title: Impact of military physician rank and appearance on patient perceptions of clinical competency in a primary care setting.
abstract: The patient-physician interaction is an important aspect of primary care medicine. Few studies have investigated the military specific factors that influence these interactions. Using a cross-sectional survey, we evaluated the impact of physician rank and attire on a patient's confidence in their physician's medical abilities and willingness to disclose personal information. Patient perception was assessed in the domains of (1) confidence in physician's medical abilities and (2) comfort discussing sexual, psychological, and personal problems with a physician. Our results found physicians of higher rank showing a higher positive impact on patient's confidence compared to lower ranks (p < 0.0001). Patients were less comfortable discussing sexual (p = 0.001), psychological (p < 0.0001), and personal (p = 0.005) problems with an O-3 (Air Force Captain) than higher ranked physicians. Casual business attire negatively affected patient's confidence in their physician's abilities and in their comfort discussing sexual, psychological, and personal problems (p < 0.0001). Removing resident physician data did not significantly alter results. This pilot study on military rank and appearance shows a statistically significant impact to patient-physician interactions. Lower rank and casual attire is statistically detrimental to the patient's perception of their physician's abilities irrespective of resident physician involvement.
authors.affiliation: David Grant USAF Medical Center, 101 Bodin Circle, Travis Air Force Base, CA 94535, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Trowbridge
authors.forename: Ryan
authors.initials: R
authors.lastname: Pearson
mesh_terms: D000293:Adolescent; D000328:Adult; D000337:Aerospace Medicine; D000368:Aged; D002983:Clinical Competence; D003020:Clothing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D008889:Military Personnel / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011446:Prospective Studies; D014481:United States; D055815:Young Adult