Does the white clinical coat matter to patients?

When it comes to the white clinical coat and doctors of optometry, clearly one size doesn't fit all.

The attire debate—white coat or no white coat—was revived recently when:

• The American College of Surgeons issued a detailed statement on Aug. 4 urging surgeons to wear appropriate professional attire for in and out of the operating room.
• A University of Miami Miller School of Medicine study, "Patient Preference in Dermatologist Attire in the Medical, Surgical, and Wound Care Settings," in the August 2016 journal JAMA Dermatology, found 73% of patients surveyed preferred their dermatologists wear white coats. The study linked doctors' appearance to patients' perception of their expertise to potential outcomes.

Below is a sampling of opinions among AOA members. Some members leaned toward wearing the lab coat—a symbol of learnedness and cleanliness. Others prefer a more relaxed fit.

From lab coats to Hawaiian shirts

"Perhaps I'm old school, but I still wear a shirt and tie along with a clinic coat," says Geoffrey Goodfellow, O.D., professor of pediatrics/binocular vision at the Illinois Eye Institute/Illinois College of Optometry in Chicago.

"I just feel more professional that way," adds Dr. Goodfellow, noting he doesn't have strong feelings on attire but isn't a fan of scrubs.

"Perhaps it is my short stature and youthful look, but I also perceive patients are more respectful in the exam room when I'm dressed up. I also think working at an educational institution is probably not your typical practice."

Long white coats were preferred by some.

Weslie Hamada, O.D., associate director of professional affairs North America for Johnson & Johnson Vision Care Inc., favors professional attire and closed-toe shoes for the sake of safety. "Wearing a white coat helps with gaining respect from patients and also protecting yourself from spills and messes. I am still in the camp of dress for success."

Douglas Melzer, O.D., who practices in Portland, Oregon, says a number of factors might go into doctors' choice of attire: their personalities, work environments and even community mores, Dr. Melzer says. Typically, he wears slacks and a knit or Hawaiian shirt in the office.

He could see the coats being helpful in a multidisciplinary practice, so patients could distinguish doctors from staff. In the end though, Dr. Melzer says, doctors have to make that decision for themselves. Dr. Melzer is in the "keep it professional but approachable" camp.

Dressing for comfort

At the office of Nathan Otte, O.D., in Seymour, Indiana, you won't find a lab coat.

"A sterile white coat or suit would feel out of place for the culture of my office," Dr. Otte says. "Most days we are business casual, but some days we will wear the office T-shirt and jeans, which is typically a day when I get the most compliments from patients.

"For me, business casual is a button-down shirt and khakis," Dr. Otte adds.

He designed the "office T-shirt"—popular with parents and children alike in his office—for the grand opening of his practice in 2013. The orange shirt has the name of his practice and its location on the front. On the back are the words, "I (image of a pair of glasses) Dr. Nate."

Dr. Otte believes his professional but relaxed appearance has a positive impact on his patients.

"By dressing slightly more casual, I find patients become more comfortable during the exam and are more likely to provide an honest, open history," he says. "Regardless of what I am wearing for the day, it is important that the presentation of myself and the office be clean and well-kept."

Coattails

Kelly Voltz, class of 2017, attends the State University of New York College of Optometry. Clinical attire is dictated by clinic administration and regulated by the department of health, Voltz says. While a coat is required for working in the University Eye Center, she says, it is not required for pediatric exams so young patients feel more comfortable.

Says Voltz, who is undecided about what she will wear when she graduates: "It really depends on your mode of practice and what you feel comfortable in, in addition to what best fits the community and your patient population."

Peter Jacques, an optometry student at the University of Missouri-St. Louis (UMSL), who expects to graduate in 2019, is undecided, too. But he's looking forward to it.

"There is a clinical proficiency exam at the end of second year at most schools," he says. "At UMSL, the white coat is awarded for passing this proficiency exam and then is to be worn when seeing patients, which starts the summer after second year.

"I have not decided, but in general, optometrists I have worked for and with, do not wear the white coat," he adds. "I will likely wear nice slacks, dress shoes, a button-down shirt and tie. This could be worn with or without a white coat."