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26th July 2013

White Coat Syndrome

There has recently been speculation in the press that patients wouldn`t trust a doctor in a t-shirt.  This has sparked some lively debate about dress code in hospital and general practice.  So, what do you wear?

There are arguments both ways on this.  We all know that flapping ties and long sleeves are banned from hospital wards because of cross infection concerns, although some of the old-guard are finding it hard to moth-ball the tweed suit.   Consultants who wear bow-ties have not had to change at all!  However, has much changed in general practice?  There seems to be a wide spectrum of dress worn, from the conservative suit and tie to the hip t-shirt and jeans and everyone has an argument to justify what they do.

Hippocrates, our father of medicine dictated that doctors should be - "clean in person, well dressed, and anointed with sweet-smelling unguents".   It is obvious that many GPs still believe this and the argument is that the public need to have a confidence in a doctor and that confidence stems from a seriousness of dress.  In other words, that professionalism starts in the wardrobe.  For many patients, that works well and a sober attire is a way of saying `I take this seriously`.   On the other hand, there is a smaller cohort of doctors who would like to break down some of the barriers to communication and step off the professional pedestal in order to make themselves more approachable.

In the USA, there is a surprisingly conservative approach to dress, with most doctors opting for a suit or smart white coat.  According to a recent BBC article, only in the ultra laid-back Californian coastal area are open shirts more common.  Although the difference between the States and the UK may be down to who is getting billed!

A BMA survey of doctors, including GPs in 2012, found that 75% agreed that doctors “Should feel free to express their individuality through their appearance?”  However, 58% agreed that doctors had become too casual in their work-wear.   GPs were more likely to comment that smart dress showed respect for patients, although some still wanted to drop the formal image.

So, we have a pretty mixed view of what is appropriate and correct.  In the end it may come down to what sort of practice we are in or in what sort of area our practice is situated.  Too smart and it will inhibit some people in sharing their intimate worries, too scruffy and it will create an image of neglect – not good for a GP!  However, it is much more important to aspire to be a good doctor than a well-dressed doctor

Dr. John Shapter - QCS GP Expert Contributor

Topics: GPs


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