Note to dermatologists: the necktie is out

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A new survey of patients at dermatologists’ offices sends a clear message to doctors about their attire: scrap the necktie, but don’t lose the white coat just yet.

“We’re going to proclaim that ties are dead,” said Dr. Dean Morrell, one of the study’s authors and the director of pediatric and adolescent dermatology at the University of North Carolina.

He and his colleagues surveyed 176 new patients at an adult dermatology clinic and the parents of 248 children attending a pediatric clinic about their views on what doctors should wear.

"Only about 20 percent of people felt like their male physicians should wear a necktie,” Morrell told Reuters Health.

The results were the same across all groups who answered the survey: it didn’t matter their age, race, education level or gender, people don’t value the tie.

At least for grown-up patients, the white coat is still in vogue, as it has been for the last hundred years.

More than half of patients seen in the adult dermatologist’s office expected to be treated by a physician wearing a white coat.

“I think (doctors) are not quite ready to lose the white coat, either,” said Dr. Charles Ellis, a professor of dermatology at the University of Michigan, who was not involved in this study.

The white coat is a doctor’s badge of authority - and both doctors and patients feel reassured by it.

“We make a big deal about it,” Ellis told Reuters Health. “We have the white coat ceremony for first year medical students, where the dean helps them put on their first white coat.”

When it comes to children, parents are less demanding of the white coat.

The study found that about one out of every four parents wanted to see their child’s dermatologist in a white coat.

Dr. Meghan Thomas, another of the study’s authors, told Reuters Health that parents’ desires reflect what they see in doctors’ offices.

“There are very few pediatricians that go all out and wear formal attire,” she said, because children can be intimidated by the white coat.

Ellis, who was not involved in this study, said it’s important to know what patients want to see when they visit the doctor.

“Patient satisfaction is important for the healing process,” Ellis said.

Yet the study, which is published in the Archives of Dermatology, found that attire doesn’t seem to be too important to patient satisfaction.

About one out of every three people who took the survey said that attire affects their trust in the doctor - which means that two out of three people are unaffected by what their doctor wears.

“It speaks to what’s really important in the relationship,” said Morrell. “If there’s an excellent therapeutic relationship that they enjoy, the exterior - whether it’s a white coat or a tie - really doesn’t matter.”

SOURCE: Archives of Dermatology, April 2011.

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