I stopped wearing a tie to work at the start of 2004. It was summer and I was hot.

Its much more comfortable working without a tie, particularly in my job. Its easier to examine patients, its easier when I need to perform a medical procedure. I’m sure you can see how a dangling tie would get in the way.

I’ve also lost quite a few ties, sadly enough, to spillage, followed by dry cleaning. Dry cleaning and silk ties don’t mix well. The tie comes out worse for wear and never again, does it look quite right.

I wonder then how people clean their ties? I guess that the answer is that they don’t.

A tie could possibly be a source of infection. Imagine your doctor seeing patient after patient, either in the hospital or in their rooms, with that dangling tie. Later that week or the next week, he may wear the same tie, probably after the tie has been sitting in a drawer somewhere at home, and almost certainly, without any attempt at cleaning. I am sure there are proper scientific studies on these but I must admit I’ve not bothered to hunt for them. It seems common sense and provides me enough extra vindication for what I do.

Many of my friends are tie-wearing doctors. They’re probably not so keen on this blog. Most would not like to give up this very traditional symbol of male authority. Some would even say that the tie (and a suit or the Doctor’s white coat) enhances patients’ satisfaction and confidence. To look like the wise and experienced consultant, some will argue that you need this part of the uniform.

I hope not. I’ll wear a nice shirt and pants because I like to and being less dressed would seem quite inappropriate. I hope that I make a good enough first impression with my practice settings, our clinic’s attention to detail, and my manner that my patients don’t mind my lack of a tie.

Irwin Lim is a rheumatologist in Australia who blogs at BJC Health Connected Care.

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