From a survey of 487 adults, researchers found that respondents rated physicians wearing casual attire (such as fleece jackets and softshell jackets) as less professional and experienced than those wearing a white coat. Results were determined by participant response to photographs of male and female models wearing various types of physician attire (white coat, business clothes, and scrubs). Julie Parsonnet, MD, an infectious diseases specialist and professor of medicine at Stanford University, wasn’t surprised that white coats gained a patient’s respect. “First impressions do matter, but I think patient confidence is much more related to physician demeanor — their self-confidence, listening skills, empathy — than to what they wear,” said Dr. Parsonnet. Lead author Helen Xun, MD, with the department of plastic and reconstructive surgery at Johns Hopkins University School of Medicine in Baltimore, and her coauthors also noted that overall respondents respondents rated females as less professional than male counterparts regardless of what they wore. Women drew lower “professionalism” ratings whether they were pictured with white coats over business wear or whether they were clad in scrubs (although curiously not when they were attired in scrubs underneath other garments). Furthermore, survey respondents were more likely to mistakenly identify women as medical technicians, physician assistants, or nurses, rather than as doctors. “The findings seems to underscore the fact that many people still have unfounded stereotypical images of what a doctor ‘should be’ in their minds,” said Sarah Samaan, MD, a cardiologist with Baylor Scott and White Legacy Heart Center in Plano, Texas. In an accompanying editorial, Amalia Cochran, MD, a general surgeon in Bozeman, Montana, and Gilbert Upchurch, MD, in the department of surgery at the University of Florida Health in Gainesville, indicated that the findings were “intriguing” because for women physicians, “no clear benefit to the patient-physician relationship can be attributed to wearing a white coat.” Parsonnet suggested that the conclusions should be taken with some reservations as the images appeared to show the men in professional dress that was more traditional while the women’s professional attire could be more subjectively interpreted. “It’s hard to go wrong with a shirt and tie, but women’s wear can be far more diverse and subject to taste,” she said. Still, Parsonnet stressed that biases continue. “Potential interventions are needed to reduce biases and support a culture of inclusivity and equal opportunity,” concluded the authors. They added that future study is needed “to identify interventions to address role confusion and cumulative career disadvantages for women in medicine.”
