PORTLAND – Everyone who has been hospitalized or has undergone an outpatient procedure knows – and probably loathes – the skimpy, ill-fitting, one-size-fits-none hospital gown.

Maine Medical Center finally decided to do something about it upon discovering that Muslim women accustomed to being fully covered were skipping appointments to avoid the immodest garments.

The redesigned hospital gown made available to all Maine Medical patients six weeks ago leaves them fully covered.

“This is a great example of a challenge raised by a specific community that can ultimately benefit all patients,” said Dana Farris Gaya, manager of

interpreter and cross-cultural services.

The “johnny,” as it’s known, is the butt of jokes because of the discomfort it causes patients. Typically, it’s a short gown tied in the back, often leaving one’s backside exposed.

Of course, the johnny was not designed with patient comfort in mind. And the institutional garment has endured, despite patient complaints and various efforts to improve upon the design.

At Maine Medical Center, administrators decided they had to act last November after the hospital identified a high no-show rate for Muslim women from African countries, particularly Somalia.

As many as three out of 10 women were skipping their appointments, said Osman Hersi, a medical interpreter at the hospital.

Tracked down at home, the women whose religion and culture requires them to be covered, described to interpreters the horror of being asked to wear the revealing gowns during outpatient procedures.

Furthermore, they were publicly humiliated when they had to wait in a hallway in the radiology department.

“I have witnessed their misery and how bad they feel about it. They don’t like it. They feel ashamed. It’s very embarrassing,” said Asha Abdulleh, a medical interpreter and native of Kenya.

The dress code for Muslim women is derived from the holy book, the Quran. Followers say teachings on modesty require women to cover themselves from head to toe. Only the hands and the face may be exposed. Many believe that their beauty should be reserved only for husbands.

On a recent morning, Shamso Abdi appeared for her first hospital visit since arriving in Portland.

She and her husband, Aden Ali, came to the United States from Mogadishu, Somalia. They lived in a small town in Kentucky, and then Columbus, Ohio, before coming to Portland.

Abdi, who was clothed in a dress, a sarong and a hijab, a scarf wrapped around her head, said she had canceled appointments in Columbus when she had to see male doctors and wear a johnny.

The “new” johnny created by the Maine Medical Center is long enough to provide more coverage of a patient’s legs and has extra material to ensure that a patient’s backside remains covered. Underneath, there’s a wraparound sarong for even more coverage.

Abdi said she was grateful to see that Maine Medical had created a patient gown with her principles in mind.

“I’m so happy they made the change. I’m so happy that they considered us,” she said, speaking through an interpreter.

Maine Medical, which has put the new johnnies on all garment carts for patients who request them, isn’t the only hospital to try to create a patient gown that is more acceptable to patients.

Hackensack University Medical Center in New Jersey introduced vibrant colors and funky patterns five years ago.

Other hospitals and garment producers have tweaked the traditional designs with snaps, Velcro and other changes.