Does what doctors wear really matter? The DRESS prospective study on patient trust

The physician white coat has traditionally been symbolic of patients' trust in their physicians. Recently, use of surgical scrubs has expanded as an alternative to traditional physician attire. We sought to evaluate whether patient trust is influenced by traditional physician attire versus surgical scrubs.

This is a prospective quasi-experimental study utilizing the Modified Trust in Physician Scale (TIPS) survey administered to 274 hospitalized English and Spanish speaking patients aged 18-80 years at the time of patient discharge or upon completion of physician shift. Five full-time hospitalist physicians alternated their weekly attire: one week wearing traditional attire with white coat and the following week surgical scrubs without white coat. Other variables examined included patients' age, gender, ethnicity, level of education and duration of time attended by the physician.

After a mean of 3 hospital days, there was no difference in patient trust in physicians wearing traditional attire with a white coat (TIPS mean score 2.00, 95% CI 1.90-2.09) versus those wearing surgical scrubs (TIPS = 2.08, 95% CI 1.95-2.21, P = 0.26).

When evaluating the impact of physician attire in the setting of an inpatient patient encounter, we found no association between patient trust and physicians wearing traditional attire with a white coat and surgical scrubs without a white coat.