Practice Management Alert

Check in on your formal rules about practice-appropriate clothing.

What your staff wears makes a huge impression on patients, especially new patients. With medicine becoming more and more of an opportunity for customer service — and not just medical treatment — clinicians and other medical professionals should take extra care in how they appear, because clients are certainly noticing.

Whatever you and staff choose to wear, the clothing must function both as workwear that protects you and patients from unnecessary exposure to pathogens and as a signal or emblem of your competency.

“Your choice of professional attire must set the precedent for a successful patient relationship, but must also maintain a high level of protection for yourself and others from potential infectious agents,” says Danielle Kalberer, optometrist and blogger at Covalent Careers in Long Island, New York.

Providers Should Beware of Long Sleeves

Whatever you deem appropriate workwear for your practice, consider the functionality of the clothing. One huge difference between scrubs and “regular” business attire — or a white coat — is the sleeve length. Results from a 2010 study, “The potential for nosocomial infection transmission by white coats used by physicians in Nigeria: implications for improved patient-safety initiatives,” suggest that white coat sleeves harbor a not insignificant amount of antibiotic-resistant bacteria, and can actually cause patients to get sick.

White coats, of course, are intended to be a sort of protective barrier for a clinician’s regular clothing, as well as the mark of a physician. If your practice’s clinicians prefer to wear white coats when seeing patients, make a point to figure out a laundering schedule where each white coat is washed at least once a week.

“In a private office setting, formal business attire with or without a white lab coat is the mainstay. Since there is limited necessity for disease control in a private office, a white lab coat can be worn multiple times as long as it is not visibly soiled and is laundered appropriately,” Kalberer says.

If your practice’s clinicians prefer more businesslike attire, the same circumstances may apply. A suit sleeve can be a point of exposure as much as a white coat sleeve, so regular dry cleaning should be a priority, even if your practice’s clinicians aren’t necessarily physically confronting much disease.

Jewelry like watches, bracelets, or even rings can prohibit effective handwashing in some scenarios, as well as present as a reservoir for bacteria or other pathogens, Kalberer says. Think carefully about whether your practice should establish rules about providers wearing clothing or jewelry below their elbows.

Scrubs Make Sense

The combination of comfort, ease of laundering, and a signifier of medical knowledge makes scrubs ideal for many medical workplaces, especially in institutions like hospitals that feature many different roles.

“Depending on the type of work you are doing, scrubs also allow for added comfort and increased range of motion. These may be added benefits in an occupation like physical therapy where range of motion is important to patient care,” Kalberer says.

Most scrubs also have short sleeves, increasing the ease of hand washing and reducing pathogen exposure, though many people wear long-sleeved shirts underneath for added warmth.

One thing to keep in mind? A lack of differentiation between the attire of different healthcare providers can be confusing.

“Identification of healthcare team members is challenging because multiple healthcare team members often wear similar scrub attire. This causes confusion not only for patients and their family members but for healthcare team members too. Patients, families, physicians, and other healthcare team members need to be able to identify who is providing care to the patient,” say Jennifer Sulanke, RN, nurse clinician, and Kevin Shimp, RN, nurse manager, at Virginia Commonwealth University Health System in Richmond, Virginia, in a 2015 article in the journal American Nurse Today.

Plus, patients in a private practice setting may expect or prefer providers to wear slightly more formal attire — either business attire or a white coat. But scrubs could make sense for other practice staff, especially nurses, as they help patients designate medical personnel from other administrative or support staff who also work at a medical practice. Practices that see lots of children can benefit especially from a dress code centered around scrubs, especially when staff members have license to choose fun, kid-friendly prints.

Move Slowly When Updating Rules on Attire

Depending on the size of your practice, making a big change in your rules about attire could mean ruffling feathers. Sulanke and Shimp, who helped change their hospital’s nursing dress code, say that focusing on and communicating evidence-based reasoning, keeping staff informed and involved in the decision-making surrounding the change, and providing a one-time stipend for new scrubs were all important factors in a successful change to nursing dress code rules.

Note: As long as footwear is safe (closed-toed and closed-backed, nonslip soles, clean, fluid-resistant), it remains a great way for a provider to display individuality.