Would you trust a doctor in a t-shirt?

A senior British doctor has complained that junior members of her profession are getting too scruffy. But since doctors are valued for their skill and knowledge does it really matter what they wear?

The father of Western medicine, Hippocrates, had a clear idea of what a doctor should look like - "clean in person, well dressed, and anointed with sweet-smelling unguents". Hippocrates would probably approve of modern hospitals, which offer "unguents" at every turn in the form of hand sanitiser - but he might take issue with the standard of doctors' dress.

Hospital consultant Stephanie Dancer certainly believes it is in decline. Writing in the British Medical Journal last month, she complained that many junior doctors were abandoning formal shirts and jackets for T-shirts.

"I hear that patients complain that they do not know who the doctor is: no tie, no white coat, no jacket, and no presence," she writes. "Doctors are members of a distinguished profession and should dress accordingly."

The stereotypical image of the (male) doctor doing his rounds in a shirt and tie, topped by a starched white coat, possibly trailing a retinue of nurses and students, became obsolete in the UK six years ago when the government issued dress code guidelines prohibiting dangling ties, long sleeves (including the white coat) and wristwatches.

The aim of the new policy was to cut down on cross-contamination within hospitals, reducing the number of germs doctors carried from one ward to another. But oddly, one of the NHS-commissioned review articles that inspired the dress code said "there were no studies that showed an epidemiological link between uniforms worn in practice and cases of health-care associated infections." It did, however, point to a public perception that doctors carried hospital bugs on their clothes.

Since 2007, UK hospital infection rates have indeed gone down, but according to Dancer - a microbiologist - there is no evidence that this is because of the absence of ties and coats, as hospitals introduced a number of hygiene measures at the same time.

Dancer argues that the dress rules may even be counterproductive. "Scruffiness… also intimates a lack of personal hygiene and lower standards of hygienic behaviour," she writes.

And she is not the only one arguing for the return of the white coat.

Like Dancer, Adam Magos, a consultant gynaecologist at the Royal Free Hospital in London says the studies that led to the new policy were flawed and misinterpreted.

"From memory, the one thing that they did find is that the public don't like to see healthcare workers - nurses, doctors - going outside the hospital in their uniform and then coming back in, which I quite agree with," he says. "But that's not the same thing as saying if you're wearing certain apparel - such as white coats in the case of doctors - that patients consider that to be a health risk."

-BBC