The importance of the orthopaedic doctors' appearance: a cross-regional questionnaire based study.
OBJECTIVE
Critics of the Department of Health 'bare below the elbow' guidelines have raised concerns over the impact of these dress regulations on the portrayed image and professionalism of doctors. However, the importance of the doctor's appearance in relation to other professional attributes is largely unknown. The purpose of this study was to determine the opinion of patients on the importance of appearance and the style of clothing worn by doctors.


METHODS
Patient questionnaire survey, administered across four Scottish regions.


METHODS
Orthopaedic outpatient departments.


METHODS
427 patients and accompanying relatives.


METHODS
The absolute and relative importance of the doctors' appearance, as reported using a 5-point Likert scale. The absolute and relative importance of the style of clothing worn by doctors, as reported using a 5-point Likert scale. The rank preferences for four different styles of doctors' attire as illustrated by standardised clinical photographs.


RESULTS
The study was appropriately powered to identify a 0.5 difference in mean rank values with 0.90 power at a = 0.05. The majority of participants felt the doctors' appearance was important but not as important as compassion, politeness and knowledge. Only 50% felt that the style of doctors clothing mattered; what proved more important was an impression of cleanliness and good personal hygiene. In terms of how patients would prefer doctors to dress in clinic, the most popular choice proved to be the smart casual style of dress, which conforms with the 'bare below the elbows' dress code policy. The smart casual clothing style was the highest ranked choice irrespective of patient age, gender, regional or socioeconomic background.


CONCLUSIONS
The doctors' appearance is of importance to patients and their relatives, but they view many other attributes as more important than how we choose to dress. While not specifically addressing the role of doctors clothing in the transmission of infection, our results do support the preference of patients for 'bare below the elbows' workplace attire.
Dept of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK. Electronic address: stuart.aitken@nhs.net.
Stuart A
SA
Aitken
Dept of Orthopaedics, Ninewells Hospital, Dundee DD1 9SY, UK.
Craig G
CG
Tinning
Dept of Orthopaedics, Southern General Hospital, Glasgow G51 4TF, UK.
Sanjay
S
Gupta
Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK.
Gareth
G
Medlock
Dept of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
Alexander M
AM
Wood
Doune Health Centre, Doune, Perthshire FK16 6DR, UK.
Margaret A
MA
Aitken
D000328:Adult; D000368:Aged; D003020:Clothing / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D057240:Patient Preference / Q000706:statistics & numerical data*; D010820:Physicians / Q000592:standards*; D012606:Scotland; D011795:Surveys and Questionnaires
Appearance; Opinion; Orthopaedics; Scotland