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Should Physicians Wear White Coats?

The Doctor’s white coat has been a symbol of the profession for decades.  In the 1800′s and up through the early 20th Century, doctors wore street clothes while performing surgery…rolling up their sleeves and plunging dirty hands into patient’s bodies.  They often were dressed in formal black, like the clergy to reflect the solemn nature of their role.  (And seeing a doctor was solemn indeed as it often led to death)

A 1889 photograph from the Mass General Hospital shows surgeons in short sleeved white coats over their street clothes and in the early 20th Century the concept of cleanliness and antisepsis was starting to take hold in American medicine.  Both doctors and nurses started donning white garb as a symbol of purity.  The white coat took on more and more symbolic meaning and the “White Coat Ceremony”, where medical students are allowed to don the formal long white coat,  has even been a right of passage with graduation from Medical School.

For the past few years, the American Medical Association and other medical societies have debated if it is time for the white coat to be retired.  A study of New York City doctors in 2004 showed their ties were a source of infectious microorganisms.  The NIH in Britain barred ties, lab coats, jewelry on the hands and wrists and long fingernails because of infection.  Researchers from Virginia Commonwealth University showed bacteria from a white cotton lab coat can cause infection just minutes after touching skin.  Another study reported that the majority of medical personnel change their lab coats less than once a week.

At this time there are no recommendations for doctors regarding wearing lab coats.  I’ve not seen a good comparative study on the hazards (or benefits) of wearing the white coat.  Are street clothes any more sanitary?  Isn’t the real issue hand washing and good hygiene from caregivers?

A number of surveys of patients show they “overwhelmingly” prefer their physicians to wear white coats.  Patients seem to have more trust in and comfort with physicians who wear the coat.  For many patients it is still a symbol of professionalism and good care and it helps them identify the physician.

I must admit I like my white coat.  It has pockets that are filled with my needed paraphernalia and tools.  It protects my clothes and when I don it, I take on a professional personae…I’m no longer a wife, mother, insecure female,  or worried about (fill in the blank)…I am a doctor.  It helps me shift into a professional role with focus and clarity.  I know it is psychologic,  but for me it works.

So what do you think?  Do you like your doctor in a white coat?  Would you prefer regular street clothes?  Physicians, do you still wear the white coat?

*This blog post was originally published at EverythingHealth*


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3 Responses to “Should Physicians Wear White Coats?”

  1. Dial Doctors says:

    I’m a psychologist so I don’t personally wear a white coat but I asked one of our doctors and my sister who is a 2nd year resident.

    My opinion: I trust doctors whether they wear a white coat or not. I’m from the ER generation so I prefer scrubs after watching a million different doctors and nurses without the coat on TV. In fact, I distinctly remember that doctors with white coats were either administrative staff or the ‘mean doctors’ like Anspaugh and Romano.

    Doctor’s opinion: I can wear street clothes while working at Dial Doctors but I choose scrubs for my practice. White coats stain easily and they’re harder to wash. I seldom use it and actually it’s really a laundry day option for me. I’ve read reports on infections that doctor’s coats may carry so I’d rather be safer than sorry. Besides I’d rather sacrifice a pair of scrubs to a bloody patient than the tie my son gave me.

    Med student’s opinion: I love the white coat. It means so much to me because I’m now recognized as a doctor. Scrubs and sneakers don’t feel as nice to me. I’ve read the information on doctors infecting patients through their clothing but following the hand washing protocol is enough for me.

  2. Jim says:

    Please remember ” White Coat Syndrome ” which in some patients makes their blood pressure go up .

  3. Federico Relimpio Astolfi says:

    I do my job seeing outpatients. It’s now a decade or so since I left behind the white coat. I had the feeling that it added nothing to the value of my job. I do the same job with or without the white coat, I feel better, I move better, I feel cleaner, without a professional mask, sure as one can be and I do not think that my patients experience an adverse feeling. Maybe that some of my patients could answer that they would prefer a physician wearing a white coat before knowing me, but I think that after, this feeling is largely dissipated. It is not merely stupidity or narcissicism, they exhibit a true tendency to come again, when they have a lot of alternatives. The profession is in what you are and in what you do, rather that in what you wear.
    Federico Relimpio. Seville, Spain. @frelimpio

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