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Join retired cardiologist and physician coach Sarah Samaan as we explore the significance of professional attire in health care. Discover how clothing choices impact patient perceptions, gender biases, and the doctor-patient relationship. We’ll also delve into practical tips for health care professionals looking to strike the perfect balance between comfort and professionalism in their wardrobe choices.

Sarah Samaan is a retired cardiologist.

She discusses the KevinMD article, “Dressing to inspire confidence: How the clothes you wear can change perceptions.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Sarah Samaan. She’s a retired cardiologist and physician coach. Today’s KevinMD article is “Dressing to inspire confidence: How the clothes you wear can change perceptions.” Sarah, welcome back to the show.

Sarah Samaan: Thank you, thanks so much for having me.

Kevin Pho: So go to KevinMD.com/podcast to search for Sarah’s previous episodes and hear her story. But today we’re going to talk about her most recent KevinMD article, “Dressing to inspire confidence: How the clothes you wear can change perceptions.” So tell us about this article, Sarah.

Sarah Samaan: Yeah. So my very first day of medical school, back in 1988, the first thing I remember, beyond the kind of chaos of trying to learn the brachial plexus, was our dean of students coming in and telling us, you must dress to inspire confidence. And he was very adamant about that.

And as a medical student, that wasn’t a lesson that I expected to learn the first day of school, but it was something that really meant a lot to me over time, and I really understood the power of that as I transitioned into being an attending cardiologist.

Kevin Pho: So tell me about that power. Tell me about how clinician dress, how can that impact perception?

Sarah Samaan: Yeah, so I think there’s a lot of angst about getting dressed for work, and especially because of the pandemic. Most of us switched over to scrubs, even if we prior to the pandemic would have made an effort to dress up for our patients. And after the pandemic sort of eased off, I think a lot of people were still very comfortable in their scrubs and preferred not to go back to maybe more constrictive clothes, or having to make that decision about what to wear each day. And so I think that there has definitely been a shift in the way that physicians and other people in health care present themselves compared to prior to 2020.

I think it’s really important to understand, though, that the way that you present yourself is a form of language. It’s a signifier. And whether we like it or not, our patients are making judgments about us from the very first time they meet us.

And when I say judgment, it’s not judgment about, does she look good, is that a stylish outfit. It’s a judgment as to, can I trust this person, is this person serious, is this person really a doctor? There’s a lot of kind of confusion sometimes about who is a doctor and who’s not. And so presenting ourselves as the professionals that we are can go a long way to truly inspire confidence and set that relationship with our patients off on a good start.

Kevin Pho: So what do the studies and data say if a physician chooses to wear scrubs versus, say, a white coat, shirt and tie? Because that scenario that you mentioned, before and after the pandemic, that describes me exactly. Before the pandemic I used to wear a white coat, shirt and tie. After the pandemic it’s scrubs almost all the time. And like you said, it is certainly more comfortable, and I definitely see around where I work I’m not the only one as well. So what does the data say about that change in attire?

Sarah Samaan: Right. Well, first of all, I do want to acknowledge that especially if you’re in a situation where you’re likely to get dirty, where you’re likely to go home with infectious processes on your clothing, then you do have to think about what’s safest and what’s most appropriate.

But the studies are actually interesting. And there’s not a lot of research, at least in the medical profession, but the studies that are out there I think are really illuminating.

So in Ireland, there’s the Irish Journal of Medical Science. They looked at what patients preferred, how did patients prefer to encounter their physicians. And before the pandemic, most patients preferred their hospital doctors to be in, like you said, the shirt and tie and the white jacket. During the pandemic most people switched to scrubs, as you say, and in that study at least, patients preferred that. And understandably, just from the fact that that was perceived as more sanitary, safer, they knew that you were going to wash your clothes. So there was that sense of acknowledgement and comfort with doctors being in scrubs.

But then after the pandemic sort of eased off, most of the physicians really didn’t want to return to wearing the suit and tie, or the shirt and tie I should say, or professional clothing for women. And nobody has gone back and looked at that particular patient population to see if their impressions have changed.

But there was a study also from Johns Hopkins in 2021 looking at patients’ perceptions of their physicians, and they were given pictures of family practice doctors. And so if the family practice doctor was wearing professional clothing with a white jacket, they were far more likely to be perceived as a physician than if they were wearing scrubs. And for women that was especially true.

And we know, as women in the medical profession, there is that barrier, or a number of barriers, that we have to overcome, whether we like it or not, to be perceived as competent, as professionals, and as physicians. So women who were wearing scrubs were more likely to be identified as a medical assistant, a PA, a nurse, than as a physician.

Kevin Pho: So after looking at all these studies, what are some conclusions, what are some inferences that you can make when it comes to professional attire and physicians? Should we reconsider wearing scrubs post pandemic?

Sarah Samaan: Yeah, I think there’s probably a lot of resistance to this idea. But again, whether we like it or not, the way that we dress is a signifier, it’s a language, it’s something that people pick up on, it tells our patients something about us from the very first time that they meet us. And if we’re professionally attired and we make some effort to present ourselves as professionals, then we are more likely to be granted that respect. And again, they will identify you more likely as a physician than as a PA or a nurse or a medical assistant.

One thing I think it’s important to think about is, when you see your hospital administrators or your practice administrators walking around, are they wearing scrubs? And the answer is usually no. And they know that the way they present themselves gives them an air of authority.

I don’t think that most physicians are sort of trained in this idea of what has been termed enclothed cognition. But again, the way that we present ourselves not only makes our patients feel more confident, but actually can inspire confidence in oneself.

Kevin Pho: Now, in your KevinMD article you also provide some tips on how physicians can construct a professional wardrobe. So we’ll talk more about that.

Sarah Samaan: Right. I think it can be a little overwhelming if this isn’t something that you’ve done before. If you’re not somebody that has typically gotten dressed for work, then perhaps this is something that’s new and a little intimidating. So a very easy thing is just to go with black pants and a shirt, just like the guys. If you’re a woman, it’s not that hard to just do simple pants and a shirt or blouse.

I think there’s also this misperception that it’s going to be expensive because you have to dry clean everything. And you really don’t have to dry clean most clothes. That’s your choice if you choose to get clothes that require dry cleaning, but most of the time you can find plenty of professional looking clothes that don’t require dry cleaning.

If you choose kind of a set of clothes that tend to go together, then you don’t have to think too hard about it in the morning. Steve Jobs is kind of the perfect example. Of course Steve Jobs wore jeans, that’s not really a good look for physicians, but just that same outfit every day, and there’s nothing wrong with that. Just something that looks clean and neat and professional, again, is a signifier that you respect yourself, you respect your patients.

Comfortable shoes, obviously that’s important, and those are easier to find, and there’s actually a lot of kind of sneaker shoes that are hybrids that you can wear. If you’re concerned about wearing a dress but you want to wear a dress, you could wear leggings underneath and that can make it more comfortable.

And then the other thing I think that’s really worth thinking about is this concern about cost of clothing. You don’t have to spend a fortune. A lot of people do enjoy going shopping, but there’s a wide range of options for pre-owned clothing. I love The RealReal, Poshmark, ThredUp, eBay. You don’t have to spend a lot of money, you can get some great deals. Or just go to Target, they have some great clothes. You don’t have to contribute to the environmental destruction by buying lots of clothes. You can buy pre-owned, or you can buy a small set of clothes for your wardrobe that you can interchange.

Kevin Pho: Now, you mentioned in your article about physicians maybe adopting a signature style or a uniform look. Now, for those physicians who want a little bit more individuality, how do you balance that desire for individuality with the pressure for that professional uniform style?

Sarah Samaan: Yeah, I mean, I’ll just speak from my own perspective, because it’s something that I enjoyed. My patients really appreciated that I made an attempt to wear things that were maybe a little bit different, maybe the pattern is a little bit different, or earrings. Of course you don’t want big dangly earrings that are going to knock into your stethoscope, you don’t want something that doesn’t look professional. But you can show your personality, you can be interesting, and people notice that stuff.

And it’s actually sometimes a way to make a connection. Someone will come in and say, oh, I love that blouse, or, those are cute shoes. And it’s a way that you kind of establish that human connection.

Kevin Pho: Now, I want to get back to scrubs, because as you know, scrubs have come a long way since I was in residency almost 20 years ago. We have high-end designer scrubs now, and scrubs themselves could be a fashion statement. So talk more about that. What do you think about that?

Sarah Samaan: Yeah, well, I had five sets of scrubs myself, maybe 10 by the end of the pandemic, that I kind of interchanged every single day. And they are really comfortable, a lot of them have a little Lycra in them, so they’re very comfortable.

And again, there’s nothing wrong with wearing scrubs if that’s appropriate to your position. If you’re in the hospital, obviously if you’re a surgeon, if you’re in the operating room, you’re going to be wearing the hospital scrubs, you’re not going to be bringing your own scrubs in.

But if you’re out of the operating room, out of the procedure lab, and you choose to wear scrubs, something that fits well, something that looks neat, nothing that’s kind of baggy or sloppy looking, and that can make a difference.

And then the other thing is, you could wear, say, a nice, reasonable knit shirt underneath, or earrings, something to just make things a little bit more dressy. Make sure your shoes are neat and they’re not like sloppy, beat up sneakers.

Kevin Pho: We’re talking to Sarah Samaan. She’s a retired cardiologist and physician coach. Today’s KevinMD article is “Dressing to inspire confidence: How the clothes you wear can change perceptions.” Sarah, let’s end, as we always do, with some take-home messages to the KevinMD audience.

Sarah Samaan: Yeah, so again, I’ve said it a couple times, but the clothes that you wear speak a language, and people are going to be looking at you, judging you, getting a sense of confidence or lack of confidence from what you’re wearing.

So dress to inspire confidence. I think that piece of advice is powerful. And when you’re getting ready for work, if you can just keep that in mind, that may affect your relationships with your patients, your staff, your colleagues, and over time can actually lead to greater respect from your patients and a stronger sense of professionalism.

Kevin Pho: Sarah, once again, thank you so much for sharing your time and insight, and thanks for coming back on the show.

Sarah Samaan: Thank you so much.