Patient Perceptions of Physicians: The Enduring Symbolism of the White Coat

A comprehensive review published in the open-access journal BMJ Open reveals that patients continue to associate the white coat with professionalism and trustworthiness in medical practitioners. Despite evolving healthcare practices and a growing acceptance of casual attire, the traditional white coat remains a significant marker of credibility, especially in conventional or high-risk settings.

The research highlights that women doctors, while often perceived as more empathetic, are frequently misidentified as nurses or medical assistants when dressed in white coats, which could influence patient perceptions. Interestingly, patient preferences for physician attire vary depending on clinical context and medical specialty. For example, in emergency situations or high-stakes environments, clinicians wearing scrubs or white coats are preferred, whereas in primary care or palliative care, casual dress may be acceptable.

Historically, the 19th century saw doctors dressing in black to signify seriousness. As understanding of hygiene and scientific progress progressed, white coats symbolized cleanliness and professionalism, becoming standard across many countries throughout the 20th century.

The review examined 32 studies published between January 2015 and August 2024, predominantly from the U.S., with contributions from Asian, European, and African countries. It found that patients generally favor male doctors in suits and white coats, perceiving them as more competent and trustworthy. However, UK practices have shifted towards a 'bare below the elbows' approach to reduce infection risks, banning accessories like watches and long sleeves.

Notably, gender and attire influence perception significantly: female physicians’ attire impacts their perceived professionalism, and presentations suggest that gendered expectations still play a role in how doctors are evaluated. During the COVID-19 pandemic, a shift toward the acceptance of hygienic and practical attire, such as scrubs, was observed, reflecting heightened awareness of infection control.

The review underscores the importance of aligning physician attire with clinical context and societal expectations, encouraging healthcare institutions to adopt flexible dress policies that foster trust and respect.

Overall, while traditional white coats symbolize expertise, patient preferences are increasingly nuanced, influenced by gender, specialty, and safety considerations. The findings suggest that healthcare providers should consider these factors to enhance patient trust and satisfaction.

Source: https://medicalxpress.com/news/2025-08-patients-view-doctor-white-coat.html