Latham at Large
Starting the new year
with new garments
Forum
Patients prefer doctors to wear smart but casual clothing, so
John Latham is determined to start the new year in new gear
“Clothes make the man. Naked people have little or no
influence on society.” So said that very quotable American Mark Twain. I am not sure that I fully agree, but have
very recently begun to think more carefully about my own
attire.
I have written previously about my dilemma as a trainee
in the NHS in Scotland; a patient presented me with a £10
note with the instruction to ‘buy a new shirt’. This dilemma
was resolved when my trainer, Gilbert Kennedy, absolved
me of all guilt and encouraged me to accept the gift graciously. I cannot remember now what my new Scottish shirt
was like, but it was certainly an improvement on my usual
threadbare garments.
What the patient (a retired miner) was telling me was that he appreciated the care I had
given him but that my appearance and clothing
left a great deal to be desired... in other words,
that he thought I was a smart doctor but not a
‘smart’ one.
To my amazement, 26 years later I received
another gift from a patient, this time it was actually a shirt... a very nice one from Marks and
Spencers. I suppose it is time that I took the
hint! And it is true that I am probably not the
best-dressed GP in Ireland. Rarely do I choose a
shirt carefully and perhaps they are not always
so well ironed, having been bundled up in the
rucksack as I cycle to work.
Various mini-surveys have been done in hospitals and in general practice to ascertain the
views of patients regarding the dress and appearance of
their medical attendants. I think I am correct in saying that
the usual findings are that patients prefer doctors to wear
smart, casual clothing and (if they are men) not to have
beards.
On several occasions recently, I have had to wear a suit
because of a later engagement. Each time, my day in the
practice was punctuated by recurrent cries of “you look very
well doctor” or “you are very smart today”. These comments
are made by people of all ages and both sexes and include
staff and other members of the primary care team... I rarely
wear a suit or decent jacket. Does this mean that I don’t
care what people think in an arrogant and uncaring way? Or
am I just a slovenly person who is too lazy to dress well?
Perhaps there is an old remnant in my psyche of previous
left-wing idealism which equated good suits with undesirable statements of power and privilege. If the latter is the
case, of course it is stuff and nonsense!
My usual reply to these accolades (whilst suited) is “I
must usually look very scruffy”. This of course brings denial
and “oh I didn’t mean that doctor, but you do look well”.
I better take note and help cheer up my patients who do
enjoy seeing me in decent rags.
Why should our patients not make assumptions about us
on the evidence of how we look, dress and deport ourselves?
But surely they do. During recent deluges I have had to
appear in patients’ homes in a luminous yellow cycling
jacket and a pair of doubtful looking black (streaked with
road splash) waterproof trousers. The first imperative has
been to make sure I never sit down and the
second has been to apologise for my appearance
as a person more suited to delivering important
documents around the city than delivering wise
and evidence-based healthcare to its citizens.
Several of my colleagues have been known
to consult with patients in warm weather while
wearing shorts, and I believe that in Australia
and South Africa, such skimpy nether garments
are de rigueur for doctors in the summer. How
seriously will a well-measured medical opinion
be received by a patient who is faced by a pair
of knobbly knees, plump calves or hairy ankles?
Naked shanks are probably more acceptable
than dripping cycling gear.
At the moment, I am wearing a bright orange
t-shirt bought on a wet day in Cobh while exploring Cork harbour, and a pair of trousers made
up for me in Kampala (on the orders of my daughter). The
t-shirt is not very attractive but the mainly green trousers
are made of brightly patterned cotton of the type often seen
in the long dresses worn by elegant African ladies. I think I
look great, but what would be the effect on patient welfare
and community health if I turned up for work tomorrow thus
attired?
In 2010 I have one resolution which may make patients
happier and thereby improve my therapeutic effectiveness. I do promise to dress better and perhaps wear a suit
from time to time; the marvellous new pink shirt, recently
received, will set the standard for the year to come.
Mark Twain also said: “Be careless in your dress if you
will, but keep a tidy soul”. So if I fail to keep my New Year
sartorial promise, I face an even greater challenge!
John Latham is an inner city GP in Dublin
FORUM January 2010 51
Latham.-NH2* 1
08/01/2010 10:19:02