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

BMJ 2013; 346 doi: (Published 13 June 2013) Cite this as: BMJ 2013;346:f3211
  1. Stephanie J Dancer, consultant microbiologist, Hairmyres Hospital, East Kilbride, Lanarkshire G75 8RG, UK
  1. stephanie.dancer{at}

Informal dress among doctors may be an unexpected side effect of a ban on ties in the UK. But, asks Stephanie Dancer, does this scruffiness also reveal something about how we view hygiene today?

Not long ago an article in the Daily Mail commented unfavourably on so called scruffy doctors.1 The fashion for dressing down in the United Kingdom is a consequence of the Department of Health’s edict in 2007 that in the interest of hospital hygiene doctors should not wear ties.2

Now many junior doctors have abandoned formal wear in favour of T shirts and the like. I hear that patients complain that they do not know who the doctor is: no tie, no white coat, no jacket, and no presence. Doctors are members of a distinguished profession and should dress accordingly. Untidiness erodes the image of doctors as responsible and competent.3

Is there any evidence that staff apparel has been implicated in the transmission of pathogens to patients? None at present, although all clothes, including ties, may be covered …

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