Slave to Fashion

Following a recent discussion about appearances I have decided that I need a wardrobe next to my consulting room library.

Dr Stephanie Dancer, a Scottish Microbiologist, has suggested that informal dress amongst doctors “erodes the image of doctors as responsible and competent” and “also intimates a lack of personal hygiene”.

Apparently in her opinion “Doctors are members of a distinguished profession and should dress accordingly. Untidiness erodes the image of doctors as responsible and competent. Scruffiness is synonymous with being untidy, dishevelled and unkempt, with having straggly hair, ill fitting clothes and scuffed shoes – or trainers – as well as not wearing a tie and so on. Together these might be taken as a flashing neon sign that says ‘I don’t care’. Scruffiness, however defined, also intimates a lack of personal hygiene and correspondingly lower standards of hygienic behaviour.”

Seems pretty harsh condemnation for a doctors who works in T-shirt, jeans and sneakers! I do know a few. I wonder  what she would think of a doctor with a pony tail and a Ned Kelly beard!

The responses to her BMJ article seem to be pretty revealing about the medical professions perceptions of itself at least in the UK.

Apparently, what I wear tells my patient I don’t care about them and worse I am incompetent and dishonest.

So now for my elderly patients I will don a crisp white shirt, dark suit jacket and pants, buffed oxfords and bow tie, quickly changing to smart casual pants and sport jacket for the antenatal clinic, changing to shorts and a polo top for a young adult then finally to the clown suit for immunisation clinic.

Hippocrates is claimed to have implored “physicians to be clean in person, well-dressed, and anointed with sweet smelling unguents”. That was unguents (soothing ointments) rather than ungulates (hoofed animals).

I think apart from the latter, I have satisfied his criteria. Ever since starting my medical career I have nearly always worn a smart casual short sleeved short, smart shorts and comfortable boots. Everything including my jocks and socks you will be glad to know gets washed at the end of the day.  My hair has also been cropped at a number 1 or 2 since I lots the dreadlocks when I was 17 and had to visit Singapore in the early 80’s. Once I wore a tie to work just to see if anyone noticed (they did – and laughed at me) and I have never worn a white coat. The last white coat I had ended up being tied dyed purple on the last day of Pharmacy school. Oh and I have a diamond stud in my ear, the right on of course.

An interesting paper which gained a mention in the Australian Doctors commentary about Dr Dancer’s opinion was published in the JAMA. Four hundred were surveyed and the author suggested a 76% favoured a white coat over scrubs over business dress over casuals. Respondents also reported that they were significantly more willing to share their social, sexual, and psychological problems with the physician who is professionally dressed. Respondents overwhelmingly favour physicians in professional attire with a white coat. Wearing professional dress (ie, a white coat with more formal attire) while providing patient care by physicians may favourably influence trust and confidence-building in the medical encounter.

The survey was carried out in Charleston in the US hence the white coat preference. I couldn’t help muse whether in the Deep South whether the pictures used to judge preference were of Caucasian or African-American faces.

Reminds how easy it would be to wander around a hospital dressed neatly with a stethoscope draped around the neck….

And as a little exercise type “Stephanie Dancer” into Google Image (with safe settings activated) and try to pic the Microbiologist!

Surely,  I earn my patient’s trust and confidence by how well address their needs rather than what I wear, may sound like, how tall I am, how long my hair is etc etc etc.

Let me know if I am wrong?



One thought on “Slave to Fashion

  1. Part of the reason why I blogged this is community expectation about what a doctor should be like. Apparently a photo I put on Facebook of me dressed in sarong, teva’s, Chairman Mao t-shirt holding up a dead feral cat transfixed by an arrow stirred some discussion. Now if I had been holding up something a little less fur, say a tuna then the comments may have been totally different.

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