TY - JOUR
T1 - Challenging the Status Quo of Physician Attire in the Palliative Care Setting
AU - Azhar, Ahsan
AU - Tanco, Kimberson
AU - Haider, Ali
AU - Park, Minjeong
AU - Liu, Diane
AU - Williams, Janet L.
AU - Bruera, Eduardo
N1 - Funding Information:
The authors acknowledge the nursing and research staff at the outpatient supportive care center, as well as our patients and their families for participation in this study. The authors also acknowledge the Research Medical Library (Rachel S. Hicklen) at The University of Texas MD Anderson Cancer Center for assistance with the literature search; Dr. Jessica H. Brown, Ph.D., technical writer, and Dr. Aimee E. Anderson, Ph.D., senior research scientist, in the department of Palliative, Rehabilitation, and Integrative Medicine for editorial assistance (no outside funding was utilized and they did not receive any financial compensation for the contribution); The University of Texas TV team for assistance with selection of professional actors and making the videos; and Elida Galan, Sr., administrative assistant in the department of Palliative, Rehabilitation, and Integrative Medicine for assistance with formatting the figures and tables. The study was funded by internal departmental funds. Partial support was provided by Minjeong Park and Diane Liu, Biostatistics Shared Resources at MD Anderson, National Institutes of Health grant CA16672. This study was presented in part at the American Society of Clinical Oncology Palliative and Supportive Care in Oncology Symposium (PallOnc18), San Diego, CA, November 16–17, 2018, and in part at the annual American Academy of Hospice and Palliative Medicine meeting in Orlando, FL, March 13–16, 2019.
Publisher Copyright:
© AlphaMed Press 2020
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background, Aim, and Hypothesis: This randomized controlled trial aimed to compare the impact of a physician's attire on the perceptions of patients with cancer of compassion, professionalism, and physician preference. Our hypothesis was that patients would perceive the physician with formal attire as more compassionate than the physician wearing casual attire. Materials and Methods: One hundred five adult follow-up patients with advanced cancer were randomized to watch two standardized, 3-minute video vignettes with the same script, depicting a routine physician-patient clinic encounter. Videos included a physician in formal attire with tie and buttoned-up white coat and casual attire without a tie or white coat. Actors, patients, and investigators were all blinded to the purpose and videos watched, respectively. After each video, patients completed validated questionnaires rating their perception of physician compassion, professionalism, and their overall preference for the physician. Results: There were no significant differences between formal and casual attire for compassion (median [interquartile range], 25 [10–31] vs. 20 [8–27]; p =.31) and professionalism (17 [13–21] vs. 18 [14–22]; p =.42). Thirty percent of patients preferred formal attire, 31% preferred casual attire, and 38% had no preference. Subgroup analysis did not show statistically significant differences among different cohorts of age, sex, marital status, and education level. Conclusion: Doctors’ attire did not affect the perceptions of patients with cancer of physician's level of compassion and professionalism, nor did it influence the patients’ preference for their doctor or their trust and confidence in the doctor's ability to provide care. There is a need for more studies in this area of communications skills. Clinical trial identification number. NCT03168763. Implications for Practice: The significance of physician attire as a means of nonverbal communication has not been well characterized. It is an important element to consider, as patient preferences vary geographically, are influenced by cultural beliefs, and may vary based on particular care settings. Previous studies consisted of nonblinded surveys and found increasing confidence in physicians wearing a professional white coat. Unfortunately, there are no randomized controlled trials, to the authors’ knowledge, to confirm the survey findings. In this randomized, blinded clinical trial the researchers found that physician's attire did not affect patients’ perception of the physician's level of compassion and professionalism. Attire also did not influence the patients’ preferences for their doctor or their trust and confidence in the doctor's ability to provide care.
AB - Background, Aim, and Hypothesis: This randomized controlled trial aimed to compare the impact of a physician's attire on the perceptions of patients with cancer of compassion, professionalism, and physician preference. Our hypothesis was that patients would perceive the physician with formal attire as more compassionate than the physician wearing casual attire. Materials and Methods: One hundred five adult follow-up patients with advanced cancer were randomized to watch two standardized, 3-minute video vignettes with the same script, depicting a routine physician-patient clinic encounter. Videos included a physician in formal attire with tie and buttoned-up white coat and casual attire without a tie or white coat. Actors, patients, and investigators were all blinded to the purpose and videos watched, respectively. After each video, patients completed validated questionnaires rating their perception of physician compassion, professionalism, and their overall preference for the physician. Results: There were no significant differences between formal and casual attire for compassion (median [interquartile range], 25 [10–31] vs. 20 [8–27]; p =.31) and professionalism (17 [13–21] vs. 18 [14–22]; p =.42). Thirty percent of patients preferred formal attire, 31% preferred casual attire, and 38% had no preference. Subgroup analysis did not show statistically significant differences among different cohorts of age, sex, marital status, and education level. Conclusion: Doctors’ attire did not affect the perceptions of patients with cancer of physician's level of compassion and professionalism, nor did it influence the patients’ preference for their doctor or their trust and confidence in the doctor's ability to provide care. There is a need for more studies in this area of communications skills. Clinical trial identification number. NCT03168763. Implications for Practice: The significance of physician attire as a means of nonverbal communication has not been well characterized. It is an important element to consider, as patient preferences vary geographically, are influenced by cultural beliefs, and may vary based on particular care settings. Previous studies consisted of nonblinded surveys and found increasing confidence in physicians wearing a professional white coat. Unfortunately, there are no randomized controlled trials, to the authors’ knowledge, to confirm the survey findings. In this randomized, blinded clinical trial the researchers found that physician's attire did not affect patients’ perception of the physician's level of compassion and professionalism. Attire also did not influence the patients’ preferences for their doctor or their trust and confidence in the doctor's ability to provide care.
KW - Attire
KW - Compassion
KW - Dress code
KW - Palliative care
KW - Professionalism
KW - Video vignette
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UR - http://www.scopus.com/inward/citedby.url?scp=85079825544&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2019-0568
DO - 10.1634/theoncologist.2019-0568
M3 - Article
C2 - 32073181
AN - SCOPUS:85079825544
SN - 1083-7159
VL - 25
SP - 627
EP - 637
JO - Oncologist
JF - Oncologist
IS - 7
ER -