Should a Psychiatrist Wear a White Coat?

Psychiatrist white coat

In a study the majority of the patient population (96%) preferred their psychiatrist not to wear a white coat although 58% did not think it would make a difference in their relationship with their doctor.

The psychiatrists mostly (64%) agreed on this point, 14% added that in situations like geriatric psychiatry, emergency psychiatry, inpatient and consultation liaison they preferred to wear a white coat.

Both the patients and psychiatrists considered dress to be an important part of the doctor–patient relationship.

The majority of the patients (65%) preferred the male psychiatrist to be dressed in casual shirt and casual trousers. Similarly, the dress shirt with skirt/pants was the most popular dress attire for female doctors (60%). The psychiatrists dressed more formally. ‘‘Suit and tie or sports coat and dress pants and tie’’ or ‘‘Shirt, tie and dress pants’’. The female psychiatrists suggested a relatively informal dress attire of ‘‘Dress blouse/shirt and pants/skirt.’’ Male psychiatrists are more critical towards their dress compared to the patients.

The study was done in Upstate New York with a chronically ill population who were attending the outpatient clinic for many years. This limits generalizability.

These results are in contrast with a UK study (1997). They reported that the doctors dressed in suits were considered to be more competent and the white coat was related to being the most understanding. The description of smart attire consisted of wearing a long sleeved shirt with formal trousers and a tie (male) and a blouse and skirt (female). Comparable to the US study the psychiatrists usually were more critical about their attire as compared to patients themselves.

What about other doctors than psychiatrists?
In a large study from New Zealand with outpatients attending clinics that covered a range of medical and surgical specialties patients prefer a semiformal style of dress over formal suits and white coats. Casual dress styles were less popular.

In the New Zealand setting this would involve dressing in a tidy, semiformal manner in conservative clothing.

In a study done in the US, South Carolina, respondents from an internal medicine outpatient clinics overwhelmingly favor professional attire with white coats for physicians. This could be due to a more formal attitude in the south of the US.

No psychiatrists shouldn’t wear white coats, special situations excluded. A happy face and smart attire is all that is needed.
S REHMAN, P NIETERT, D COPE, A KILPATRICK (2005). What to wear today? Effect of doctor’s attire on the trust and confidence of patients The American Journal of Medicine, 118 (11), 1279-1286 DOI: 10.1016/j.amjmed.2005.04.026
Nikhil D. Nihalani, Arun Kunwar, Jud Staller, J. Steve Lamberti (2006). How Should Psychiatrists Dress?—A Survey Community Mental Health Journal, 42 (3), 291-302 DOI: 10.1007/s10597-006-9036-9
M. M Lill (2005). Judging a book by its cover: descriptive survey of patients’ preferences for doctors’ appearance and mode of address BMJ, 331 (7531), 1524-1527 DOI: 10.1136/bmj.331.7531.1524