By Ruth Carol, contributing writer

Do you want to improve patient satisfaction? How about improving compliance rates? If so, consider adopting a dress code that requires professional attire. It might just be the key to enhancing patient satisfaction, trust, and even outcomes.

Studies show that patients prefer their physicians, and dermatologists in particular, to wear professional attire. That means a button-down shirt, tie, and slacks for males, and a blouse, skirt, or suit pants for females under a white lab coat. “While appearance doesn’t necessarily reflect the quality of care you provide, people presume that it does,” said Karyn Grossman, MD, who practices in Santa Monica, California and New York City. “That’s why it’s important to appear professional.

Patient expectations

It boils down to patient expectations. “Having professional attire fits into their natural biases of what they expect a physician to look like,” said Robert S. Kirsner, MD, PhD, chair and Harvey Blank Professor in the department of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine, who is the senior author of a study on the subject published in JAMA Dermatology (see sidebar). Patients associate professional attire with a higher level of knowledge and competence. When physicians wear professional attire, it sets patients at ease and gives them more confidence, which emerging data suggest has a placebo effect, he said. When patients believe the treatment will work, they’re more likely to fill prescriptions, take medications as prescribed, and follow instructions. That, in turn, can affect patient outcomes. “We want patients to have confidence in us because they have the opportunity to see other specialists, and even non-physicians, to treat their dermatologic conditions,” Dr. Kirsner noted.

“We know that patients take notice of what we’re wearing and that they respond better when we are dressed professionally,” said Corey Hartman, MD, who wears a shirt, tie, and slacks under a white coat in his practice in Birmingham, Alabama. On the occasion that he leaves off the white coat, patients remark about it. “I tend to overdress rather than underdress, so that sets the tone for the office,” said Dr. Hartman, who wears his AAD scrubs on procedure days.

When he started in practice, patients often commented that he looked very young. “It’s a compliment on one hand, but it can diminish your credibility in their eyes,” Dr. Hartman said. As a result, he started dressing up to present himself very professionally. Although the dress code doesn’t dictate that the three dermatologists in his practice wear white coats, they all do. An advantage of the white coat is that it displays the provider’s name, credentials, and title so that patients know with whom they are speaking at all times. “These days, it’s hard for the public to tell the difference between the physician, a physician extender, and an aesthetician,” he said.

Dress code addresses more than attire

The dress code in Dr. Hartman’s offices calls for neat, professional, and modest attire, but does not get into specifics. “We want to allow for fashion expression, but within the confines of what we deem professional,” said Dr. Hartman. He provides lab coats for the physicians and scrubs for the nurses, aesthetician, and front office staff. Anybody who touches the patients wears scrubs that are embroidered with the practice logo, and their name and title. They have three to four pre-determined styles to choose from that accommodate different body types. “The last thing you want is someone to wear a uniform that isn’t comfortable or flattering because that will affect their confidence and patients will pick up on that,” Dr. Hartman said. Office staff can wear either the scrubs or professional attire.

When Dr. Grossman started out, she wore business casual attire under a white lab coat; the staff wore business casual clothing. Due to differing opinions about what constitutes business casual, black slacks and shirts — that she paid for —became the “uniform.” That didn’t last long because some staff did not choose modest professional-looking options. Dr. Grossman switched her attire to scrubs, and four years ago she required all staff to wear practice-issued logoed scrubs with their name and title. She wears a long-sleeve white coat while the non-physician providers wear short-sleeve white coats to distinguish them. Although Dr. Grossman was concerned that she would get some pushback from the staff, they love the scrubs. Patients have also commented that the uniforms look crisp and clean.

Similarly, the dress code at the Austell, Georgia practice of Janice Warner, MD, changed before settling on scrubs. Front desk staff used to wear business casual, explained Holley Garrett, CPM, CPC, CDC, the practice manager. “We found out over the years that it’s better to buy the uniforms because you have more control over what people wear,” she said. “Otherwise, you leave too much to interpretation as to what is appropriate.”

Two of three dermatologists wear scrubs under white lab coats, and one prefers business casual. All of the physicians and non-physician providers wear white coats embroidered with their name and credentials, thus eliminating the need to replace lost badges. The clinical and non-clinical staff wear scrubs in complementary colors, which helps patients to distinguish the staff. The practice pays $175 per employee for scrubs. An advantage of wearing scrubs is that if they get soiled, staff can change in the office, Garrett said.