Would you care if your doctor had a ‘Mad Max’ tattoo?

Tattoos are a growing fashion item. Even the usually concealed ones are more visible now in the hot weather. Rugby and soccer players have embraced the trend. GAA players less so.

But how would you feel if a doctor rolled up to your hospital bed with a full-length sleeve tattoo? Or one of those that encircles the neck and stretches up to the mandible? Would you consider her or him to be unprofessional by virtue of having a tattoo or multiple piercings?

Previous research on patient attitudes towards doctors’ appearance has indicated a preference for traditional attire, however, many of these studies have been based primarily on photos and written descriptions and few have involved actual clinical practice.

A 2002 Australian study of 12 male general physicians and 1,680 patients in a teaching hospital took place over a seven-month period. The 12 doctors sequentially removed, changed or added one piece of clothing during this time.

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Firstly, they shed their white coat, then took off their ties, before changing from formal trousers to jeans. The next sequence involved wearing Hawaiian shirts, followed by highlighting their hair before finally donning a nose ring.

Formal attire promoted the greatest patient confidence and trust. The item that triggered the most dramatic loss of confidence was the nose ring, while wearing a formal shirt and trousers was the minimum required to inspire a reasonable amount of confidence by patients in their physicians.

In a 2005 paper titled Judging a book by its cover: descriptive survey of patients preference for doctors' appearance, some 450 patients in New Zealand were asked for their opinion of photographs showing doctors wearing different dress styles.

They said they were more comfortable with conservative items of clothing, such as long sleeves, covered shoes and formal trousers and skirts than with items such as facial piercing and earrings in men.

Interestingly, jeans were acceptable to most patients, but the highest satisfaction score was for doctors who dressed in semi-formal attire – and who also smiled.

However, the latest research into doctors' appearance found the presence of visible body art seems to have no discernible impact on what they think of their doctor's professionalism or competence. US researchers quizzed nearly 1,000 emergency-care adult patients in an urban trauma centre in Pennsylvania about their doctors' appearance after they had had a consultation.

Body piercings

The seven doctors taking part in the nine-month study variously wore fake body piercings or tattoos, or both, or no body art, in addition to their usual hospital scrubs.

Their patients were specifically asked what they thought of their physician’s competence, professionalism, caring attitude, approachability, trustworthiness and reliability. The patients were told the survey aimed to find out how the centre could better provide courteous and competent medical care, with the aim of improving their experience, rather than what they thought of doctors with visible tattoos and piercings.

Interestingly patients rated all the studied qualities highly more than 75 percent of the time, irrespective of whether or not they were treated by a doctor wearing visible body art.

“Given the (growing prevalence of tattoos among younger adults), those who enter the medical field today are more likely to have body art than medical professionals did previously,” say the researchers. “Despite this, dress codes and institutional policies at most hospitals still prohibit medical professionals from having visible body art.”

Concerns that body art might undermine perceived professionalism or patient satisfaction with care would seem to be groundless, they conclude.

An important caveat surely is that emergency care patients are not typical. Many attending EDs have more severe symptoms which may lower their threshold for how a treating doctor offering relief appears.

I’d like to ask readers how they feel about the issue.

How do you like your doctor to dress?

Would you consider a tattoo an indicator of poor professionalism?

Let me know your thoughts at mhouston@irishtimes.com