Take Off Your Tie, Doc

I just learned yesterday that it may well be that one of the most dangerous things a doctor can do is wear a tie around patients. This is unfortunate, because wearing a tie lends a degree of gravity, authority, and respect to a man, and a doctor is in a position where such a badge of authority is an important facet of the doctor-patient relationship. Many of a doctor’s customers (as distinguished from his “patients” who may be the same person but sometimes are not) expect him to wear a tie as such a badge of his position.

It’s not conclusive that silk ties can transmit disease; if they can, the lab coats  may well serve the same function, particularly if they are not laundered frequently. But it makes sense. Shirts, pants, undergarments, and possibly the traditional white lab coat can be put through a washing machine with some frequency. But ties are typically made of silk or some other delicate material, and therefore not laundered often because it is expensive to do that. Most guys gradually acquire a collection of ties, some of which can grow to prodigious sizes, but as a practical matter they run through a rotation of between ten to fifteen ties in a cycle because the favorite ties, or the ones that are known to look good with a particular coat and shirt combination, get worn more often. I’m certainly guilty of that.

Typically, I only send my ties to the cleaner when I spill a visible amount of soup or sauce on them.  But that doesn’t mean that just because I come home with a clean-looking tie, I’ve managed to avoid smaller amounts of organic material getting lodged in there – and if there is organic material in there, maybe other stuff is eating it, like dust mites or molds or other unpleasant beasties. Beasties that you wouldn’t want to be spreading around to other people, especially if you were in the business of healing them. Not all that many at any one location or time, but after a while, it can add up.

The last time I went to see a doctor, he was wearing surgical scrubs, a white lab coat, and running shoes.  I didn’t think anything of it since the doctor I saw is a surgeon. I noticed the lack of tie, but didn’t think much of it since scrubs seemed an appropriate thing for a doctor to be wearing — obviously “medical,” easily-laundered, and permitting substantial freedom of movement while treating patients. But now that I think about it, if he was either coming from or going to surgery after treating patients for several hours in his office, shouldn’t he have changed his scrubs coming in to or going out of the OR? Doctors, help he out here. Those scrubs he was wearing when he saw me must have been for office wear only; he wouldn’t go in to surgery wearing the same scrubs that had absorbed whatever microorganisms I had exhaled onto them earlier in the day, right? Or is this something that doctors, being human, sometimes forget about?

I don’t think there’s much of a counterpart to the necktie for women. Some women’s suits include silk scarves or frilly collars on the blouses, which I guess could be like a man’s tie. Sometimes there are shirts or blouses that go up to the neck on a woman’s suit, but mainly they seem to be open-throated. A woman wearing a necktie is making a fashion statement,* and doctors are not in the business, usually, of making fashion statements like that. Like all professionals, they wear what they wear to stick in, to conform, to demonstrate that they are part of the establishment.

But these are not as important goals for doctors to have as protecting the health of their patients. So more scrubs, doc; I for one am not going to forget that you are a doctor even if you leave the tie at home.

* I include servers at the Olive Garden in this. The women servers, seaters, and bartenders wear ties similar to the men, as part of the server’s uniform. The statement there is one of uniformity. Nor is wearing a tie a bad fashion statement for a woman to make; more often than not I’ve been pleased with the look.

Burt Likko

Pseudonymous Portlander. Homebrewer. Atheist. Recovering litigator. Recovering Republican. Recovering Catholic. Recovering divorcé. Recovering Former Editor-in-Chief of Ordinary Times. House Likko's Words: Scite Verum. Colite Iusticia. Vivere Con Gaudium.


  1. Doctors' ties, bed sheets & mattresses. Germs, germs, germs & bedbugs- they're everywhere!! Only one solution– live in a bubble and soak in Purell. Or, spritz your doctor with Purell before he gets too close.

  2. I may have been a criminal defense attorney too long. When I saw the title of this post, my mind immediately went to imagining a story about a patient choking a doctor with the doctor's own tie.

  3. Founder of the iTie, your comment was deleted because it looked like spam. If it was not, please feel free to repost your remarks without a link to your for-profit commercial site. I've no problem with for-profit businesses but this blog is not a for-profit venture nor is it a commercial medium.

  4. TL, as you know my wife is a doctor. This is a subject of particular interest to us because she used to always wear scrubs before dress codes caught up with her. She prefers scrubs, though she definitely noticed that after she stopped wearing them people stopped confusing her for a nurse.As you brought up coats, I assume you are aware of the whole AMA misunderstanding from several years back?If they took away the coats and took away the ties, laundry would be a lot simpler in the Truman household!

  5. "Many of a doctor's customers (as distinguished from his "patients" who may be the same person but sometimes are not) expect him to wear a tie as such a badge of his position.I generally judge medical professionals by their patient survival rates, not by their manner of dress.

  6. His Lordship, that seems logical in theory and I hope that you actually find somewhere to get that data in a meaningful format. But in practice, it's astonishing as to what factors really motivate people to pick one professional service provider over another.

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