Doctor Dress Codes – Please Off Ties!

In SGH, there is a circular reminding all medical students to be neatly attired at all times. The dress code for male students is shirt, dress pants, shoes and ties at all time.

Link: Doctors should abandon ties and avoid nose rings – Roger Dobson

Wearing ties is about striking a balance between patient confidence and infection control.

1. Patient confidence

Nair BR, Attia JR, Mears SR, Hitchcock KI. Evidence-based physicians’ dressing: a crossover trial. Ned J Aust 2002 Dec 2-17:177(11-12):681-2

The results of the above study indicated that formal trousers and shirt accounted for most of the patients’ confidence. Loss of a tie did have some negative effect in patients’ perception, however.

2. Infection Control

The tie is a fomite – An inanimate object or substance that is capable of transmitting infectious organisms from one individual to another.

Not everyone wears tie pins. The tie ends flopping around tend to touch surfaces the doctor fails to notice and transmits organisms left on these surfaces to other places. Ties are rarely washed, even more so than white coats. Medical staff regularly clean stethoscopes, tendon tappers and pens.

3. Comfort and Convenience

This is Singapore! Male medical students, fairly well-insultated individuals like J. are usually sweltering under dress shirt/pants/labcoat/tie in 32 degrees Celsius, 70-90% humidity. It might not seem like much, but releasing the tie does allow for considerable relief.

Although it’s been second nature for a long period of time, ties are an additional piece of clothing that takes time. It takes time to pick one out, takes time to tie, takes time to wash, and fails to contribute much.

What about bow ties?

Well, one study (BMJ 1993;307-1582-4) suggests that there was no significant difference in contamination rate between bow ties and ties (mentioned in the above link).

J.’s preference:
Ward Work –
Formal shirt, trousers with no ties for Registrars/Consultants.
Scrubs for all medical personnel based only in wards/OT as well as medical students. Think Scrubs (the comedy).

Outpatient/Clinics –
Formal shirts and trousers with no ties for clinics/outpatient work.
Lab coats to be worn by medical students when attending clinics.

It’s a win-win situation, as long as the hospitals don’t think that milking every last drop of patient confidence is worth more than infection control. Who knows? Patient confidence has an impact on litigation and plays a very important, practical part in hospital practices, it’s true.


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