of a statement when a respectful, collaborative environment is desired.

White coats have been around for more than 100 years and they’re meaningful to the medical community, especially medical students who receive them in a white coat ceremony that signals the start of their careers as physicians. The tradition launched in 1993 by the Gold Foundation and is now practiced at many medical schools.

“I’ve come to learn that the white coat is not a superhero cape. Instead, it is a symbol of something much greater; our commitment to take the best care of each other and of our patients,” said Slavena Salve Nissan, a graduate from the Icahn School of Medicine at Mount Sinai, in an article on the Association of American Medical Colleges (AAMC) website.

Before the late 1800s, doctors wore black, not white, to nod to the serious nature of their work. A doctor who explored the meaning of today’s white coat found that two Thomas Eakins paintings of surgeries show the shift from black clothes in 1875’s “The Gross Clinic” to a white smock in 1889’s “The Agnew Clinic,” as attention turned to cleanliness and early infection control.

But white coats can have a downside and there’s even a medical term for it: “white coat syndrome,” when patients experience higher blood pressure simply because the presence of the doctor or other medical professional makes them anxious.