Practice Gaps—Patient Preference vs Personal Preference, and What Should I Wear Today? | Health Care Quality | JAMA Dermatology | JAMA Network
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Research Letter
April 2011

Practice Gaps—Patient Preference vs Personal Preference, and What Should I Wear Today?

Author Affiliations

Author Affiliations: Department of Dermatology, University of Michigan Medical School, and Dermatology Service, Veterans Affairs Medical Center, Ann Arbor, Michigan.

Arch Dermatol. 2011;147(4):506-507. doi:10.1001/archdermatol.2011.71

When I coach departments and physician practices on improving patient satisfaction, my goal is to exceed patients' expectations—to provide what patients do not even realize they expect. Expressing concern about the patient and showing a genuine interest go a long way to creating high patient satisfaction. While the physician's diagnostic and treatment skills may be superb, patients often have difficulty assessing medical ability, and sometimes clinical outcomes are delayed, possibly for years. Thus, the patient's full experience during the physician visit is important to informing his or her assessment of having received high-quality medical care.

The survey results reported by Thomas et al help to identify a practice gap of not knowing the true impact of physician attire in maximizing patient satisfaction. Physicians and patients have biases about appropriate physician attire, and the white coat has a long and storied connection with medical practitioners. (It also, fortunately, covers many sartorial blunders.) For patients, the white coat exerts a positive placebo effect in some cases and an anxiety-provoking effect in others. The white coat still says “physician.” Many medical schools have a ceremony during which the dean helps students put on their first white coat. We are affected by training, tradition, institutional expectations, and by media portrayals of physicians. It is my impression that physicians portrayed in commercials are more likely to wear white coats and ties (for men) than physicians in television shows. Is there a message here?