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Patients' perceptions of doctors' clothing: should we really be ‘bare below the elbow’?

  • L Bond (a1), P J Clamp (a1), K Gray (a1) and V Van Dam (a1)



In September 2007, the Department of Health published Uniforms and Workwear: an Evidence Base for Guiding Local Policy. Following this, most National Health Service trusts imposed a ‘bare below the elbow’ dress code policy, with clinical staff asked to remove ties, wristwatches and hand jewellery and to wear short-sleeved tops. There is currently no evidence linking dress code to the transmission of hospital-acquired infection. We designed the current survey to assess patients' perceptions of doctors' appearance, with specific reference to the ‘bare below the elbow’ policy.

Materials and methods:

A questionnaire showing photographs of a doctor in three different types of attire (‘scrubs’, formal attire and ‘bare below the elbow’) were used to gather responses from 80 in-patients and 80 out-patients in the ENT department. Patients were asked which outfit they felt was the most hygienic, the most professional and the easiest identification of the person as a doctor. They were also asked to indicate their overall preference.

Results and analysis:

Formal attire was considered most professional and the easiest identification that the person was a doctor. Scrubs were considered most hygienic. Respondents' overall preference was divided between scrubs and formal clothes. ‘Bare below the elbow’ attire received the lowest votes in all categories.


This finding raises significant questions about the Department of Health policy in question. The authors suggest that an alternative policy should be considered, with scrubs worn for in-patient situations and formal attire during out-patient encounters.


Corresponding author

Address for correspondence: Dr Laura Bond The Health Centre Station Approach Bradford-on-Avon BA15 1DQ, UK. Fax: +44 (0)1225 868493 E-mail:


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Presented at the 13th British Academic Conference of Otolaryngology and ENT, 8th–10th July 2009, Liverpool, UK and at the South Western Laryngological Association Winter Meeting, 13th November 2009, Bristol, UK.



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