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Put your ties back on: scruffy doctors damage our reputation and indicate a decline in hygiene

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3211 (Published 13 June 2013) Cite this as: BMJ 2013;346:f3211

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Re: Put your ties back on: scruffy doctors damage our reputation and indicate a decline in hygiene

I am pleased to see that this issue has garnered a lot of attention and debate. I am a firm believer that the image projected by a healthcare professional, whether doctor or student, is key to the patients' perception of competence.

Work in political psychology has shown appearance has a significant impact on unconscious perceptions of competence (1). Indeed, evaluations of attractive professors are 0.8 points higher on a five point scale (2). It would therefore be advisable for doctors to take note of their own appearance, particularly in a world of patient evaluations and physician rating websites.

Lastly, the placebo effect is an established part of the medical literature (3). It is therefore not inconceivable that perceptions of competence derived from appearance may correlate with outcomes and may be an interesting avenue for future research.

1. Olivola C, Todorov A. Elected in 100 milliseconds: Appearance-Based Trait Inferences and Voting. J Nonverbal Behav. 2010 2010/06/01;34(2):83-110. English.
2. Riniolo TC, Johnson KC, Sherman TR, Misso JA. Hot or not: do professors perceived as physically attractive receive higher student evaluations? The Journal of general psychology. 2006 Jan;133(1):19-35. PubMed PMID: 16475667. Epub 2006/02/16. eng.
3. Benson H, Epstein MD. The placebo effect: A neglected asset in the care of patients. JAMA. 1975;232(12):1225-7.

Competing interests: No competing interests

24 July 2013
Jameel Mushtaq
Medical Student
St George's University of London
Cranmer Terrace, London SW17 0RE