Am I a better doctor if I wore a tie?
by Irwin Lim, Rheumatologist
I stopped wearing a tie to work at the start of 2004. It was summer and I was hot.
Its much more comfortable working without a tie, particularly in my job. Its easier to examine patients, its easier when I need to perform a medical procedure. I’m sure you can see how a dangling tie would get in the way.
I’ve also lost quite a few ties, sadly enough, to spillage, followed by dry cleaning. Dry cleaning and silk ties don’t mix well. The tie comes out worse for wear and never again, does it look quite right.
I wonder then how people clean their ties? I guess that the answer is that they don’t.
A tie could possibly be a source of infection. Imagine your doctor seeing patient after patient, either in the hospital or in their rooms, with that dangling tie. Later that week or the next week, he may wear the same tie, probably after the tie has been sitting in a drawer somewhere at home, and almost certainly, without any attempt at cleaning. I am sure there are proper scientific studies on these but I must admit I’ve not bothered to hunt for them. It seems common sense and provides me enough extra vindication for what I do.
Many of my friends are tie-wearing doctors. They’re probably not so keen on this blog. Most would not like to give up this very traditional symbol of male authority. Some would even say that the tie (and a suit or the Doctor’s white coat) enhances patients’ satisfaction and confidence. To look like the wise and experienced consultant, some will argue that you need this part of the uniform.
I hope not. I’ll wear a nice shirt and pants because I like to and being less dressed would seem quite inappropriate. I hope that I make a good enough first impression with my practice settings, our clinic’s attention to detail, and my manner that my patients don’t mind my lack of a tie.
Dr Irwin Lim is a rheumatologist and a director of BJC Health. BJC Health provides coordinated, comprehensive, and colocated multidisciplinary care to achieve effective solutions for patients. We call this model of care, Connected Care. Our clinics are located in Parramatta, Chatswood and Brookvale. Contact us.
This blog focuses on musculoskeletal disease, healthcare in general, and our Connected Care philosophy. Read More.
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Thank you for your blog comment the other day. I’m glad your wife liked the recipe for the stuffed dates! Been thinking of your locale lately as I’m sitting here with several feet of snow on the ground and watching the Open last week seeing everyone in shorts and t-shirts and hearing about how warm it is there! Still, with all the flooding there’s some bad stuff there too. I have to admit being lazy with my writing lately so I default to the food posts. I’ll try to think of some more academic topics soon! Love your posts . . .
Hi Dr. Lim–
My “uniform” can range from jeans & scrubs to the standard khakis/tie/white coat. I’m not especially picky, but when I’m on for consults at the University, where the dress code is a little more formal than the smaller hospital where I moonlight, I would be lying if I told you that my white coat & tie made no difference as to how I was received by patients, and how I myself felt.
For the most part, I don’t care much if other docs, residents or students adhere to the more formal dress code, but I do think (especially with the impressionable students) that there’s a line somewhere where clothing gets too informal. I have no idea where the line is, although people wearing shirts that are too short to reach their pants, thus revealing their midriffs to patients and staff, goes well beyond it. Call me a Puritan, I guess.
You are right to note the infection control aspect of ties. Our Infection Control officer at our University Hospital always wears turtlenecks when he rounds, and it looks pretty cool to me.
The hospital where I worked wants the male resident doctors to wear long-sleeved shirts and ties with the white coat (in a tropical country) and the female resident doctors wear dresses and 2-inch high heels. Even during 24 hours duty! I can’t imagine what the hospital administrators or the resident training officers wanted to accomplish: to turn us into better clinicians or into fashion models (with lower back pains).
I believe resident doctors can still make themselves look credible and professional, without having to be so formal. It is in the manner of speaking to patients and addressing their needs. I believe those who have imposed these rules do not understand its implications.
Thanks for thinking about the patient and infections. I don’t know of a report about ties and infections, but have seen one about the white coat itself spreading infections. I don’t care what you wear – jeans and a tshirt are fine for me. Plus they’re easy to wash. Jackets and ties have to be dry cleaned, and have longer wear and more chance for infections between cleanings.If you want to look professional, wear a collared shirt, have it pressed and starched.
Ties are a nuisance for a doctor. They just get in the way as they flop around. I suppose using a tie pin helps but all the same, I have worked without one for the last 8 years. I bet you most ties are rarely dry cleaned.