One of the main reasons for studying healthcare providers’ attire is the importance of patients to be able to identify those providers.11-13 Several studies have found that patients care about their physicians’ attire,12, 14, 15 whereas other studies showed that patients were satisfied with their doctors regardless of what they wore.16 However, it was argued that patient perceptions of their physicians’ attire are influenced by various sociodemographic factors.5 In this study, the respondent’s gender, nationality, occupation, level of education, and military rank were the factors found to affect such perceptions.
Generally, numerous studies have found that patients prefer their doctors to be dressed formally, including a white coat.10, 11, 13, 15, 17-20 However, in some studies performed in the settings of orthopedics as well as obstetrics and gynecology, participants preferred their doctors to be wearing scrubs.14, 21 Nevertheless, most evidence supports that dress preferences have a limited impact on patients’ satisfaction,22 as well as the confidence in physicians’ ability and the level of their medical knowledge and expertise.8, 9, 11, 14 On the other hand, some studies found that patients’ comfort and confidence are influenced by their doctors’ attire.10, 17, 19, 23
There has been little research evaluating the effect of civilian versus military attire on patients’ perceptions of their healthcare providers. McClean et al24 tested whether military uniforms might affect patients’ perceptions towards their treating doctors and found that the clinicians’ attire does not adversely influence these perceptions. In another study that was carried out in an obstetrics and gynecology clinic at the Naval Medical Center Portsmouth, Niederhauser et al7 found that female patients generally do not have a preference for specific physician attire. However, they argued that a physician’s ability to optimally manage and treat an active-duty patient would be significantly affected since military uniform may negatively impact the patient’s ability to communicate his or her personal medical information freely with their healthcare provider.7 They explained that such a barrier may be formed due to differences in military rank between the physician and the patient, which makes patients less comfortable with discussing personal information with their doctors.7
Overall, male participants, military personnel, Kuwaiti nationals, non-commissioned officers, and individuals with lower educational qualifications preferred doctors in civilian attire. In this study, the respondents were 69% male, 72% Kuwaiti, 38% high-school educated or below, and 61% non-commissioned officers. Since the Kuwaiti military service members are exclusively male, our results may indicate a barrier in the doctor-patient relationship that is formed due to the military hierarchy. Another piece of information that supports this finding is that most treating doctors in the healthcare facilities examined are officers.
There has been limited research evaluating professional attire preferences in the Middle East and North-Africa region. In a study performed in the Kingdom of Saudi Arabia, patients expressed a preference for doctors to be dressed formally, including a tie, shirt, trousers, and white coat for males and long skirts for females.8 Al-Ghobain et al8 explained that such formal attire was an indication of physicians’ medical professionalism and respect toward their patients.
The issue of health service providers’ attire is context-specific. Despite the numerous pieces of evidence that support the preference of formal attire in an OPD setting,8 there have been some contradicting observations in an acute-care setting, where there was less preference for traditional attire.25 Some evidence suggests that professionals gave more importance to attire than patients.11, 26
Some researchers have shown that irrespective of how a doctor is dressed, professionalism, neat grooming, and a clear name tag are found to be important.12, 25, 27 There is evidence suggesting that a friendly manner, like having a smiling face, might be more important than what a provider is wearing.28 Brandt12 explains, “There is no substitute for a gentle, concerned physician with an engaging, friendly, empathic demeanor.”
Limitations. This study had several limitations. Similar to previous studies,27 this study evaluated a small section of a much larger spectrum of personal attire and grooming choices. Additionally, since attire preferences are context-related and culture sensitive, the findings of this study cannot be generalized to other healthcare settings. This study only looked at patient attitudes regarding the attire of doctors working in the OPD. Moreover, since this study was performed in a military healthcare setting, the attitudes of respondents may differ from the attitudes in civilian settings, as noted in previous studies.9