What comes to your mind when you think of doctors? It’s most likely people wearing white coats with stethoscopes around their necks. You could also be picturing someone in scrubs. These will come to mind if you picture a doctor in their natural habitat: the hospital. If you’re thinking of doctors outside, you’ll probably picture them in a suit or something formal. You don’t think of them in shorts or sweatpants, because it just doesn’t seem natural. Should doctors be restricted to wearing certain clothes? Let’s talk about if doctors should have a dress code and what they should wear.

Doctors describe the white coat as a badge of office. Even as a student, once you wear that white coat for the first time, you’re instantly filled with pride. You look at yourself wearing it and you know you’ve made it; you’ve accomplished one of your greatest dreams by becoming a doctor, and only a few years of practice and studying are between you and saving lives. It’s also very practical: you have two large pockets which you may use to keep a pen, notes, and even a coiled-up stethoscope if you’re not a fan of keeping it around your neck. It’s not all glorious, though; it’s very likely a patient will vomit all over your coat, or you might end up covered in blood.

In the 1990s, however, white coats were seen to be infection hazards, and their use started to diminish. Doctors started to find ways to distinguish themselves through other attire: a lot of physicians turned to wearing ties. Pediatricians, especially, wore ties that had cartoons on them, which made them more approachable to children. Then, of course, ties were seen as an infection risk as well.

Doctors have reacted differently to the loss of the white coat. Some felt sad, saying doctors look like regular laborers without a dress code or a white coat. The sight of doctors walking around a hospital in jeans and sweatshirts annoys some physicians who prefer the more professional, traditional look. They think looking professional is necessary for a doctor who is looked upon by others as a caregiver and a healer.

Of course, there are two sides to every story, and there are doctors who are glad they can wear whatever they want; they believe wearing white coats makes physicians seem superior and less approachable to patients. This isn’t unfounded, as there’s a phenomenon called “white coat hypertension.” This is a condition where, due to the stress that comes with seeing the “white coat,” getting your blood pressure measured by a doctor will yield high readings, even though you don’t actually have hypertension.

Some believe it may not be official, but some doctors do have dress codes. One doctor says members of a consultant’s team will often dress the same way he or she does. If a consultant wears a three-piece suit, for instance, with matching tie and handkerchief, it’s likely the rest of the team will do the same.

It’s also possible to identify certain specialties by how they choose to dress. A plastic surgeon, Dr. Beryl De Souza, says that in plastic surgery, they tend to dress formally while meeting patients in a clinic, and wear theater gear during operations. Some pediatricians like to wear short-sleeved shirts without ties, which is both professional and not too intimidating for children.

On the other hand, psychiatrists have the luxury of wearing less formal clothes. It’s very important for a patient to open up to a psychiatrist, and to do that, they can’t be intimidated by them. Of course, this isn’t an excuse to wear jeans and seem too casual, but a suit and tie aren’t as necessary as they are in other specialties.

Of course, all these choices are personal and not mandated by anyone or any institution. There’s an opinion that it’s not good for healthcare professionals to be walking around a hospital not knowing who’s a doctor and who’s a patient, as this can result in a lot of mix-ups. Some think it’s necessary to have some kind of color code, at least color-coded nametags, in order to differentiate people according to their role in a hospital.

What does the research say? A meta-analysis of this topic was done in 2014 that showed patients do care about what doctors wear. Regardless of specialty, patients seem to have a preference for professional attire. The preferred clothes are “roughly business casual, with or without a tie, and with a white coat.”

As for clinical outcomes, there isn’t a decisive result from the research done. In the United Kingdom, the National Health Service has issued a policy that states doctors should be bare below the elbow, meaning long sleeves aren’t preferred. This is because they might easily transmit diseases and pathogens. All this talk about the spread of infections has given rise to the use of scrubs. They’re comfortable with short sleeves and are supposedly made to minimize infection transmission.

We’ve discussed shirts and ties enough, so what about shoes? Comfortable shoes are a necessity in the hospital setting. They aren’t obligatory, but why would you want to wear shoes that hurt your feet for several hours during a rotation? In fact, it’s not just recommended to wear comfortable shoes, it’s also recommended you have several shoes with you so you can switch between them to keep your feet comfortable, rather than trapped in the same shoes all day long. Of course, in a clinic where a doctor will spend a few hours, classic shoes or heels would be okay and not too annoying.

A study in the United States, Japan, Switzerland, and Italy will take place where doctors will be surveyed on what they prefer when it comes to attire. The doctors will be surveyed in hospitals, clinics, and offices in order to see what they like best. Factors like age and how often a person interacts with the healthcare system will be analyzed because, of course, they influence how a person thinks and what they prefer.

For now, it is recommended that male doctors wear formal attire with ties, and business attire for women. Recent studies have shown that ties, sleeves, and white coats don’t transmit infections as much as previously thought and can be worn by physicians. It’s also recommended that doctors wear the same attire when working on weekends, not just on workdays.

As for scrubs, they are best suited for emergency and operating rooms, but it’s better to change into something more formal when checking up on patients in their rooms in the hospital or when meeting them in a clinic.

There isn’t really a definitive say on what a doctor should wear. Studies previously showed that white coats transmitted infections, then newer studies showed they didn’t. Some doctors believe white coats are essential while others believe they intimidate patients. According to most studies, patients prefer doctors wear formal clothes. It seems they would like doctors to uphold the image they have in their heads. Of course, up to now, no one can force a doctor to wear anything, and a physician’s choice of attire will come down to their own style, how important comfort is to them, and how professional they want to look.