Outliers: Traditional trumps casual for docs' first impressions

You get only one chance to make a first impression, the saying goes. And, if that first impression is made in an intensive-care unit, it could make the difference for physicians trying to establish trust with a patient's family members in a short period of time.

That was the premise of a report written by Canadian researchers with the University of Calgary and Alberta Health Services and posted on the JAMA Internal Medicine website as a research letter. The authors surveyed people who had family members admitted at three ICUs in Calgary, Alberta, asking what visible characteristics were important upon the first meeting with their family member's doctor. The top answers among the 337 respondents were an easy-to-read name tag, 77%; neat grooming, 65%; and professional dress, 59%. Far behind on the importance scale were absence of visible piercings, 39%; wearing a white coat, 32%; and absence of visible tattoos, 30%.

But, when selecting preferred physicians from a set of pictures, most respondents (52%) chose the models wearing the traditional white coat; followed by physicians wearing scrubs, 24%; suits, 13%; and casual attire, 11%.

Dr. Rebecca Lesto Shunk, with the San Francisco VA Medical Center, summed up the findings in an accompanying editorial.

“Maybe I am old-fashioned, but I think the dress and appearance of healthcare providers should demonstrate professionalism and support a serious and sacred pact with our patients,” Shunk wrote. “By dressing and appearing professionally, we validate the significance of the relationship, acknowledging that we are not their barista, but a person to whom the patient entrusts their most private thoughts and concerns.”