By Brenda Mooney, Special to AHC Media

ANN ARBOR, MI – Surgeons and emergency physicians might be able to get away with wearing baggy scrubs to see patients, but physicians who work in offices probably need to spruce up a bit more, especially if they are seeking older patients or those of foreign backgrounds.

That’s according to a new analysis published online recently by British Medical Journal Open that finds the answer to “what not to wear” can be complicated for physicians. University of Michigan researchers suggest that the answer to that question can influence how patients perceive clinicians and their satisfaction with the care they receive.

For the analysis, researchers conducted a comprehensive international review of studies on physician attire, and other sources. In all, the data they reviewed came from 30 studies involving 11,533 adult patients in 14 countries.

In general, according to the results, patients prefer their physicians dress up a bit. Suits and/or a white coat – for either gender – appear to inspire more trust and confidence in some patients, although for other, it doesn’t seem to matter much.

Medical specialty also makes a difference in what physicians wear, according to the review. In fact, patients may prefer to see doctors in scrubs if they are emergency physicians, surgeons or critical care specialist.

The results especially vary based on age and culture, the authors point out. In general, Europeans and Asians of any age, and Americans older than 50, trusted a formally dressed doctor more. Americans in Generation X and Y, however, were less concerned if their doctor dressed down.

"As physicians, we want to make sure that we're dressing in a way that reflects a level of professionalism and also mindful of patients' preferences,” said lead author Christopher Petrilli, MD, an internal medicine resident at the U-M Health System who was an investment banker before switching careers. “Many studies have looked at various aspects of physician attire, so we wanted to look across this body of literature to find common threads. But at the same time, we found a lack of detailed guidance from top hospitals to their physicians about how to dress."

In most of the studies reviewed, 21 of the 30, patients had clear opinions on what their doctors to wear, with 18 of the studies coming out on the side or more formal attire. Four of the seven studies that involved surgery patients, however, reported that attire choice didn't matter or that scrubs were preferred, in line with four of five studies involving patients receiving emergency care or intensive care.