Physician Attire and Appreciation of Physician Communication in Postpartum Women
Condition: Patient Satisfaction
Study type: Interventional

Summary: 
      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.
    

Detailed 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.
    

Intervention name(s): non White coat
Intervention type(s): Other
Intervention description(s): Postpartum patients are randomized to either arm of the study (white coat or standard scrub suit only) by location. All the obstetric physicians associated with patient's postpartum care should use or not use white coat in every single encounter with patient.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Women are randomly assigned to having their postpartum physician team wear a white coat (WC) or not (no-WC) during rounds.
Masking: None (Open Label)
Primary purpose: Other
Keywords: Attire; White coat; Patient physician communication