White coats are considered such an integral part of a doctor’s identity that many medical schools have formal ceremonies where medical students formally don their white coats for the first time. — Filepic
A doctor’s white coat is still a symbol of trust and professionalism for patients, a study by South Korean and Chinese researchers found.
However, the review of the available research on this topic also found that female doctors in this attire were often misidentified as nurses or medical assistants.
In addition, patient preferences for doctors’ attire seem to be strongly influenced by clinical context and medical speciality.
In the 19th century, doctors primarily wore black, because medical encounters were viewed as serious and formal occasions.
But with the growing emphasis on hygiene and scientific advancements in medicine, white coats came to represent cleanliness and professionalism, and became standard attire for doctors worldwide in the 20th century, note the researchers.
Their review, which was published online Aug 12 (2025) in the open access journal BMJ Open, involved 32 studies from 13 countries, including one from Malaysia.
The included studies indicated a distinct preference among patients for male doctors to wear suits.
One study indicated that accessories, such as watches and glasses worn by male doctors, significantly enhanced perceived professionalism and trustworthiness.
This aligns with the findings of previously-published studies, note the researchers.
However, national policy can limit these sartorial options.
Britain, for example, has implemented a “bare below the elbows” policy, which bans doctors from wearing white coats, watches, ties and long sleeves, to minimise infection risks.
The clinical setting also had some bearing on patient preferences.
For example, palliative care doctors’ attire didn’t affect patients’ trust or assessments of the practitioner’s capabilities, but patients preferred emergency care doctors to wear white coats or scrubs.
And they were happy for primary care doctors, i.e. general practitioners (GPs), to be dressed casually and to wear white coats.
Speciality also seemed to influence perceptions, with patient preferences for doctors to wear white coats observed in orthopaedics, surgery, dermatology, ophthalmology, and obstetrics and gynaecology, for example.
Gender was another factor in patient perception.
Even when male and female doctors wore identical attire, female doctors were still more likely to be misidentified as nurses or medical assistants – a misidentification that was consistently observed across different cultural settings.
But patients preferred white coats over business or casual attire for both male and female doctors, perceiving practitioners in these coats to be trustworthy, respectful, skilled, communicative and empathetic.
Interestingly, male surgeons wearing a white coat over scrubs were looked on less favourably than those wearing a suit with a white coat, scrubs or just a suit.
But female surgeons in white coats over scrubs were preferred over those in suits or casual attire.
“This preference aligns with recent evidence indicating that female physicians are often judged more on appearance than their male counterparts.
“The way female physicians dress significantly influences perceptions of competence and professionalism, highlighting the gendered expectations that patients hold,” write the researchers.
“These gender-specific preferences for surgical attire were each supported by a single study and warrant further validation...
“Nonetheless, gender-related perceptions of physician attire were consistently reported across studies with a low risk of bias, supporting the robustness of this theme,” they add.
A few studies explored doctors’ attire during the Covid-19 pandemic, when numerous doctors reported a preference for wearing scrubs to prioritise hygiene and ease of movement.
These studies consistently reported a shift in patient preference towards practical and hygienic attire, such as scrubs and face masks, reflecting heightened sensitivity to infection control, say the researchers.
“While the traditional white coat is seen as a symbol of professionalism and trust, patients have increasingly accepted scrubs, especially in emergency or high-risk settings,” they write.
“The expectations regarding attire are often gendered, particularly affecting the recognition and respect given to female physicians, which highlights the importance of institutional initiatives aimed at reducing bias and fostering equitable perceptions among patients,” they add.
Medical institutions should consider adopting flexible dress codes that align with patient preferences for different clinical environments and medical specialities, they suggest.
