What not to wear, dermatology edition


Paging Stacy London and Clinton Kelly: Apparently dermatologists need some help in deciding what to wear when they see patients.

The biggest controversy appears to involve whether skin specialists should wear their iconic white coats into the exam room or leave them in their offices. A survey reported this week in Archives of Dermatology found that 54% of adult patients want their dermatologist to wear the coats; however, only 26% of parents who brought their children to a pediatric dermatologist think the white coat is helpful in that setting.

“For patients, the white coat exerts a positive placebo effect in some cases and an anxiety-provoking effect in others,” Dr. Charles Ellis, a dermatologist at the University of Michigan Medical School, notes in a short commentary that accompanies the survey.


The survey administrators, from the University of North Carolina at Chapel Hill, note that children in particular “may feel intimidated by a white coat,’ which is why many pediatricians choose not to wear them.

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The need for neckties was also a matter of contention, though less so. Only 18% of adult patients wanted their male dermatologist to wear a tie, along with 15% of parents who brought their child to a male pediatric dermatologist.

Overall, the survey responses gleaned from 424 volunteers conveyed that “women found the appearance of the physician to be more important than men did,” the researchers said. They also noted that “a well-groomed appearance does register with patients and parents.”

That may seem obvious, but Ellis pointed out that at the University of Michigan, “many of our dermatologists in training would wear pajamalike surgical scrubs every day if we allowed it.”

Perhaps those derm residents are on to something. Fresh sets of scrubs are always available at hospitals, but the same cannot be said of white coats and ties. In fact, studies have turned up methicillin-resistant Staphylococcus aureus -- better known as MRSA -- and other bacteria on doctors’ ties. White coats also harbor nasty pathogens. Ellis advises dermatologists to launder their coats at least once every three days.


You can read about the survey here, and read Ellis’ comments here.

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