Elsevier

The Journal of Emergency Medicine

Volume 16, Issue 4, July–August 1998, Pages 541-543
The Journal of Emergency Medicine

Original Contributions
Does wearing a necktie influence patient perceptions of emergency department care?

https://doi.org/10.1016/S0736-4679(98)00036-5Get rights and content

Abstract

We conducted a prospective study of discharged emergency department (ED) patients to determine the effect of wearing a necktie by emergency physicians (EPs) had on patients’ impression of their medical care. All male EPs were assigned randomly by dates to wear a necktie or no necktie, and the attire worn was otherwise similar in all respects. The study was conducted at a community teaching hospital with an Emergency Medicine residency and an annual census of 40,000. A total of 316 patients were surveyed. There were no statistically significant differences between patient groups in any of the five areas surveyed, including patient perception of physicians’ appearance. Nearly 30% of patients incorrectly identified their doctor as wearing a necktie when no necktie was worn, and the perception of tie wearing was correlated with a positive impression of physician appearance. Wearing or not wearing a necktie did not significantly affect patients’ impression of their physician or the care they received. However, patients seemingly preferred the appearance of physicians who were perceived to wear neckties.

Introduction

Opinions as to what constitutes acceptable and proper attire for practicing emergency physicians (EPs) are varied. Traditional dress includes dress pants, shoes, shirt, and necktie with a white lab coat, while other options might include surgical scrubs, athletic footwear, or casual clothing with or without a lab coat. Although several studies have addressed patient and physician preferences and perceptions regarding multiple aspects of physician attire 1, 2, 3, 4, 5, no study has simply investigated one specific variable exclusively. We conducted a study attempting to determine the effect of wearing or not wearing a necktie by male EPs on patient impression of their overall medical encounter.

Section snippets

Materials and methods

During a 6-week study period, all male students, residents, and attendings were assigned by dates to wear either a tie (T) or no tie (NT) by the use of a random number table. The setting for the study was a community teaching hospital with an Emergency Medicine (EM) residency and an annual census of approximately 40,000. All males were required to wear dress pants, buttoned dress shirts with a collar (which might be buttoned or unbuttoned), and shoes. White lab coats, sports jackets, surgical

Results

A total of 316 surveys were completed, 162 in the NT group and 154 in the T group. There were no statistically significant differences between the groups in their ratings regarding overall care, interactions with or appearance of the physician (p = 0.45, 0.56, and 0.49, respectively; see Figure 1 ). When asked about the physician’s appearance, 7.5% of patients gave an unfavorable score of 3 or less on NT days as compared to 3.9% on T days (p = 0.27).

Results demonstrated that 28.6% (46/161)

Discussion

Attitudes regarding physician attire have been discussed by several authors 1, 2, 3, 4, 5, 6, 7. Most have surveyed physicians or interviewed patients concerning a variety of particular aspects of a physician’s dress that may impact positively or negatively on patients’ impression of the physician and his care 1, 2, 3, 4, 5. Colt and Solot reported that 73% of physicians believe that their physical appearance influences patients’ opinion of medical care received (1). A study relating attire to

Acknowledgements

The authors acknowledge John Krall, phd, for his statistical assistance.

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Cited by (16)

  • What you wear does not affect the credibility of your treatment: A blinded randomized controlled study

    2017, Patient Education and Counseling
    Citation Excerpt :

    Our findings do not support the use of formal attire (suit, tie) among clinicians working in primary care and in so doing contrast with the dominant view held by clinicians [26,27] and the available evidence [6,15]. To our knowledge, only two other studies have randomized professional attire during a clinical encounter, although they did not evaluate effects on credibility [16,17]. Our results add to the findings of Fischer et al. [16] and Pronchik et al. [17] on measures of patient satisfaction, and support the notion that attire does not determine whether a patient views the treatment as credible or not during a clinical encounter.

  • Does physician attire influence patient satisfaction in an outpatient obstetrics and gynecology setting?

    2007, American Journal of Obstetrics and Gynecology
    Citation Excerpt :

    The results of our study are consistent with 4 others in which patient satisfaction surveys were administered after encounters with physicians in different attires. Pronchik et al11 randomized male attendings, residents, and students in an emergency department to wear a necktie or no necktie over a 6-week period. Patients completing a postencounter survey had similar ratings between the 2 groups with regard to medical care, interaction, and general physician appearance.

  • Patient preference for emergency physician age and gender [14]

    2004, American Journal of Emergency Medicine
  • Scrubs versus professional attire: ED patients are indifferent [4]

    2004, American Journal of Emergency Medicine
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