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Doctors’ Garments And Bacterial Contamination

This colorized 2005 scanning electron micrograph depicts numerous clumps of methicillin-resistant Staphylococcus aureus bacteria, magnified 2,390 times. Content provided by CDC/Jeff Hageman, MHS, via the CDC's Public Health Image Library (PHIL)Bacterial contamination of physicians’ newly laundered uniforms occurs within three hours of putting them on, making them no more or less dirty than the traditional white coats, researchers reported.

Researchers sought to compare bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians’ white coats to freshly laundered short-sleeved uniforms, and to determine the rate at which bacterial contamination happens. They reported results in the Journal of Hospital Medicine.

ACP Internist‘s blog recently took up the debate as well. The issue has cropped up over the years, assessing not only the cleanliness but the professionalism inherent in the white lab coat.

Researchers conducted a prospective, randomized, controlled trial among 100 residents and hospitalists on an internal medicine service at Denver Health, a university-affiliated public safety-net hospital. Subjects wore a white coat or a laundered, short-sleeved uniform.

At the end of an eight-hour workday, no significant differences were found between the extent of bacterial or MRSA contamination of infrequently-washed white coats compared to the laundered uniforms. Sleeve cuffs of white coats were slightly but significantly more contaminated than the pockets or the midsleeves, “but interestingly, we found no difference in colony count from cultures taken from the skin at the wrists of the subjects wearing either garment,” researchers wrote.

And, there was no association found between the extent of bacterial or MRSA contamination and the frequency with which white coats were washed or changed. Colony counts of newly laundered uniforms were essentially zero, but after three hours they were nearly 50 percent of those counted at eight hours.

*This blog post was originally published at ACP Internist*

The Humanistic Side Of Medicine

An excellent opinion piece by Sally Satel, M.D., a psychiatrist, appeared in the Wall Street Journal this morning about white coat ceremonies as ways to reinforce the humanistic qualities of medicine. The best part, however, was this perspective:

But the question of whether empathy can be taught—and, in particular, whether a white-coat ceremony is a good means for promoting that virtue—is a matter of some debate.

Judah Goldberg, a young doctor at Chilton Memorial Hospital in New Jersey raises an intriguing paradox. He asks how the white coat can bring doctors closer to the subjective experience of patients when, as an icon of the profession, it is meant to isolate and distinguish them from the lay community.

“To the extent that empathy can be taught through a ritual,” Dr. Goldberg told me, “a hospital gown, the common garb of human frailty, would be more fitting than a distancing white coat.”

I must say, the thought of everyone seeing each others’ posterior sides as they paraded across the stage at such a ceremony did make me smile. Read more »

*This blog post was originally published at Dr. Wes*

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