While physician dress codes have evolved over time—ranging from white coats, to scrubs, to professional attire—female physicians often face misconceptions about their roles and skills regardless of what they wear, Trisha Pasricha, a gastroenterology research fellow at Massachusetts General Hospital, writes for The Atlantic.

What patients want doctors to wear

There has been a decent amount of research conducted into what patients would prefer their physicians to wear. For instance, one study published in BMJ Open surveyed over 4,000 patients and found that just over half preferred both male and female physicians to wear formal attire with a white coat. The second-highest rated option was scrubs with a white coat, followed by formal attire without a white coat.

In addition, the researchers found that patients' clothing preferences varied by care setting. According to the study, 62% of patients said they either agreed or strongly agreed that doctors seeing patients in a hospital should wear a white coat, and 55% said doctors in an office setting should wear a white coat. However, fewer patients, 44%, said emergency physicians should wear a white coat.

Similarly, a review of more than 30 studies examining how patients viewed physicians' attire found that patients had a strong general opinion about what physicians wore and strongly preferred doctors dress in formal clothing and wear a white coat.

The researchers also found that patients' preferences were influenced by care settings. For example, patients preferred their physicians to wear scrubs in the more "hands-on" settings of the ICU, ED, and OR, but viewed physicians wearing scrubs unfavorably in doctors' offices or outpatient settings.

Female physicians face more rigid expectations than their male counterparts

However, regardless of the myriad ways physicians may present themselves, female physicians are often held to different standards than their male counterparts when it comes to their work attire, writes Pasricha. Male physicians generally command respect no matter what they're wearing, but a majority of patients still believe it's inappropriate when female physicians don't wear a white coat, she says. Even when female physicians are in professional attire, they can still face inappropriate comments that make them second-guess what they're wearing.

And while some hospitals opted to replace white coats with unisex scrubs to "level the playing field," patients often view female physicians differently when they're wearing scrubs than when male physicians do. For example, Pasricha writes that when she wore scrubs, a patient believed she was "a nurse, or a medical technician, or a physician assistant—anything but a doctor, especially his doctor"—even though she had expressly introduced herself as a doctor and explained a highly specialized procedure to him.

Unfortunately, Pasricha writes, this is not an uncommon experience for many female doctors. According to a study published in JAMA Network Open, patients were 20% less likely to assume a woman in scrubs was a surgeon compared with a man. The study also found that patients believed a woman wearing scrubs was "less professional" than a man wearing the same attire.

Female physicians also face similar sexist experiences regarding their attire from their own colleagues, Pasricha writes. In July 2020, an article titled "Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons" was posted in a medical journal. In it, the authors accused off-duty female surgeons of "provocative posing in bikinis/swimwear" after finding vacation photos on their social media accounts. After significant backlash, the article was quickly retracted.

According to Pasricha, "The time and energy [women] expend dealing with role misidentification ... is an insidious diversion that keeps [them] from focusing on [their] merits and career advancement."

To help combat these experiences, Pasricha encourages female physicians to speak out against "biases that continue to limit [them]" instead of worrying about how to measure up to their male colleagues.

She also calls on patients to change their behavior towards female physicians. Specifically, patients should listen when female physicians explain their roles, not interrupt them when they're speaking, and avoid assuming a male member of the care team is the doctor. "And above all," Pasricha writes, don't comment on what female physicians are wearing.

"Female physicians want to be judged by the treatment [they] give you—and nothing else," Pasricha writes. "It's about time we all recognized that male and female physicians are cut from the same cloth." (Pasricha, The Atlantic, 10/16)