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Looks matter, even in the ICU: Doctors in white coats with names tags preferred

Appearances count, it seems, even when a loved one's life may be hanging in the balance.

A new study shows that family members of people in hospital intensive care units place more trust in doctors who are well groomed, in a white coat or scrubs and wearing an easy-to-read name tag.

Interestingly, doctors in business suits were not terribly well received, and didn't fare much better than doctors in casual clothing when respondents were asked to assess them for competency, honesty, caring and knowledgability.

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The work was conducted by researchers at the University of Calgary, who surveyed 337 people visiting family members in three Calgary-area intensive care units.

It is published in this week's issue of the journal JAMA Internal Medicine.

Doctors wearing traditional garb were judged as being most knowledgeable and most honest.

"Traditional attire was associated with perceptions of knowledge, honesty and providing best overall care," the authors wrote.

"Physicians wearing (surgical) scrubs were a second choice among participants and were perceived as being caring and competent to perform a lifesaving procedure."

The study found that even when respondents said they didn't care whether a doctor was wearing a white coat, they actually did.

In a questionnaire most respondents said it didn't matter if the doctor treating their loved one was wearing a white coat. But when respondents were asked to select a preferred doctor from a panel of photographs — the photos were of models posing as doctors — they strongly favoured those wearing white coats.

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The study was done by Dr. Selena Au and Dr. Henry Stelfox, of the University of Calgary's department of critical care medicine and Farah Khandwala, of Alberta Health Services, Calgary zone. (Au and Stelfox also work with Alberta Health Services.) The research was supported by a grant from Alberta Innovates.

They suggested physicians' appearances in ICU settings may be especially crucial, because patients and their families do not have pre-existing relationships with these doctors, and trust needs to be established quickly.

"These results suggest that while families may not express preferences for how physicians dress, there may be subconscious associations with well-recognized physician uniforms including white coats and scrubs," the authors wrote.

"Given the importance of effective communication in the ICU, physicians may want to consider that their attire could influence family rapport, trust, and confidence."

That's important, the authors said, because when patients are sick enough to require ICU care, family members often need to act as surrogate decision-makers, interacting with their loved ones' medical caregivers.

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