Should You Sack a Doctor Who Wears a Necktie?
18 Feb 2006
What happens when researchers show patients photos of doctors? Some show physicians dressed casually in open neck shirts. Others in sneakers and jeans. Still others with neckties and wearing a white coat. Then patients were asked, "Which doctor would you prefer?" The experiment showed that time and again patients chose the doctor with the tie and white coat. But is this the right choice?
Researchers at New York Medical Center of Queens recently reported these interesting findings about neckties at the meeting of the American Society of Microbiology.
The authors of the study revealed that although wearing a necktie and white coat provides patient confidence, it also carries a risk. To prove their point they tested the neckties worn by 42 male physicians, physician assistants and medical students. They also sampled the neckties worn by 10 security guards.
What researchers found might make some patients switch to the security guard for treatment. The study found that 20 of the 42 physician neckties were infected with Alcaligenes faecalis bacteria which are non-pathogenic. But some ties carried Klebsiella pneumoniae which can cause life-threatening pneumonia and toxic shock.
Staphlococcus aureus, the germ that is often associated with food-poisoning, was found in 33 per cent of neckties worn by doctors. But only one of the neckties worn by security guards was contaminated.
This study emphasizes that we live in a very buggy world. And it’s easy to see how a doctor’s necktie, particularly under an unbuttoned white coat, could easily become infected.
So should doctors toss away their ties? Certainly where I work most of the younger doctors have already done so. And emergency physicians have learned from experience that disturbed patients can use a tie to strangle a doctor. There’s no debate in this case.
For many years I’ve worn neck ties and a white coat in my office. I hope this hasn’t caused ill health for my patients. And it appears that it hasn’t affected my own health.
I still believe that many patients feel more comfortable with a doctor who doesn’t look as if he’s slept in his clothes for a week and not bothered to shave or showered. Besides, whether we like to admit it or not, how we look and listen to patients often has much more affect than the medication we prescribe. In fact, medication may be many times more dangerous that bacteria on the tie.
But having said that, suppose I suffered from coronary artery disease and required a bypass operation. Being a doctor I have a great advantage over the general public. Patients always assume they’ve been referred to the best surgeon which may or not be the case. I’ve known very rich people who thought, because of their money and connections, they were getting the best medical care when I would have gone elsewhere for treatment. So as a doctor and being on the inside is a great advantage when serious disease strikes. I’d be 100 per cent certain of being in the best hands.
But I’d also realize that in these serious circumstances neck ties and white coats wouldn’t play any role in my selection of a doctor or surgeon. I wouldn’t give a tinker’s damn if my surgeon had the personality of Dracula. Or if his attire looked as though he had been dragged him in from the street. All I’d be interested in was his brain, good judgement and his experienced hands. So if his surgery sent me to the Great Beyond I’d know at least I had been carved up with style.
So should I toss away my ties? Not yet, unless more damaging evidence appears. I believe my germ infected tie still serves a useful purpose and that Shakespeare was right, "The apparel off proclaims the man."
