Physician Attire and Appreciation of Physician Communication in Postpartum Women

The University of Texas System (UT)

Status: Completed

Conditions: Patient Satisfaction

Treatments: Other: non White coat

Study type: Interventional

Funder types: Other

Identifiers

NCT03403660

IRB 17-0096

Details and patient eligibility

About

Wearing white coat during hospital rounds has been associated with increased risk of colonization and transmission of resistant pathogens. On the other hand, studies have shown that physicians' attire affects patients' confidence in their physician and the patient-physician relationship. The results of these studies were highly dependent on the practice setting, with no data in postpartum patients.

The objective is to test the hypothesis that not wearing a white coat during physician postpartum rounds impact patient-physician communication scores.

Full description

Patient satisfaction is an important measure of quality of care. One of the most important variables in patients satisfaction scores is the physician communication skills. There have been several studies evaluating different strategies to improve the patient perceptions of patient - physician communication including delayed physician rounds, improvement of handoff strategies, and family centered rounds. Additionally, research has shown that patients develop a first impression of their physician based on the physician's verbal and nonverbal communication, including the clothing and cleanliness. Patient - physician communication scores not only have an impact on patient care, but are also now linked to Medicare reimbursements.

White coats have been widely used in the medical profession, however some physicians believe that this can be a nonverbal barrier to patient's interaction. Prior studies on the impact of physician attire have reported conflicting results. In a survey published by Cha et al, obstetric and gynecologic patients seen in the outpatient clinic preferred that the resident use white coats. Another study showed that patients favor the use of white coat in the Internal Medicine outpatient clinic which may favorably influence trust and confidence in the medical encounter.

No randomized controlled trial has been published on the impact of the use of white coat on patient - physician communication scores in the postpartum patients. This trial's primary outcome is to evaluate the impact of physician attire (specifically wearing white coat) during postpartum rounds on "patient - physician communication" scores.

This study is a randomized controlled trial performed in postpartum patients to evaluate the impact of not wearing white coat during rounds on "patient - physician communication" scores.

Enrollment: 178 patients

Sex: Female

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Maternal age ≥ 18 years and <50 years
• Patient admitted to postpartum floor at University of Texas Medical Branch (UTMB)
• Patient care managed by obstetric physicians during the postpartum period.

Exclusion criteria

• Patient admitted to ICU
• Delivery resulting in stillbirth Patient not fluent in Spanish and/or English

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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178 participants in 2 patient groups, including a placebo group

non white coat rounding

Experimental group

Description:

The postpartum physician rounding in this group will be performed wearing white coat.

Treatment:

Other: non White coat

White coat rounding

Placebo Comparator group

Description:

The postpartum physician rounding in this group will be performed not wearing white coat.

Treatment:

Other: non White coat