Author: John Gever, Contributing Writer, MedPage Today July 30, 2021
Want to look "professional" in healthcare? Wear a white coat, office-style clothes, and don’t wear work clothes. Especially if you are a woman.
On the other hand, if you are a surgeon, the scrub under the white coat will actually increase your professionalism. If you want patients to think they know what they are doing, then no one should wear a woolen vest or softshell jacket (even if it is embroidered with name and institution logo).
These are some of the highlights of a survey that appeared on JAMA Network Open, if we can call them that way. Approximately 500 non-professionals were asked to rate their professionalism and guess the job categories of male and female models wearing different types of clothing that medical staff often wear.
The authors, led by Helen Xun, MD, Johns Hopkins University in Baltimore, quickly argued that the findings showed that the industry still has a lot of work to do in overcoming prejudices based on gender and clothing choices.
Perhaps the least surprising finding in this study is that no matter what they wear, women are significantly less likely to be regarded as doctors than men. Women’s “professional spirit” scores are also lower than those of men when they wear white coats or work clothes outside of professional attire-but strangely, when these clothes are worn under other clothing, this is not the case.
However, this is not the main interest of researchers. The main purpose of the study they conceived was to examine the trend towards more casual clothing for healthcare workers, including vests and jackets worn over work clothes or office outfits.
Xun and colleagues pointed out that a large number of previous studies have focused on patients' perceptions of traditional white coats and scrubs. However, problems and concerns have arisen especially around the white coat, because it is a potential medium for spreading pathogens, and because it hinders certain medical functions.
In addition, the researchers pointed out that the white coat has a subtle sense of superiority in the level of healthcare, and with the recent emphasis on teamwork in the healthcare field, “the white coat has become an obsolete relic to some people.”
Therefore, the organization wrote, “Due to practical reasons such as comfort, ease of commuting to and from get off work, and/or warmth or weatherproof features, practitioners may wear casual clothes as a more modern alternative to white coats.”
In this study, Xun and colleagues recruited and surveyed adults through Amazon's Mechanical Turks service. The average age of the participants was about 36 years old, about 76% were white, and the ratio of men to women was equal. Approximately 20% of people are medical staff themselves (roughly the same as the general population), and 60% have been hospitalized at least once in the past.
Participants saw photos of models wearing various combinations of white coats, frosted, soft shell jackets and pullovers, some of them in office clothes and some in frosted. In one series, participants were told that these models represented family doctors, dermatologists, or surgeons, and were asked to rate each person based on their perceived experience in healthcare and overall professionalism. Another stage requires participants to guess whether the model is a doctor, surgeon, nurse, doctor's assistant, or medical technician.
For family doctors and dermatologists, white coats are the clear winners, while surgeons get higher ratings for top or bottom scrubs. Overall, the average experience score for white coat coats is about 5 points, while the average score for all other clothing combinations is 3 points (P<0.05); the professional level scores are similar.
A special finding shocked Xun and his colleagues: “Compared with models wearing white coats, respondents tended to think that models wearing gray fleece jackets or black softshell jackets had less experience and less professionalism.” The researchers hypothesized that since this casual wear is a relatively new phenomenon, participants may not see it often in real-life healthcare and therefore will not associate it with "valuable doctor characteristics" stand up.
The organization also observed that it might be wrong to replace white coats with casual wear out of concerns about cleanliness, because there is no obvious reason to believe that woolen vests or jackets are less susceptible to contamination. Xun and colleagues acknowledge that providers must consider the patient's views when seeking to establish rapport, whether reasonable or not.
But this does not mean that the white coat must remain supreme.
The researcher wrote: "[T] His introduction of the new doctor costume provides a disruptive opportunity to address the persistent gender bias in medicine." The new status quo is becoming increasingly diverse. This includes clearly identifying professional roles during the introduction process, immediately correcting misrecognition of roles, and raising awareness (such as more diverse representatives) training levels; spotlight features; in the board of directors, speakers and leadership positions Representatives on social media; and their presence on social media)."
In addition, they added that this job must be undertaken by all healthcare professionals, not just those who suffer from prejudice in the workplace (such as women).
John Gever served as editor-in-chief from 2014 to 2021; he is now a regular writer.
There is no specific external funding for this work. The study authors state that they have no relevant financial interests.
Source reference: Xun H et al. "Public views on American doctors' dress and professionalism" JAMA Netw Open 2021; DOI: 10.1001/jamanetworkopen.2021.17779.
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