Send to

Choose Destination
See comment in PubMed Commons below
Surgeon. 2014 Feb;12(1):40-6. doi: 10.1016/j.surge.2013.07.002. Epub 2013 Aug 6.

The importance of the orthopaedic doctors' appearance: a cross-regional questionnaire based study.

Author information

  • 1Dept of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK. Electronic address:
  • 2Dept of Orthopaedics, Ninewells Hospital, Dundee DD1 9SY, UK.
  • 3Dept of Orthopaedics, Southern General Hospital, Glasgow G51 4TF, UK.
  • 4Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK.
  • 5Dept of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
  • 6Doune Health Centre, Doune, Perthshire FK16 6DR, UK.



Critics of the Department of Health 'bare below the elbow' guidelines have raised concerns over the impact of these dress regulations on the portrayed image and professionalism of doctors. However, the importance of the doctor's appearance in relation to other professional attributes is largely unknown. The purpose of this study was to determine the opinion of patients on the importance of appearance and the style of clothing worn by doctors.


Patient questionnaire survey, administered across four Scottish regions.


Orthopaedic outpatient departments.


427 patients and accompanying relatives.


The absolute and relative importance of the doctors' appearance, as reported using a 5-point Likert scale. The absolute and relative importance of the style of clothing worn by doctors, as reported using a 5-point Likert scale. The rank preferences for four different styles of doctors' attire as illustrated by standardised clinical photographs.


The study was appropriately powered to identify a 0.5 difference in mean rank values with 0.90 power at a = 0.05. The majority of participants felt the doctors' appearance was important but not as important as compassion, politeness and knowledge. Only 50% felt that the style of doctors clothing mattered; what proved more important was an impression of cleanliness and good personal hygiene. In terms of how patients would prefer doctors to dress in clinic, the most popular choice proved to be the smart casual style of dress, which conforms with the 'bare below the elbows' dress code policy. The smart casual clothing style was the highest ranked choice irrespective of patient age, gender, regional or socioeconomic background.


The doctors' appearance is of importance to patients and their relatives, but they view many other attributes as more important than how we choose to dress. While not specifically addressing the role of doctors clothing in the transmission of infection, our results do support the preference of patients for 'bare below the elbows' workplace attire.


Appearance; Opinion; Orthopaedics; Scotland

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center