Do clothes make the doctor? | Expert Opinion

Do you care what clothes your doctor wears when they see you?

When I was in my residency training, I was required to wear a tie every day. I objected, citing the well-documented risk of transferring bacteria from patient to patient. My department chair offered me one alternative: bow-ties. I politely declined, shut my mouth, and dutifully continued to wear regular length ties.

Medicine has an unwritten code that doctors must wear a white coat and/or a dress shirt and tie to look professional (or equivalent wear for women), or scrubs to do surgery in the operating room. This reflects a mindset that patients and colleagues want us to dress professionally to show respect to the work we do and the position we hold.

Yet when I became an attending physician, I soon ditched the tie, save for formal occasions. It was a relief. Patients did not seem to care, and I appreciated the comfort. (No more neck chafing and ingrown hairs.) Plus, I kept wearing my white coat, so there was no mistaking my role as a physician.

When COVID hit, I dropped the white coat and started wearing scrubs every day, along with a mask. Medical culture had shifted to pare everything down to minimize risk of infection. I’d throw my scrubs in the wash at the end of a shift.

I’ve since stopped wearing masks all the time, but the scrubs remain my daily uniform, with my name neatly embroidered above the chest pocket. Now, in what some might call my working pajamas, I can care for patients in comfort. My enthusiasm must be shared: One of the most popular brands of scrubs, FIGS, just opened its second store in Rittenhouse Square here in Philadelphia; the first is located in Los Angeles.

For dermatologists like me, who do many surgical procedures daily, scrubs are functional, reasonable as far as infection risk, and easy to wear. I also appreciate the break from the mental burden of choosing different outfits to wear to work daily — allowing me to piggyback on a so-called productivity hack touted by famous innovators like Steve Jobs, Mark Zuckerberg, and Albert Einstein.

Without ties, I still have found ways to let my personality shine through — down at my feet with my growing collection of medically themed or otherwise quirky socks, tucked neatly into black and white Onitsuka Tiger sneakers. My socks’ themes range from colorful designs of pills, stripes, x-ray bones, question marks (acquired as a tourist at The Mystery Spot in Santa Cruz, CA), to red and yellow socks with the letters KC that let me quietly cheer on my football team while caring for a potentially less enthusiastic Philadelphia crowd (yet still sparking many a fun conversation).

Researchers studied the effect of doctors’ choice of clothes on patients in a 2017 study published in the medical journal BMJ Open. They found that patients’ preferences depended on where they were being treated (hospital vs. outpatient clinic), and other factors. For instance, patients expect ER doctors and surgeons to wear scrubs more often. Most patients did not have a problem with doctors wearing either a white coat, scrubs, or a shirt and tie. Still, some patients did prefer that their doctors dress in white coats and more formal work wear. Older patients and patients in the South were among those with the strongest preferences for more formality. (The study did not specifically comment on patients’ feelings regarding doctors who wear socks that cheer on a home city football team’s most recent Super Bowl opponent.)

Citing other research, the study’s authors speculated that dressing more formally might also encourage doctors to be more focused on their tasks (“enclothed cognition” as some researchers refer to it). Still, they concluded that any such benefit needed to be weighed against the risk for spreading bacteria — a concern that has led countries such as the United Kingdom, Canada, and Australia to adopt “bare below the elbows” or BBE policies.

As a doctor, I have found clothing choices a challenging topic. Having tested out different options over the years, I definitely prefer my scrubs for their comfort, their cleanliness, and simplicity. But I recognize that some patients might prefer to see me more formally dressed.

To each doctor their own — and for me, I’m sticking with my scrubs and my silly socks.

Jules Lipoff practices as a board-certified dermatologist for The Dermatology Specialists in Old City and serves as a clinical associate professor (adjunct) in the Department of Dermatology, Lewis Katz School of Medicine, Temple University.