Patients Attitude towards Surgeons Attire in Our Lady of Lourdes Hospital Drogheda

Document Type : Original Article


1 Our Lady of Lourdes Hospital, Drogheda, Ireland

2 Adelade and Meath Hospital, Tallaght, Ireland

3 Royal College of Surgeons, Dublin, Ireland


A doctor’s competence and professionalism is often judged on the basis of attire. Our Lady of Lourdes (OLOL) is a leading Irish hospital in the implementation of Bare Below the Elbows (BBTE) policy, however surgical attire is not standardised and there is great variability in attire worn on wards. We aimed to evaluate patients attitude towards surgeons attire in OLOL.
A prospective survey of adult surgical in-patients was conducted from October 2013 to February 2014. A twelve-question questionnaire was used as data collection tool, using a five point Likert scale to assess patients response to each question. Data were collected on patient demographics, patients level of trust and confidence based on different surgical attire, and patients perception of different attire worn by surgical teams.
There were 150 completed surveys during the study period with a male to female ratio of 44% to 56% respectively. The mean patient length of in-hospital stay (LOS) was 4.7 days (range 1–22). The most commonly represented age group was 30–40 years (18%), with a comparable spread among all age groups. The majority of patients found the attire worn by surgeons on the ward to be very appropriate (93%). Majority of responders believed scrubs to be the most appropriate attire for surgeons on wards (39%), followed by shirt and tie with white coat (38%) followed by short sleeved shirt and no tie (18%). Shirt and tie with white coat had a positive effect on patients trust in 63% of responders, a negative effect in 10% and no effect in 26%. Scrubs had a positive effect on patients trust in 63%, negative effect in 11% and no effect in 25%. Short sleeved shirt and no tie had a positive effect in 44%, negative effect in 25% and no effect in 30% of patients.
Patients in OLOL find attire worn by surgeons to be appropriate. Shirt and tie with white coat or scrubs remains the patient’s choice attire for surgeons. Shirt and tie with white coat or scrubs has a more positive effect on trust of patients compared to short sleeved shirt and no tie.


Main Subjects

  1. Bond L, Clamp PJ, Gray K, Van Dam V. Patients' perceptions of doctors' clothing: should we really be 'bare below the elbow'? J Laryngol Otol 2010; 124: 963-6. doi: 10.1017/s0022215110001167
  2. Landry M, Dornelles AC, Hayek G, Deinchmann RE. Patient Preferences for Doctor Attire: The White Coat's Place in the Medical Profession. Ochsner J 2013; 13: 334-42.
  3. Colt HG, Solot JA. Attitudes of patients and physicians regarding physician dress and demeanor in the emergency department. Ann Emerg Med 1989; 18: 145-51. doi: 10.1016/s0196-0644(89)80104-0
  4. Rehman SU, Nietert PJ, Cope DW, Kilpatrick AO. What to wear today? Effect of doctor's attire on the trust and confidence of patients. Am J Med 2005; 118: 1279-86. doi: 10.1016/j.amjmed.2005.04.026
  5. Greham J. Uniforms and workwear: an evidence base for developing local policy. UK: Department of Health; 2007.
  6. Munoz-Price LS, Arheart KL, Mills JP, Cleary T, Depascale D, Jimenez A, et al. Associations between bacterial contamination of health care workers' hands and contamination of white coats and scrubs. Am J Infect Control 2012; 40: e245-8. doi: 10.1016/j.ajic.2012.03.032
  7. Dancer SJ. Pants, policies and paranoia. J Hosp Infect 2010; 74: 10-5. doi: 10.1016/j.jhin.2009.10.012
  8. Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, et al. Estimating healthcare-associated infections and deaths in U.S. Hospitals, 2002. Public Health Rep 2007; 122: 160-6.
  9. Kurihara H, Maeno T, Maeno T. Importance of physicians' attire: factors influencing the impression it makes on patients, a cross-sectional study. Asia Pac Fam Med 2014; 13: 2. doi: 10.1186/1447-056x-13-2
  10. Trowbridge RE, Pearson R. Impact of military physician rank and appearance on patient perceptions of clinical competency in a primary care setting. Mil Med 2013; 178: 994-1001.
  11. Najafi M, Khoshadel A, Kheiri S. Preferences of Iranian patients about style of labelling and calling of their physicians. J Pak Med Assoc 2012; 62: 668-71.
  12. Nibhanipudi KV, Mason B, Pandey A, Henriquez R, Hassen GW. A study regarding Spanish-speaking parents' preference of physician attire in the pediatric emergency room. Clin Pediatr (Phila) 2013; 52: 593-8. doi: 10.1177/0009922813483001
  13. Al-Ghobain MO, Al-Drees TM, Alarifi MS, AL-Marzoug HM, Al-Mumaid WA, Asiry AM. Patients' preferences for physicians' attire in Saudi Arabia. Saudi Med J 2012; 33: 763-7.
  14. Longmuir S, Gilbertson A, Pfeifer W, Olson RJ. Pediatric ophthalmology attire: should we wear a white coat? Insight 2010; 35: 11-3.
  15. Yamada Y, Takahashi O, Ohde S, Deshpande GA, Fukui T. Patients' preferences for doctors' attire in Japan. Intern Med 2010; 49: 1521-6. doi: 10.2169/internalmedicine.49.3572
  16. Reddy R. Slippers and a white coat? (Hawai'i physician attire study). Hawaii Med J 2009; 68: 284-5.
  17. Fischer RL, Hansenn CE, Hunter RL, Veloski JJ. Does physician attire influence patient satisfaction in an outpatient obstetrics and gynecology setting? Am J Ostet Gynecol 2007; 196: 186.e1-5.
  18. Sotgiu G, Nieddu P, Mameli L, Sorrentino E, Pirina P, Porcu A, et al. Evidence for preferences of Italian patients for physician attire. Patient Prefer Adherence 2012; 6: 361-7. doi: 10.2147/ppa.s29587
  19. Collins AM, Connaughton J, Ridgway PF. Bare Below the Elbows: A comparative study of a tertiary and district general hospital. Ir Med J 2013; 106: 272-5.