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International patient preferences for physician attire: results from cross-sectional studies in four countries across three continents

N. Houchens, S. Saint, C. Petrilli, L. Kuhn, D. Ratz, Lindsey B. De Lott, Marc Zollinger, Hugo Sax et al.

BMJ Open, 2022

9,171 participants · 14 citations

Abstract

Objective The patient–physician relationship impacts patients’ experiences and health outcomes. Physician attire is a form of nonverbal communication that influences this relationship. Prior studies examining attire preferences suffered from heterogeneous measurement and limited context. We thus performed a multicentre, cross-sectional study using a standardised survey instrument to compare patient preferences for physician dress in international settings. Setting 20 hospitals and healthcare practices in Italy, Japan, Switzerland and the USA. Participants Convenience sample of 9171 adult patients receiving care in academic hospitals, general medicine clinics, specialty clinics and ophthalmology practices. Primary and secondary outcome measures The survey was randomised and included photographs of a male or female physician dressed in assorted forms of attire. The primary outcome measure was attire preference, comprised of composite ratings across five domains: how knowledgeable, trustworthy, caring and approachable the physician appeared, and how comfortable the respondent felt. Secondary outcome measures included variation in preferences by country, physician type and respondent characteristics. Results The highest rated forms of attire differed by country, although each most preferred attire with white coat. Low ratings were conferred on attire extremes (casual and business suit). Preferences were more uniform for certain physician types. For example, among all…

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