Are today’s doctors too scruffy?

Informal dress among doctors “erodes the image of doctors as responsible and competent” and “also intimates a lack of personal hygiene” argues a consultant microbiologist on bmj.com today.

In 2007, the Department of Health said doctors should not wear ties in the interest of hospital hygiene. But Stephanie Dancer, a Consultant Microbiologist at Hairmyres Hospital in NHS Lanarkshire, says this has led to many junior doctors abandoning formal wear and patients complaining that they “do not know who the doctor is.”

“Doctors are members of a distinguished profession and should dress accordingly,” she argues.

There is no evidence that the white coat is a vehicle for the transmission of bacteria to patients, she explains, whereas “hand-touch contact, airborne delivery, environmental reservoirs, and human carriage are all implicated in transmission.”

As such, she believes the focus on white coats “seems disproportionate and perhaps even irrelevant” when considering the more likely modes of transmission. However, the current alternative, doctor’s own choice of clothes, does not aspire to expected levels of smartness and could indicate “a lack of personal hygiene and correspondingly lower standards of hygienic behaviour.”

She also warns that easy access to antibiotics “has eroded the importance of basic hygiene over the past half century” and adds, given that cleanliness is no longer a matter of life or death, “it is no wonder our junior doctors dress the way they do.”

Before the antibiotics run out, Dr Dancer says “we need to revisit the hygiene values of the past and we need to communicate those values to the doctors of the future.”