Physician attire is more than a matter of style. It influences how patients perceive professionalism, competence and empathy, shaping relationships that underpin effective care. Over time, clothing has become symbolic of authority in medicine, with the white coat in particular acting as an emblem of clinical identity. Yet expectations are not uniform. Patients’ preferences differ depending on the clinical environment, the medical specialty and the gender of the physician. The impact of the COVID-19 pandemic has further reshaped attitudes, bringing hygiene and safety to the forefront. For healthcare leaders, these findings highlight the importance of dress codes not just as operational standards but as strategic tools for reinforcing trust, improving patient satisfaction and addressing workplace equity.
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Attire and the Clinical Environment
One of the strongest determinants of how attire is perceived is the setting in which care is delivered. In primary care, where continuity and communication are priorities, patients often respond positively to casual clothing paired with a white coat. This balance conveys approachability while preserving authority. In contrast, hospital environments, particularly inpatient wards and emergency departments, are associated with greater formality. Here patients tend to value scrubs or white coats, both of which signal readiness, hygiene and competence in high-pressure contexts. Surgical settings follow similar patterns, with scrubs perceived as the most appropriate attire due to the association with infection control and technical preparedness.
These distinctions carry operational implications. Leaders designing dress codes for hospitals must recognise that a single policy may not serve all environments. Instead, flexible approaches tailored to specific clinical areas can strengthen patient confidence. Emergency rooms may benefit from standardising scrubs to project preparedness, while outpatient clinics can allow more variation to foster rapport. By aligning attire with patient expectations, organisations can improve both experience and trust without compromising professional standards.
Specialty and Gender Considerations
Preferences are also shaped by medical specialty. In fields such as dermatology, neurosurgery and ophthalmology, patients have consistently linked white coats with credibility and professional expertise. Conversely, in anaesthesiology, gastroenterology and oral or maxillofacial surgery, scrubs are viewed as more practical and trustworthy. Family medicine shows more tolerance for casual dress, though patients still expect a balance of empathy and professionalism. These findings underline the need for specialty-sensitive policies rather than uniform regulations.
Gender adds further complexity. Male physicians are often perceived as more authoritative when wearing suits or formal attire combined with white coats. Accessories such as glasses or watches can strengthen perceptions of professionalism. Female physicians, however, face additional challenges. Even when dressed identically to male colleagues, they are more likely to be misidentified as nurses or assistants, reflecting persistent stereotypes. Female physicians wearing white coats may be regarded as competent and professional, yet casual attire often leads to negative assumptions. These disparities affect recognition, credibility and patient trust. For healthcare executives, addressing such inequities is not merely a matter of fairness but also of ensuring that all clinicians are able to establish authority and rapport on equal terms. Policies that reduce misidentification and promote equitable perceptions can help create a more inclusive and effective working environment.
Shifts Following the COVID-19 Pandemic
The pandemic profoundly altered perceptions of professional dress. Scrubs and protective equipment became associated with hygiene and safety, and many patients began to prefer these garments across a variety of settings. Face masks were widely viewed as essential, with surgical and N95 types most favoured. At the same time, some protective measures, particularly opaque masks, hindered communication and reduced patients’ ability to interpret emotional cues. Among younger patients, preferences leaned towards more casual attire that conveyed warmth and approachability, showing how generational expectations interact with broader cultural shifts.
For healthcare organisations, the lesson is clear. Dress codes must evolve with patient priorities, balancing infection control with human connection. The pandemic demonstrated that rigid adherence to traditional symbols such as the white coat is no longer sufficient to inspire trust in all contexts. Instead, attire policies should emphasise hygiene and safety while leaving space for approaches that maintain rapport. This flexibility can support resilience in future crises while reinforcing confidence in routine practice.
Clothing choices for physicians carry implications well beyond individual style. Attire influences perceptions of competence, professionalism and empathy, shaping the quality of the physician–patient relationship. Preferences vary according to clinical environment, specialty and gender, and have shifted further since the pandemic. For executives and healthcare leaders, the findings highlight the need for thoughtful dress code policies that respond to these dynamics. Flexible standards aligned with patient expectations can enhance trust and satisfaction, while equitable approaches can address gender disparities and reduce misidentification. Medical attire should be recognised as a strategic component of patient-centred care, requiring leadership attention to balance tradition, safety and inclusivity.
Source: BMJ Open
Image Credit: iStock
