Clinical Question: Are patients influenced by what physicians wear? Does wearing a white coat instead of surgical scrubs enhance patient trust in their physician and the care they are providing?
Background: White coats have come to define physicians, personifying cleanliness, authority, and competence. However, fashion trends in medicine have changed since the COVID-19 pandemic, with more physicians wearing scrubs, jackets, and fleeces on inpatient medicine services. A systematic review of 30 studies found that 60% of image-based studies favored white coats and formal attire, yet in studies where patients were surveyed following an actual clinical encounter, only 25% preferred formal attire with white coats. This study sought to determine if acutely ill patients admitted to an inpatient medicine service favor their doctor wearing a white coat during an extended inpatient stay.
Study Design: Prospective quasi-experimental study in which five hospitalists alternated weekly between scrubs and formal attire, with each serving as their own control.
Synopsis: This study of 220 adult patients given the modified Trust in Physician Scale (TIPS) survey showed no difference in patient trust, whether the physician wore a white coat with formal attire (mean TIPS score, 2.00; 95% CI, 1.90 to 2.09) or surgical scrubs without a white coat (mean TIPS score, 2.08; 95% CI, 1.95 to 2.21; P=0.26). Participating physicians wore either traditional attire or surgical scrubs in alternating weekly rotations. Patients had a mean length of stay of three days (range, 1 to 11) and spoke English or Spanish. Notably, despite patients’ stated preferences for either type, there was no correlation between these stated preferences and their actual trust in their physicians. The single-center sampling in one academic medical center limits generalizability to other geographic areas and clinical settings.
Bottom Line: This study suggests that trust in hospitalized medicine patients is not influenced by whether their physicians wear white coats or surgical scrubs. Clinical competence, communication, and interpersonal warmth matter more than physician attire.
Citation: Tudtud-Hans L, et al. Does what doctors wear really matter? The DRESS prospective study on patient trust. Am J Med. 2026;139(7):922-930.e4. https://doi.org/10.1016/j.amjmed.2026.02.019.
Dr. Cary
Dr. Cary is an academic hospitalist at Erlanger Hospital and program director of the internal medicine residency program and associate professor of medicine and pediatrics at University of Tennessee Health Science Center College of Medicine, both in Chattanooga, Tenn.