Patient perception of physician attire: a systematic review update

This systematic review aims to update and analyse patient perceptions of physician attire, focusing on its impact on the physician-patient relationship across different medical settings and specialties.

A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria.

PubMed, Embase, Cochrane Library and Google Scholar were searched for relevant studies from 1 January 2015 to 1 June 2025.

This review examined studies focused on physician attire and its impact on patient perceptions.

Studies were assessed based on authors, study setting, study design, objective, study population, physician specialty, measures, findings, main conclusion and risk of bias. Then, thematic analysis was employed to synthesise the findings of the articles.

28 studies met the inclusion criteria. Patient preferences for physician attire varied significantly by clinical context, medical specialty and physician gender. In outpatient and primary care settings, mixed evidence was reported, with some studies suggesting that a combination of casual attire and white coats may foster approachability and communication, while others showed no clear preference. In contrast, in high-acuity settings such as emergency rooms and operating theatres, scrubs were consistently favoured, indicating moderate to strong evidence for the association with professionalism and preparedness. During the COVID-19 pandemic, patients expressed stronger preferences for scrubs and PPE, emphasising infection prevention and hygiene. Gender-specific findings indicated that male physicians were perceived as more professional when wearing formal attire with white coats, while female physicians in similar attire were often misidentified as nurses or assistants. Specialty-based differences were also observed, with preferences for white coats in dermatology, neurosurgery and ophthalmology, while scrubs were preferred in anaesthesiology and gastroenterology.

This study demonstrates that physician attire consistently and significantly impacts patients' perceptions of professionalism, trust and communication. The collective findings provide robust evidence that these perceptions are highly context-dependent, necessitating adaptable dress codes tailored to clinical environments and patient expectations to enhance trust and patient satisfaction.

https://osf.io/kjr4p.