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Does the attire determine professionalism?

Adam Bitterman, DO
Physician
April 10, 2015
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I recently sat down with a well-known physician within the orthopedic community as well as among the medical socialites of social media.  When I walked into his office, the first words out of his mouth were about my attire.  As I was concerned about first impressions, I broke out the fancy suit, custom tailored, of course, a matching shoe and belt combination, as well as my go-to “interview tie.”  I even made sure my initials, monogrammed on the shirt, were exposed the correct amount at my wrist.  I had not even sat down, and I was second-guessing my outfit.

I was taken aback when my efforts and formal attire were quickly questioned within a matter of seconds of stepping foot into his office.  How do you respond appropriately?  Do you nod?  Is this something you try and laugh off with your superior?  I was at a loss for words other than saying, “Thanks a lot for seeing me today.  I appreciate you taking the time to meet with me.”  I apologized questioningly for my get-up, but again I could not put my finger on exactly what I did wrong.

I sat down and kept my attire intact as originally planned, however, throughout the meeting I kept thinking about the importance of “professional attire” and what it really means.   Here I was, sitting across from a potential mentor, donning jeans, a button down shirt, with his sport jacket draped over the back of his executive chair.

He went on to tell me more about how he ended up fashioning professional attire without the suit jacket, matching slacks or tie.  He drove home his hatred of white coats and even shared a story of being scolded for not following the appropriate dress code as a resident physician, a move that nearly ended his career at an early stage.

I continued to wonder what this really meant?  Should I take off the tie?  Was it time to give in and follow his lead?  It did not make sense.

He stated that his patients have yet to question his attire and never doubt his medical opinion because he has jeans on instead of slacks.  In fact, his patients have told him that they feel he is closer to them and better able to relate and have a conversation with them.  He is not producing an aura of superiority.

In a recent study out of the University of Michigan, Petrilli and colleagues, examined the perceptions patients have of their physicians based on their dress.  As a means to enhance the physician-patient relationship and improve patient satisfaction, they set out to better understand the influence of physician attire.  Specifically, they investigated confidence level, trust and satisfaction across a variety of scenarios and patient encounter locations.

After completing a systematic review of the literature, the authors concluded, “finding a ‘one-size-fits-all’ approach to optimal physician dress code is improbable.”  Instead, they note that specific “tailored” approaches should be implemented based on “patient, population, and contextual factors.”

Another area to consider is the pediatric population.  Most of this population is unable to participate in a survey about their perceptions, but their parents certainly have an opinion.  Should doctors dress for the children and comply with the “no white coat” rule?  Leaving the white coat on the door rack may provide a less intimidating feel for the pediatric population allowing for a smoother visit for both the patient and his or her parents.

I commend the work out of the University of Michigan and wonder how our medical system will digest their findings and apply their conclusions.  The next time you prepare for your work day, whether in the office, hospital rounding or in the operating room, be sure to think twice about whether the dressed up garb is really necessary; ask yourself if there is enough evidence to support the suit.  After all, the way health care is going, you may be graded on your appearance similar to the way television personalities judge celebrities on fashion police.

And for what it’s worth, my meeting went well. I think.

Adam Bitterman is an orthopedic surgery resident. 

Image credit: Shutterstock.com

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