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Rheuminations: Can Clothing Influence How Physicians Practice?

Simon M. Helfgott, MD  |  Issue: June 2013  |  June 1, 2013

Enclothed Cognition: Can Your Clothes Make You Smarter?

How did the white coat achieve this preeminent status in medicine? Perhaps the answer lies deep within our psyche. It seems that we think not just with our brains but with our bodies, too. According to theories of embodied cognition, our thought processes are based on physical experiences that set off associated abstract concepts. This idea has been carried a few steps further by Adam Galinsky, PhD, professor of management at Northwestern University in Evanston, Ill.7 Galinsky and colleagues introduced the term “enclothed cognition” to describe the systematic influence that clothes have on the wearer’s psychological processes. They proposed that enclothed cognition involves the co-occurrence of two independent factors—the symbolic meaning of the clothes and the physical experience of wearing them.

First, they explored the effects of wearing a lab coat in a group of nonmedical volunteers. A pretest found that a lab coat was generally associated with heightened attentiveness and carefulness. Thus, the researchers predicted that wearing a lab coat would increase performance on attention-related tasks. In the first experiment, physically wearing a lab coat increased selective attention compared to not wearing a lab coat. In two subsequent experiments, wearing a lab coat described as a doctor’s coat increased sustained attention compared to wearing a lab coat described as a painter’s coat, and compared to simply seeing or even identifying with a lab coat described as a doctor’s coat. Thus, their research suggested that the symbolic meaning and the physical experience of wearing certain attire such as a white coat may influence the wearer’s cognitive skills.

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Despite these benefits, some physicians and ethicists have argued that the white coat can actually interfere with the doctor–patient relationship. They suggest that it has evolved into a symbol of authority that establishes a hierarchic relationship, which may impede better communication. Indeed, wearing a white coat sometimes serves as a power trip. This is especially true when doctors and other medical personnel are sporting lab coats, wearing surgical scrubs or dangling stethoscopes around their necks when they are out shopping in a supermarket.

What might we conclude from all of this? What doctors wear or are perceived to wear can affect how patients relate to them. For example, one study of emergency room visits focused on the impact of male doctors wearing a necktie.8 When discharged patients were surveyed, approximately 40% incorrectly recalled whether their doctor was wearing a tie. More fascinating was the observation that patient satisfaction responses actually correlated with the mere impression of the presence of a tie, independent of objective reality.

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Filed under:OpinionRheuminationsSpeak Out Rheum Tagged with:Historypatient communicationPractice Managementrheumatologist

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