If doctors want to be taken seriously by their patients, they’ll have to dress the part. A new study from the University of Michigan reveals this bias, adding to a long list of prejudices that patients are known to hold against doctors and their physical appearances. However, as the paper notes, this dismissal of perfectly qualified doctors is doing more harm to the patients themselves.

As part of the study published in the medical journal BMJ last month, researchers collected over 4,000 patient responses from 10 academic medical centers across the United States. Led by Dr. Christopher M Petrilli of the University of Michigan’s Department of Internal Medicine, the team found that 53 percent of the patients interviewed shared that a physician’s attire was important to them during care. Not only that, but over one-third agreed that the way a doctor dressed influenced their satisfaction with care.

Preference for white coat by clinical care setting and physician gender
Preference for white coat by clinical care setting and physician gender

“Professional dress on Wall Street, law and nearly every other industry is relatively clear — and it typically mirrors what applicants would wear to their job interview,” said Petrilli, who used to work in finance before he entered the medical field, in a statement published Wednesday. “In medicine, the dress code is quite heterogeneous, but as physicians, we should make sure that our attire reflects a certain level of professionalism that is also mindful of patients’ preferences.”

While Petrilli posits that these results should encourage doctors to keep their looks professional to improve patient relations, it’s just one of many patient prejudices that have been identified in recent studies. In October 2017, WebMD and Medscape published the study “Patient Prejudice: When Credentials Aren’t Enough” with STAT, showing that nearly six in ten US-based doctors (59 percent) say they’ve been confronted with bias from patients based on their physical appearance, including offensive remarks about gender, age, race, and ethnicity. This has resulted in prejudiced patients requesting new doctors due to the doctor’s appearance, even if that doctor is the most qualified specialist available.

The WebMD study showed that black and Asian doctors are 70 percent and 69 percent more likely to receive biased remarks, respectively. Moreover, nearly two-thirds of female doctors experience bias, while 55% of men experience biased comments and other conflicts. Weight, accent, sexual orientation, and religion also played roles. The study also included anecdotes of patients requesting male and/or white doctors and recounted other incidents in which renowned experts in the field were rejected on account of their Muslim faith.

The most common types of bias, as reported by doctors
The most common types of bias, as reported by doctors

With these variables in mind, Petrilli said that in his study of how doctors’ clothing influences patients’ trust, researchers only used images of young, slender, white doctors for consistency. The sample survey was 71 percent white and 65 percent male, with 70 percent having attended some college or having a college degree. Thus, as the study points out, whether Petrilli’s findings hold true across race or ethnicity is not known.

While Petrilli encourages doctors to dress better to improve doctor-patient relations, the doctor’s physical appearance, whether clothing, gender, race, or other physical attributes, should not play a factor in deciding the trustworthiness of the prognosis. In the cases laid out in the WebMD/Medscape study, it becomes clear that these prejudices do more harm to patients, limiting the professional care accessible to them. Thus, the onus is on patients to acknowledge their own prejudices in order to receive the best care.