The Patient Gown Dilemma

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It has always amazed me that after all these years the patient gowns we use are still basically the same.   Talking about needing a better mousetrap!  Anyway, this article looks at how these gowns have an effect on patients’ dignity.   “Some doctors argue the garments may strip patients of their dignity and self-esteem, and push them into the passive and low-status ‘patient role.'” It turns out that most people would want to wear pants.  Duh.   They don’t love gowns and would choose to wear their own clothing.  Duh.   This article was mostly about inpatient care but it pertains to outpatient care as well.  The paper gowns are useless.  The cloth gowns are antiquated but feel better to wear (barely).  Does anyone out there have a better mousetrap they are using?  Please send me your ideas or links.

 

 

 

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  7 comments for “The Patient Gown Dilemma

  1. DOCDADDT
    September 25, 2014 at 7:28 pm

    I am clearly old school in that I do not believe a proper physical can be done on a clothed person. Of course, I am a pediatrician but———-I see adolescents too. Properly draped (velcro, anyone?) they are reasonably comfortable since most all of them know me well too–and I can perform the physical I believe that they are paying for–and it is a COMPLETE PE. I do, usually, leave the underpants on unless there is a suggestion of a problem in the area…………I also cannot properly evaluate gait and range of joint motion and have the patient perform the various movements I require during a sports PE with jeans on. As long as I am commenting, I will also mention that I insist the girls NOT wear thongs to a sports PE, again because of some of the movements that they must make as part of my exam. I advise them to wear “granny panties” or brief shorts if they wish….I find the bra is frequently in the way of my cardiac exam and provide the girls with a very secure gown–velcro again, as mentioned in another comment. Most of the adolescent girls ask if they can take the drape home! Old school if you must, but it works for me and my patients..

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  2. Princess of Problem Patients
    September 25, 2014 at 5:10 pm

    D’oh – I forgot to state that I *always* wear pants with my patient gown, unless I’m being checked over by my gyno or dermatologist. I don’t recall having to de-pants myself with any other physicians.

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  3. Princess of Problem Patients
    September 25, 2014 at 5:05 pm

    I’ve been in so many different paper and cloth gowns over the years with various specialists that I lose the “Will it open in the front or in the back?” game about 80% of the time now. If I have to wear a gown, I prefer it to be soft cotton cloth that has been laundered a billion times, ideally knee length, with a belt of sorts to tie around the waist if it opens in the front. A solid color is much easier on the eyes than any small floral bedspready or wallpapery pattern, too. When I see my surgical oncologist for an annual breast exam, I get to don a poncho that has Velcro along the ends so that it’s more like a solid cape when it’s properly fastened. I’m pretty thrilled about that because every woman deserves to wear a royal purple cape to each boob smash!

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  4. Michael
    September 25, 2014 at 12:42 am

    Someone once said; there are times when I am happy, and there are times when I am wearing pants. These times do not overlap.

    That being said, this is about the patients (and not me). Our world as physicians is being destroyed, one small cut at a time. I believe if they see a doctor, they deserve and are entitled to a professional exam. This exam is best performed when the individual is comfortable, and minimally clothed. Ponchos? Rainslicker? Apron? Fine. I don’t really care. Want to keep your underwear on? Fine. Just as long as I can do my job with efficiency and grace and get the information I need while making the patient feel like they matter (they do).

    But several layers of clothing says to me—you are too busy to care and actually get the patient undressed to try to examine them right.

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  5. Bridget Reidy MD
    September 24, 2014 at 12:08 am

    Though seldom used, I have cloth gowns of various sizes which were very simple to sew. They are basically “short sleeved” ponchos, (of course ponchos don’t have sleeves-picture a rectangle of cloth folded in half, still rectangular, with a linear hole at the fold.). Though the breast exam is no longer indicated without symptoms, they provide much better access to those than traditional cloth gowns. It’s still pretty hard to do a breast exam with a bra just pushed out of the way. Now that we know paps are needed much less often as well, and someone with status finally gave us permission to prescribe birth control without pelvics, I rarely bring home a load of laundry from my family practice job. Patients love them.

    I understand the old school thinking though. Patients are much more likely to come in one layer these days, or perhaps an easily lifted or removed second layer. Earlier in my career the elderly sometimes had so much under layers that auscultation of heart and lungs, a frequent necessity, sometimes did require a complete change of attire. Two layers moving with breathing sounds pathologic.

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  6. Randy
    September 23, 2014 at 1:18 pm

    The only time I have patients wear gowns is for pap/pelvic exams. I used to get the terrible paper gowns and drapes but now am using mammography gowns which end just above the knee. These open in the front and the design is such you can access what you normally have to access. They are heavier than standard gowns so are tougher and warmer, and so far the feedback from patients is positive.

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  7. Sir Lance-a-Lot
    September 23, 2014 at 10:40 am

    This is a recurring issue where I work.

    Some of our “providers” are the kind of old-school altruistic professionals who could not ever in good conscience see a patient who had clothes on, as William Osler himself has appeared to them in their dreams or waking visions (while waiting for some patient to finish droning on about her bowels) and told them that this was an essential and non-negotiable part of the practice of Medicine.

    Others of us, like me, really don’t give a crap.
    In my years of EMS work, before deluding myself, and the Admissions Committee, into believing I should be a doctor, I never took anyone’s clothes off unless they’d been shot or stabbed, and most of them survived their time in my care just fine. I have this radical notion that if I need to look at a body part, I can lift an article of clothing and look under it. I even do that sometimes. I have no idea whether my patients appreciate this humanistic gesture, but I know that I feel better not having to watch them shiver on the exam table, plus, I’ve noticed that the vast majority of people look better with their clothes on, so by doing this, I make each and every one of my days just a little bit brighter.

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