Physicians’ Attire Influences Patients’ Perceptions in the Urban Outpatient Orthopaedic Surgery Setting

Background Previous work has established that physician attire influences patients’ perceptions of their physicians. However, research from different specialties has disagreed regarding what kinds of physician attire might result in increased trust and confidence on the part of patients. Questions/Purposes The purpose of this study was to investigate how surgeon attire affects patients’ perceptions of trust and confidence in an urban orthopaedic outpatient setting. Methods Eighty-five of 100 patients solicited completed a three-part questionnaire in the outpatient orthopaedic clinic at an urban teaching hospital. In the first section, participants viewed eight images, four of a male surgeon and four of a female surgeon wearing a white coat over formal attire, scrubs, business attire, and casual attire, and rated each image on a five-level Likert scale. Participants were asked how confident, trustworthy, safe, caring, and smart the surgeon appeared, how well the surgery would go, and how willing they would be to discuss personal information with the pictured surgeon. The participant ranked all images from most to least confident in the second part and the last section obtained demographic information from the patients. Surveys were scored using a five-level Likert scale and a Friedman test was used to detect statistical significance when comparing all attires. For multiple pairwise comparisons, a Bonferroni correction was applied. Results The white coat on the male surgeon elicited modestly higher ratings in confidence (mean difference [MD], 0.367 ± 0.737; 95% CI, 0.202–0.532; p < 0.001), intelligence (MD, 0.216 ± 0.603; 95% CI, 0.077–0.356; p = 0.027), surgical skill (MD, 0.325 ± 0.658; 95% CI, 0.175–0.474; p < 0.001), trust (MD, 0.312 ± 0.613; 95% CI, 0.173–0.451; p < 0.001), ability to discuss confidential information (MD, 0.253 ± 0.742; 95% CI, 0.087–0.419; p = 0.023), caring (MD, 0.279 ± 0.655; 95% CI, 0.124–0.432; p = 0.006), and safety (MD, 0.260 ± 0.594; 95% CI, 0.125–0.395; p = 0.002) compared with business attire. Similarly, the white coat was preferred to casual attire in all categories (confidence: MD, 0.810 ± 0.921; smart: MD, 0.493 ± 0.801; surgical skill: MD, 0.640 ± 0.880; ability to discuss: MD, 0.564 ± 0.988; trust: MD, 0.545 ± 0.836; safety: MD, 0.581 ± 0.860; caring: MD, 0.479 ± 0.852; p < 0.001 for all comparisons). For the female surgeon, white coat and scrubs were not different, however the white coat was preferred to business attire