In the pre-pandemic world, I had a carefully curated collection of “clinic clothes,” the professional attire worn to signify seriousness in the clinic. As clinic visits were narrowed down to the essential and infection control became even more paramount, wearing scrubs in clinic was a small luxury allowed among mounting restrictions. Now, as we transition back to a more normal daily grind, I don’t know if the prior formality will ever return.
As society at large has moved away from the idea of formal dress in general, I’ve seen the trend ripple through medicine. Gone are the days of gloves and hats, ties and starched shirts. The years of largely being stuck at home with no one to impress has accelerated this; sneakers with suits and dresses are in and a fresh face is on trend. People are starting to look like themselves, discarding the traditional uniformity of “professional” dress.
A colleague of mine (who almost exclusively worked in the autopsy suite) used to wear long sleeves every day to cover her tattoos for fear of seeming unprofessional. A few years later, I’ve worked with scrub techs with facial tattoos and surgeons with full tattoo sleeves proudly on display. Piercings beyond the single lobe stud are now incredibly common, and not all hair colors are natural. At professional conferences, there are attendees who wear a three-piece suit and a full Windsor knot tie and others in jeans and a T-shirt. Even within the relative uniformity of the OR, scrub cap fabric choices are wide ranging, personal, and sometimes a little questionable. (I’m looking at you, OR circulator who wears a cap with a bad pun about GI surgery on it.)
This shift has raised some questions for me about the balance between personal expression and perceived professionalism. Does it matter what you look like? Does the color of your hair signify your intellect (coming from someone who has been the unamused audience of many a dumb blonde joke), or the cut of your pants signify your devotion to your job? It would be naive to suggest that first impressions aren’t powerful. There is a whole industry devoted to book cover design because we all judge books this way. There are certainly parts of our appearance that we can’t change, but the choices we make about those we can telegraph our values, status, and personality.
A study in JAMA from 2021 found that patients preferred their doctor wear a white coat and considered them more professional and experienced than those without one. I wonder if this preference is more about the abstract concept of a physician than the one sitting in front of a patient in the clinic. Many specialties, like pediatrics and psychiatry, eschew formal dress to avoid intimidating patients. As a medical student, I rotated with a family medicine doctor who wore cargo pants to work (he would have been really cool at my middle school), and his patients could not have cared less. My team has been ribbed by colleagues in other services for seeming too serious by wearing white coats for rounds.
Appearance can be a valuable tool for establishing a relationship and setting expectations. A white coat and tie read as serious and professional and can be a powerful tool for those who may be automatically judged for “not looking like a doctor,” but it can also create an immediate distinction between the physician and patient that distances them. More casual dress leaves the relationship more ambiguous at first but may be more relatable.
I certainly would not advocate slovenliness in the hospital, but I will say scrubs are so comfortable that I sometimes wear them electively at home. On the other hand, I do get aesthetic satisfaction from bringing fashion to the blandly beige hallways of the clinic. I don’t personally enjoy looking like everyone else and trying to fit a mold, at work or otherwise, and I would argue that professionalism is an attribute you embody with your actions rather than resemble with your appearance. It can be difficult to overcome the expectations of others as to what a doctor looks like, but the less effort we focus on trying to fit in, the more we have to devote to what really matters — the care of our patients.
How should clinicians dress in the clinic? Share your thoughts in the comment section.
Heather is a chief otolaryngology – head & neck surgery resident at the University of Kansas Medical Center. Her clinical interests include patient communication, medical education, and facial plastic and reconstructive surgery. Heather was a 2021-2022 Doximity Op-Med Fellow, and is a 2022-2023 Doximity Op-Med Fellow.
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