The Message behind that Tie (Article)

Every once in a while, I stop and notice how much has changed in health care during my career. This morning while I was making rounds at the hospital, I had one of these thoughts. I think of these as another type of Senior Moment: instead of the traditional “I can’t remember something” moment, I get a ” I noticed a change” moment. I noted that I was the only physician who was wearing a tie. It seems like dress has become very casual in the medical world. When I was a resident in training, sneakers and scrubs were the rule, but this made a lot of sense because we were doing really dirty things. When I graduated and became a full-fledged attending doctor however, the button-down look with a tie was the daily routine.  I can even recall physicians that I would see in the Emergency Room at 3am attending to sick children, having come in from home, who took the time to put on a tie to present themselves to the patients. This was 3am mind you. Why were they doing this, and why to this day do I wear a tie to work whenever I am going to have patient contact? This is the question that I was pondering this morning while making rounds.

The answer suddenly struck me: visiting the doctor was a special, unique, and rare event 50 years ago. During my childhood people rarely went to the doctor, so there was a certain pagentry associated these visits. We only wore our fancy clothes when we wanted to show respect for a special occasion or person; visiting the doctor was one such event, and the doctor recognized this by dressing up for the occasion. Parents got into it too, dressing up their children prior to these visits simply so they would look good before they were asked to take their clothes off. Maybe my mother took this to an extreme, I don’t know. As a child, I was instructed only to wear my best underwear on days when we went to the doctor. Imagine, my mother was even worried about what my underwear looked like!
The next time you see a doctor dressed especially nicely, maybe even with a bow tie on, recognize that they are sending you a message: you are special, and the opportunity to help improve your health is a special gift, a special encounter between humans.  Make sure you put on a little smile in response and say thanks for the thought. Sometimes retro is really hip, don’t you think?
Your comments are welcome at www.docsmo.com.  Take a few minutes while you are there to explore literally hundreds of podcasts, articles, and now videos, about pediatrics.  You’ll be glad you did.  Until next time.
written by Paul Smolen M.D.

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