I am usually required to remove them. I think my doctor judges circulation based on the warmth or coldness of my feet. Unfortunately, I am required to get my physicals in the winter months so my feet are cold to begin with from walking around outside to get there, and the tile floor is cold to make things worse. Not sure if that is a valid test or not but I can tell there is usually some concern when they are found to be cold. The docs always feel and listen to the pulse in my ankles while my socks are off as well.