title: Importance of physicians' attire: factors influencing the impression it makes on patients, a cross-sectional study.
abstract: OBJECTIVE
  The aim of the present study was to determine the importance of physician attire in inspiring confidence in patients, patient preferences and factors influencing the impression made by the clothing worn by doctors.
  
  
  METHODS
  Self-administered questionnaires were distributed and completed in five pharmacies across Japan (April-October 2012) to patients or their carers (aged ≥20 years). The survey was performed over 2 consecutive days in each pharmacy. To estimate patient confidence in doctors, questions were asked addressing six items, namely doctors' attire, speech (way of speaking, volume, tone etc.), age, gender, title (professor, PhD etc.) and reputation. Participants were shown photographs of five different types of attire for male and female doctors (i.e. white coats, scrubs, semiformal, smart casual and casual wear) and asked to rate the appropriateness of each clothing style using a five-point Likert scale.
  
  
  RESULTS
  Of the 1411 patients or carers who attended the pharmacies, 530 responded to the questionnaire, with 491 complete responses used in subsequent analyses. The mean age of respondents was 51.9 years and 40.3% were male. Speech was the most important factor (mean score 4.60) in determining confidence in doctors, followed by reputation (4.06) and attire (4.00). With regard to attire, regardless of a doctor's gender, the white coat was judged to be the most appropriate style of dress, followed by surgical scrubs. Only the preference for scrubs was significantly affected by age, gender and region (P < 0.05). Using binomial logistic regression analysis, we evaluated the effects of age on the appropriateness (Likert score 3-5) versus inappropriateness (score 1-2) of scrubs. There was a significant increase in the number of subjects aged 50-64 and >65 years of age who thought scrubs were inappropriate compared with those aged 20-34 years (adjusted odds ratios of 4.30 and 12.7 for male doctors, and 3.66 and 6.91 for female doctors).
  
  
  CONCLUSIONS
  Attire is one of the important factor that inspires patient confidence in physicians. White coats were deemed the most appropriate clothing style for doctors, followed by scrubs. However, older participants perceived scrubs to be less appropriate attire than younger subjects.
authors.affiliation: Department of General Medicine and Primary Care, University of Tsukuba Hospital, Amakubo 2-1-1, Tsukuba City, Ibaraki Prefecture 305-0005, Japan. hkurihara-tkb@umin.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurihara
authors.forename: Takami
authors.initials: T
authors.lastname: Maeno
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Maeno