Cover the tattoos: In the ICU, doctor appearances matter

Your mother may have been right: Tattoos looks unprofessional in the workplace--or at least, a new study finds, if you're a physician in the intensive care unit.

Physician attire plays a role in quickly building trust between the physician and the patient, according to a study published online Wednesday by JAMA Internal Medicine. Because ICU patients don't normally have a long-term relationship with their physicians, and families are often making decisions on behalf of the patients, they're more likely to scrutinize the physician's appearance, according to the study. The survey was conducted in three ICUs to examine patient family perceptions and preferences for physician attire.

A majority of respondents indicated "it was important for physicians to be neatly groomed, be professionally dressed, and wear visible name tags, but not necessarily a white coat." Respondents related traditional attire with honesty, knowledge and good care, compared with other factors such as age, race, gender, dress, the presence or absence of a name tag, tattoos or visible piercings, and overall first impression.

"I think more than anyone in the hospital, that we are having very intense discussions where we're talking about end-of-life care, where we may be talking about treatment options where decisions have to be made quickly," study author Selena Au of the University of Calgary, which conducted the study, told The Canadian Press.  "And so family members have to make some quick judgments as to whether or not they trust us. ... So things that are part of non-verbal communications come into play quickly."

According to the study, 65 percent of respondents said neat grooming was necessary, 59 percent liked seeing professional dress and a third said it was important that physicians not have tattoos or piercings.

"Maybe I am old-fashioned, [but] I think the dress and appearance of health care providers should demonstrate professionalism and support a serious and sacred pact with our patients," San Francisco Medical Center physician Rebecca Lesto Shunk said in a piece accompanying the report, the Chicago Tribune reported. "We are not their barista."

The ICU differs from more traditional care practices. In 2011, Dr. Dean Morell, director of pediatric and adolescent dermatology at the University of North Carolina, found that only 20 percent of respondents in a survey of 176 new patients and the parents of 248 children thought male physicians should wear a necktie. The white coat still holds importance, though; over half of respondents said they expected their physician to wear one.

To learn more:
- read the JAMA study
- read the article in The Canadian Press
- read the article in The Chicago Tribune

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