Objectives: To determine hospitalised patients' feelings, perceptions and attitudes towards doctors and how these are affected by whether or not doctors wear a white coat.
Design: Cross-sectional questionnaire survey.
Setting: The medical and surgical wards of two Sydney teaching hospitals, on one day in January 1999.
Patients: 154 of 200 consecutive patients (77%).
Main outcome measures: The effects of white-coat-wearing on patients' feelings and ability to communicate and on their perceptions of the doctor; why patients think doctors wear white coats and their preferences for the wearing of white coats and doctors' attire in general; and patients' rating of the importance of these effects and preferences.
Results: Patients reported that white-coat-wearing improved all aspects of the patient-doctor interaction, and that when doctors wore white coats they seemed more hygienic, professional, authoritative and scientific. The more important that patients considered an aspect, the greater the positive effect associated with wearing a white coat. From a list of doctors' reasons for wearing white coats, patients thought that doctors wore white coats because it made them seem more professional, hygienic, authoritative, scientific, competent, knowledgeable and approachable. 36% of the patients preferred doctors to wear white coats, 19% preferred them not to wear white coats and 45% did not mind.
Conclusions: Patients reported feeling more confident and better able to communicate with doctors who wore white coats. The recognition, symbolism and formality afforded by a white coat may enhance communication and facilitate the doctor-patient relationship.