S. Cheon1,3, J. N. Whitrock1, S. Sisak1, C. G. Pratt1, R. C. Chae1, A. D. Price1, D. McGough1, C. F. Justiniano1,2, R. M. Van Haren1,2, R. C. Quillin III1,2, S. A. Shah1,2 1University Of Cincinnati, Cincinnati Research In Outcomes And Safety In Surgery (CROSS) Research Group, Department Of Surgery, Cincinnati, OH, USA 2University Of Cincinnati, Department Of Surgery, Cincinnati, OH, USA 3University Of Toledo Medical Center, College Of Medicine, Toledo, OH, USA
Introduction: Recent studies have been published evaluating patient perception of physician attire; however, no studies have considered physician preferences and perceptions of workplace attire. This study sought to assess the current changing trends regarding provider-preferred attire, namely the white coat, among surgeons of different generations, genders, and regions in the modern era.
Methods: A national, population-based survey was distributed via email and social media to surgical attendings, fellows, residents, and medical students. Participants were asked to complete an online questionnaire regarding their perception of the white coat, preferred attire in different clinical settings, and reasons for choice of attire.
Results: Of the 481 surveys evaluated, 172 (36%) were attendings, 164 (34%) were residents, 125 (26%) were medical students, and 20 (4%) were fellows. We found no difference in rate of wearing a white coat between different races or genders, except for women being more likely to wear a white coat in clinic (64% vs 54% for men, p<0.05). Factors associated with wearing a white coat included length of career and region of practice, with the Midwest having the highest rate of white coat wearing (p<0.05). Late career surgeons (practicing >20 years) were more likely to wear a white coat while rounding in the hospital (Figure) and more likely to report wearing their white coat daily (56% vs 36% of middle career surgeons, 34% of early career surgeons, and 26% of those in training, p<0.05). The most common reasons for wearing a white coat were professionalism (n=260, 54%), workplace requirement (n=167, 35%), and to identify as a doctor (n=157, 33%). Top reasons for not wearing a white coat were personal preference (n=227, 47%) and lack of comfort (n=183, 38%). In the hospital, the most popular alternate attire was scrubs with fleece (n=157, 44%) followed by scrubs alone (n=95, 27%), business professional (n=21, 6%), and business casual (n=15, 4%). Female surgeons more frequently reported that their decision to wear a white coat was influenced by their program’s culture (61% vs 46% of males, p<0.05), that they would stop wearing a white coat if other members of their department stopped (50% vs 35% of males, p<0.05), and that they believe the white coat helps distinguish female doctors from nurses (61% vs 50% of males, p<0.05).
Conclusions: This study is the first to demonstrate generational, regional, and gender differences among surgeons in their perception and opinion of the white coat at a national level. Recognizing and understanding the evolving preferences of surgeon apparel may be advantageous in enhancing the team environment while supporting a contemporary and inclusive culture.
