a review of the literature , including two dermatology studies , indicates that patients prefer their physicians to wear white coats , not only for identification purposes but to build trust and confidence .
this preference holds stable whether studies have addressed general practitioners , specialists , or dermatologists specifically . a study in
which subjects were shown digital photographs of doctors with or without white coats found that subjects perceived the doctors wearing white coats to have greater authority , to be more friendly and to be more attractive .
no study has assessed the prevalence of dermatologists wearing white coats on their websites . given that patient preferences are well known and that websites are a major marketing and communication tool
, we conducted an observational study to evaluate the prevalence of dermatologists in white coats on websites .
to estimate national trends , we evaluated six states from varying regions : northwest ( oregon ) , southwest ( arizona ) , west ( colorado ) , midwest ( indiana ) , northeast ( massachusetts ) , and southeast ( south carolina ) .
one author ( ah ) used google to search the terms arizona dermatology , colorado dermatology , indiana dermatology , massachusetts dermatology , oregon dermatology , and south carolina dermatology . during october 1824 , 2010
she evaluated the first 100 websites for each search term , assessing for relevancy , redundancy , and english language use .
if multiple photos or videos of a dermatologist existed on the site , she only recorded one image per dermatologist with the profile image taking priority .
she recorded the total number of dermatologists , their gender , and whether they were photographed with or without white coats .
massachusetts and south carolina had the highest white coat prevalence rate at 29% and 39% , respectively .
colorado had the lowest rate at 13% , one third of south carolina s rate .
there was moderate variation by gender between various states : arizona and colorado had a higher prevalence of women wearing white coats , while the other four states had a higher prevalence of white coat - wearing men . 

table 1white coat prevalence by state.arizonacoloradoindianamassachusettsoregonsouthcarolinatotaltotal : whitecoats17% ( 13)13% ( 12)20% ( 11)29% ( 38)20% ( 12)39% ( 23)23% ( 109)total : nowhitecoats3% ( 64)87% ( 82)80% ( 43)71% ( 91)80% ( 48)61% ( 36)77% ( 364)men : whitecoats11% ( 5)8% ( 4)23% ( 8)33% ( 21)21% ( 7)43% ( 16)23% ( 61)men : nowhitecoats89% ( 41)92% ( 47)77% ( 27)67% ( 42)79% ( 26)57% ( 21)77% ( 204)women : whitecoats26% ( 8)19% ( 8)16% ( 3)26% ( 17)19% ( 5)32% ( 7)23% ( 48)women : nowhitecoats74% ( 23)81% ( 35)84% ( 16)74% ( 49)81% ( 22)68% ( 15)77% ( 160)adata expressed as percent ( number ) . 
  data expressed as percent ( number ) .
the results indicate that , on their websites at least , dermatologists are largely not wearing white coats .
prevalence rates vary by state , but in all six states the majority of dermatologists did not wear white coats . the east coast is customarily known for being more traditional , which may account for its relatively high white coat prevalence rate .
physicians report various reasons for not wanting to wear white coats - infection risk , discomfort , and interfering with the patient - physician relationship .
however , a recent study found no statistically significant difference between bacterial or methicillin - resistant staphylococcus aureus contamination of physician s white coats versus newly laundered physician attire after an eight hour work day .
the study also found no difference in bacterial contamination at the wrists of doctors wearing white coats versus newly laundered attire , suggesting that white coats may pose no greater risk of infection than newly laundered clothing .
further , infection risk and comfort are not significant concerns when posing for a photo for one s website .
a recent study on dermatology patients indicates that most patients prefer their dermatologist to wear a white coat , while a study involving digital images of doctors with and without white coats patients perceive doctors to have more authority , be more friendly and be more attractive when they are wearing a white coat .
while white coats can provoke anxiety in some , such as in reported white coat hypertension , they may also have a positive placebo effect in others .
since many non - physician healthcare professionals also wear white coats , white coats may not be as helpful to patients for identification of the physician as they once were .
rather , identification badges clearly marked as doctor or physician may help to alleviate confusion for patients .
however , we chose states in distinct geographic areas of the country in an effort to measure a representative sample of the entire united states .
it is also possible that photographs on websites do not accurately reflect dermatologist attire in the office .
photographs on websites are nonetheless important . as most dermatologists websites are designed primarily to market their practice , it would follow that they should accommodate patient preferences . while recruiting new patients through the internet currently may not be paramount , using practice websites as advertising tools is likely to become more important as younger patients turn to the web to find medical information and recommendations for health care providers .
thus , as dermatologists develop and update their websites , we suggest donning a white coat to visually brand medical professionalism .
in our study sample , most ( 77% ) dermatologists did not wear white coats on their practice website .
our results were approximately equal among men and women , but east coast states had the highest rates of white coat - wearing physicians ( 29% in massachusetts and 39% in south carolina ) , whereas colorado had the lowest rate ( 13% ) .
since patients report they prefer their dermatologist wear a white coat , and practice websites may be patients first introduction to their dermatologists , dermatologists should consider presenting themselves wearing white coats online .
 physicians wearing white coats are perceived as having more authority , being more friendly and being more attractive than those not wearing white coats , and patients report that they prefer their dermatologist to wear a white coat . 
 the aim of the study was to determine the prevalence of dermatologists wearing white coats on practice websites . 
 we searched google for dermatology practice websites in six states representing distinct geographic regions in the united states . 
 the first one hundred search results were evaluated , and photographs of dermatologists on these websites were examined for the presence or absence of white coats . 
 most ( 77% ) of dermatologists did not wear white coats . 
 the highest prevalence was in the eastern states of massachusetts and south carolina , with 29% and 39% , respectively . 
 colorado had the lowest rate at 13% . 
 rates were essentially equal when segmented by gender . 
 although patients report that they prefer their dermatologist to wear a white coat , dermatologists often do not wear a white coat on their practice websites . 
Introduction
Materials and Methods
Results
Discussion
Conclusion