Patient Perceptions of Surgeon Attire, Professionalism, and Gender Bias in Pakistani Public Hospitals

Objective: Surgeon attire significantly influences patient perceptions of professionalism, competence, and trust. This study aims to assess public perceptions of formal and informal surgeon attire and to analyze gender biases in these perceptions among male and female surgeons. Methodology: A cross-sectional survey of 300 individuals aged 18 to 60 years was conducted in Lahore, Pakistan, from January to March 2024. Eligible participants, excluding healthcare professionals to avoid bias, were adults who had visited a tertiary care hospital and could understand the survey questions. Gender-balanced participants rated male and female doctors shown in photographs wearing various surgeon attires, including white coats with scrubs, business attire, fleece jackets, and casual clothing. Ratings were based on perceived professionalism, experience, and friendliness using a 5-point Likert scale. Participants also identified the doctors' likely professions and indicated their preferred gender for seeking medical assistance. Results: Of the 300 surveys completed, respondents significantly preferred doctors wearing white coats, particularly when paired with scrubs, rating them higher in professionalism and experience. Doctors in fleece and softshell jackets were rated lower in these categories (p < 0.001). Gender biases were apparent, with female doctors consistently receiving lower professionalism ratings compared to their male counterparts, regardless of attire. They were also less likely to be chosen as the preferred gender for seeking assistance and were more frequently misidentified as nurses or medical technicians. Conclusions: Both attire type and gender bias significantly shape public perceptions of a surgeon's professionalism and approachability. These findings highlight the importance of addressing gender biases in patient perceptions and developing culturally sensitive dress codes that align with expectations for both male and female surgeons to enhance trust and equity in healthcare settings. Keywords: Surgeon attire, professionalism, gender bias, patient perceptions, public hospitals.