Patients' perceptions of doctors' clothing: should we really be 'bare below the elbow'?

J Laryngol Otol. 2010 Sep;124(9):963-6. doi: 10.1017/S0022215110001167. Epub 2010 Jun 2.


Introduction: In September 2007, the Department of Health published Uniforms and Workwear: an Evidence Base for Guiding Local Policy. Following this, most National Health Service trusts imposed a 'bare below the elbow' dress code policy, with clinical staff asked to remove ties, wristwatches and hand jewellery and to wear short-sleeved tops. There is currently no evidence linking dress code to the transmission of hospital-acquired infection. We designed the current survey to assess patients' perceptions of doctors' appearance, with specific reference to the 'bare below the elbow' policy.

Materials and methods: A questionnaire showing photographs of a doctor in three different types of attire ('scrubs', formal attire and 'bare below the elbow') were used to gather responses from 80 in-patients and 80 out-patients in the ENT department. Patients were asked which outfit they felt was the most hygienic, the most professional and the easiest identification of the person as a doctor. They were also asked to indicate their overall preference.

Results and analysis: Formal attire was considered most professional and the easiest identification that the person was a doctor. Scrubs were considered most hygienic. Respondents' overall preference was divided between scrubs and formal clothes. 'Bare below the elbow' attire received the lowest votes in all categories.

Discussion: This finding raises significant questions about the Department of Health policy in question. The authors suggest that an alternative policy should be considered, with scrubs worn for in-patient situations and formal attire during out-patient encounters.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Clothing / psychology*
  • Clothing / standards
  • Cross Infection / prevention & control
  • Female
  • Humans
  • Infection Control / methods*
  • Male
  • Middle Aged
  • Organizational Policy*
  • Patient Satisfaction / statistics & numerical data*
  • Physician-Patient Relations*
  • United Kingdom
  • Young Adult