What do you wear when you are seeing patients? I have often thought that what doctors wear says a great deal about how they see themselves and that this impacts on the image they portray to their patients.

Do you practise in a cuddly sweater, a dress, a suit or an open necked shirt? If you are male, do you ever wear a tie? Have you deliberately chosen to look formal or more casual? Would you wear jeans in the surgery or shorts?

Most GPs I have worked with or consulted tend to choose a look, and then stick to it. The advice from the BMA is that doctors should ‘dress in a manner which is likely to inspire public confidence.’

What does that phrase mean to you? After all, patients inevitably vary in their preferences. Research seems to suggest that suit-wearing denotes a doctor of greater competence but who is less approachable, while the more casual look denotes the opposite.

It is also interesting to see how you feel when consulting another non-medical professional. I must admit that if I consult a lawyer or financial adviser I will breathe a sigh of relief if they are dressed smartly, and immediately have more confidence in them. Completely illogical, I know.

But do most patients really take much notice about what their friendly family doctor is wearing? It’s difficult to be sure, though many years ago I recall once being totally astonished at how observant some patients can be. On the occasion of a significant wedding anniversary my wife gave me a ring. I had never worn one before. Two days later a patient interrupted a consultation with the words: ‘You’re wearing a wedding ring – you’ve never done that before!’ I often found it difficult to remember the names of patients that I had looked after for decades, let alone how they dressed.

When I was RCGP Chairman, I found that whenever I appeared on television, patients who consulted me in the next few days would inevitably pass a comment. Never once did they talk about the vitally important issue that I had been interviewed about. No. The comments were always: ‘I liked the shirt you were wearing,’ or ‘I hadn’t seen that tie before, doctor.’ Sometimes you wonder why you bother.

I have written before in this column about having to tell a patient of mine with cancer that her prognosis was not good.

When I asked if she had any questions, she said yes. Then asked me where I had got my shoes from, as she had been looking for a similar pair for her husband.

That day I learnt the important lesson that people need information at their own pace, and that there is no right and wrong way of talking about topics that are literally a matter of life and death.

It was immensely valuable, even if for a moment it did leave me tongue-tied and confused.

I still remember the very first patient I had to break bad news to.

I was a medical student and doing an elective in Providence, Rhode Island. In the USA attitudes to honesty and openness were quite different from the bizarre, antiquated, and patronising British method that was the norm at the time, namely never using the word cancer.

One day I was tasked with telling a delightful New England lady that her chest X-ray showed that she had lung cancer. I took a deep breath and tried to break the news as best I could.

As I finished she looked into my eyes and said words that I will never ever forget. ‘Gee, doc, I just love your British accent, it’s so cute.

Do say all that again.’

And so I did.