What is the evidence supporting physicians wearing business-casual attire versus scrubs in the acute inpatient hospitalist (Internal Medicine) role in medical-surgical (med-surg) floor/ward settings, rapid response/medical emergency team settings, and transitional care between med-surg and Intensive Care Unit (ICU)?

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Last updated: March 7, 2025View editorial policy

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From the Guidelines

Physicians working in acute inpatient settings, including med-surg floor, rapid response/medical emergency team, and transitional care between med-surg and ICU settings, should wear scrubs as they offer several benefits including improved mobility, protection from bodily fluids, and reduced risk of pathogen transmission. In med-surg floor settings, while business-casual attire may help establish professional rapport with patients and families, the infection control benefits and practicality of scrubs generally outweigh these considerations, particularly in settings where patient care involves physical examinations, procedures, or potential exposure to bodily fluids 1. Some of the key benefits of wearing scrubs in these settings include:

  • Easily cleaned and reduced risk of pathogen transmission between hospital and community
  • Clear identification of medical staff
  • Comfort during long shifts
  • Improved mobility and protection from bodily fluids in rapid response/medical emergency team settings
  • Practicality in transitional care between med-surg and ICU due to the unpredictable nature of patient conditions and potential exposure to contaminants. The guidelines for clothing in the operating theatre also emphasize the importance of attire in preventing postoperative infections and limiting the transfer of microorganisms and body fluids between caregivers and patients 1. While these guidelines specifically pertain to operating theatre staff, the principles of infection control and practicality can be applied to other acute inpatient settings, supporting the use of scrubs as the preferred attire for physicians in these environments.

From the Research

Evidence Supporting Attire in Medical Settings

  • There is limited direct evidence supporting physicians wearing business-casual attire versus scrubs in the acute inpatient hospitalist role, particularly in med-surg floor/ward settings, rapid response/medical emergency team settings, and transitional care between med-surg and ICU 2, 3.
  • Studies have focused on infection prevention and control practices, including hand hygiene and the use of personal protective equipment (PPE), with no specific mention of attire 2, 3.
  • The role of hospitalists in internal medicine has been discussed, highlighting the potential advantages and disadvantages of this practice mode, but without addressing attire specifically 4, 5, 6.

Infection Prevention and Control

  • A study on infection prevention and control practices found that healthcare workers' routine work goes beyond hand hygiene and PPE, involving the distribution of team members during rounds and the choreography of performing aseptic procedures 2.
  • Another study investigated cross-contamination risks between hospitals by external medical staff via hand hygiene, but did not address attire directly 3.

Hospitalist Role and Education

  • The hospitalist model has been discussed in relation to its potential benefits and risks for family physicians, as well as its implications for medical students' education, but without addressing attire specifically 4, 5, 6.
  • The focus has been on the hospitalist's role in providing high-quality and efficient care, as well as their potential impact on medical education and the development of standardized communication and partnership strategies with other healthcare professionals 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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