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Do patients care what you look like?


Do you have a visible piercing or tattoo? If you do, you probably remove or cover it up before turning up to work, either because of the hospital or practice dress code, or because you fear your patients might disapprove. But perhaps you don’t need to cover up after all. According to a new study from the US, patients don’t really care if you have visible body art, and don’t consider you any less competent if you’re inked or pierced.

The innovative, nine-month study involved nearly 1000 patients who were interviewed after presenting at an emergency department. The seven participating doctors alternated from day to day between wearing fake piercings and tattoos with their scrubs, or wearing no body art. After treatment, patients were asked to rate the doctors from 1 to 5 on their competence, professionalism, approachability, trustworthiness and reliability. Patients were simply told the survey was aimed at improving care at the hospital, and weren’t specifically asked about tattoos and piercings.

Whether or not doctors had piercings or tattoos did not seem to have any bearing on how patients scored them for any category. Doctors were scored highly around 75% of the time, regardless of the presence or absence of body art.

The finding runs contrary to a slew of studies which have suggested that, yes, patients are concerned about your appearance and that it may affect the way they judge your competence. For example, another recent US study, the largest of its kind, involved over 4000 patients who were given photos of doctors dressed in a variety of ways. Doctors wearing a traditional white coat were rated more highly in terms of knowledgeability, trustworthiness, approachability and several other metrics compared with those dressed in different attire.

“Nuanced policies addressing physician dress code to improve patient satisfaction appear important,” the authors of that study concluded.

But the authors of the tattoo/piercing research say the white coat study and others similar to it are flawed, for several reasons. To begin with, the study was based on showing pictures of doctors to patients, rather than interacting with actual doctors in a genuine clinical situation. And secondly, it was not blinded to the participants. In other words, patients involved in the white coat study knew what they were being asked to evaluate, while in the tattoo/piercing study, participants were unaware that their attitudes to body art was what was being assessed.

That’s not to say patients don’t show prejudice based on a doctor’s appearance or on their non-medical qualities. There is plenty of research to show that patients can be less accommodating with doctors whose race or ethnicity is not their own, or with female doctors.

In a recent survey of 1,200 doctors, female physicians were far more likely to say they had experienced bias due to their gender (41%), compared with male physicians (6%). Female doctors were also more likely to hear comments about their age (36% vs 23% of men) and weight (15% vs 9% of men).

Around 70% of black and Asian doctors in this US-based survey had heard biased remarks about their race or ethnicity from their patients.

Close to a third of patients surveyed said they would be inclined to avoid a healthcare professional based on personal characteristics, such as gender, sexual orientation, ethnicity, religion or political views.

You can access the studies cited in this article here, here and here.