While physicians are usually more concerned with monitoring patient heart rates and reading lab results than with their personal grooming, a recent study showed that a physician's appearance can be quite important. It is part of making patients' families feel comfortable in a high-stress hospital environment.

The study, published by the Journal of the American Medical Association (JAMA), found that about one-third of patient families members in an intensive care unit (ICU) considered a lack of tattoos and piercings important in their first impression of a physician. While this number is considerably less than those for other professional attributes that respondents deemed important – wearing an easy-to-read name tag (77%), neat grooming (65%) and professional dress (59%) – the number is still considerable.

Respondents also favored traditional medical attire, such as a white coat (52%) or scrubs (24%). They were less partial to a suit (13%) or casual attire (11%).

So what it is about a clean-cut, tattoo-less doctor in a white coat that makes family members more comfortable with the care the patient is receiving?

According to the study, respondents associated professional attire with honesty, knowledge, and better care. Surprisingly, professional appearance was more important to patients than even age, which is typically an indicator of experience. Patients' families may believe that a physician is more competent or intelligent if he or she is dressed appropriately for the hospital.

Physician grooming may be particularly important in an ICU because of the high-pressure environment in which patients' families need to bond quickly with the physician who is working to keep the patient alive.

While professional grooming and attire send clear signals to family members in a hospital, it is less clear why a physician with a tattoo would seem any less trustworthy than one without. Tattoos and piercings seem to retain a stigma.

According to a 2010 Pew Research study, almost four-in-ten teens and twenty-somethings (so-called millennials) have a tattoo. About half of those with tattoos have between two and five, and 18% have six or more. And nearly one-in-four individuals in this age group have a piercing on a body part other than an earlobe.

Right now, patient family members in the ICU are more likely to be Baby Boomers. And the numbers are drastically different for them – far fewer have body piercings and multiple tattoos. That could account for the difference in attitudes.

While it is possible that opinions may change as the millennials age and become the family members holding vigil in ICU waiting rooms, one thing is clear. For the time being, critical care doctors should consider covering up the tattoos, taking out the eyebrow ring, and putting on a white coat. It may seem trivial to some, but it is a small price to pay to increase the trust of patients' families in those taking care of their loved ones.

-       By Erica B. Cohen