Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier. There must be a reason why so many professions require a uniform. Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele. It certainly doesn’t enhance professional performance. For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings? If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?
The medical profession for most of its existence has had its
own uniform. Male doctors donned a shirt
and tie and all doctors wore the iconic white coat. The stated reason was that this created an
aura of professionalism that inspired confidence in patients and their
families. Indeed, even today you will
often see physicians sporting this sartorial style. But I am not one of them.
I haven’t worn a white coat or a tie at work in decades. I do have a box of starched and folded white
coats in the trunk of my car provided to me by my employer. I’ll be sure to return them in pristine
condition when I retire years from now.
Imagine how much I am saving them on cleaning fees. Perhaps, I should request a laundry
reimbursement.
I haven’t found that my casual presentation has affected my
relationships with my patients. As far
as I can tell, patients are appreciative of my work and judge me by criteria
other than how I package myself. I think
this is how it should be. I certainly
come to work well-attired, but my style clearly departs from the classic image
of the white-cloaked physician in a traditional necktie.
It seems that there has been an overall societal dressing
down in recent years. Come to the
theater or a decent restaurant and you will see patrons dressed very
differently than they would have been a few decades ago. There was a time when many men came to work
every day in a business suit. These days
are long gone. In fact, many folks are
now working at home wearing just about anything or perhaps nothing.
I work hard for my patients.
I listen to them very carefully.
I care about them. I offer my
best advice. I admit when I have
erred. Would a white coat add anything
to this?
To each his (or her) own on this issue, to be sure. However, I will say (as a woman) that when I am NOT wearing my white coat, patients frequently referred to me as a Nurse. As much as I respect my nurse colleagues, with 3 fellowships, 3 Board certifications, and over 20 years of medical practice under my belt, I am a Doctor and feel I should be recognizable as such. Last week— even in my white coat— a patient told the person who called her cell phone (yes, she answered during our visit) that she was with the nurse right now. My manner in clinic is warm and casual, and I prefer to think this is why patients think I am a nurse and not a doctor…but I’m not about to add to the confusion by ditching the white coat.
ReplyDeleteI was making rounds one morning with the male attending, 3 male residents and I, the lone female resident. We all had our white coats on. The patient was on the phone and just before hanging up said “I’ve got to go, the doctors and the nurse are here”. To this I replied “Isn’t it wonderful to have so many male Nurses!” Touché’
DeleteHow do we differentiate between a lab technician or a transport helper or a pharmacy tech and a doctor if both are wearing a "lab coat"? Even administrators wear "lab coats"! That's why we donot write "Dr" before our name on our presentation clothes including "lab coats".
DeleteI agree that white coat per se is not needed, however I believe the traditional classic dress code should be kept as a standard. If you let it go, you will open the door to different styles that may not be appealing to everyone. The classic dress code has already gained the trust of the public. In their most vulnerable moments, patients expect to be handled by a physician they trust, and believe it or not, having a white coat or classic dress code helps to establish this trust. You wouldn't trust a fireman coming to save my house in a sagging pants and flip flop (which can happen if you open this door).
ReplyDeleteI wore a white coat consistently in residency and in my first year as an attending. Then, I quickly noticed that everyone else at the hospital was wearing one too - phlebotomists, case managers, social workers, pharmacists, sleep-language pathologists - almost everyone. How were patients to know that I was a physician aside from introducing myself as one? I stopped wearing one shortly after and mostly just wear my scrubs with my residency fleece and a stethoscope around my neck - I don't look like everyone else now at the hospital and I'm more identifiable as a physician now.
ReplyDeleteI agree. However, 'everyone' is wearing scrubs, too. Early on, believe it or not, someone thought I was in pajamas when wearing scrubs. I still dress professionally, but without a tie (or lab coat).
DeleteAlot of the staff are wearing scrubs, but that's why the uniform is so important. Nurses are wearing one color of scrubs, and are identifiable because of that color.
DeleteAppreciate comments. @anonymous female MD, clearly more progress is necessary. I hear your frustration. We are all battling our biases. For instance, if we are told that a police officer entered a building, many of us assume that the officer is male. Ahmed, with all respect, if a firefighter is coming into my home to save me and my family, I assure you that his or her state of dress would not concern me! All the best, MK
ReplyDeleteAs a woman, my professional clothes are generally made without anything resembling a pocket of any use. If I do not a white coat on, then it is impossible to carry any of the many useful tools with which I practice medicine. I have some colleagues who have the same disdain for the white coat as the author but I do think there is some male privilege here. I suspect people of color may also have challenges. If you are in the group considered dominant, one does not have to worry about how one is perceived.
ReplyDeleteAgree fully! ( as a petite woman MD of color)
Delete@anonymous above, I had not considered issues of bias regarding the white coat issue, but you raise good points. I appreciate your input. Best, MK
ReplyDelete@anonymous. I agree 100% with you about the white coat helping to distinguish me from a nurse. After almost 40 years of practice, I have had numerous instances where a patient who I had just examined was heard telling a family member that they had just seen the nurse. This occurs even though I wear a badge that states “PHYSICIAN” and I identify myself as a physician when I enter the room. Often I think the level of patient understanding is exceedingly low, but without the white coat, it would be worse.
ReplyDeleteI agree- I haven’t worn a white coat since residency and will never wear one again. In fact, after a decade of wearing khakis and dress shirts or sweaters to work (and jeans on Fridays), I switched this year to jeans every day and a variety of casual shirts and sweaters. Patients didn’t blink an eye and we have continued to enjoy a trusted relationship with each other. In fact, many of them love the fact that I am dressed like they are- it makes them feel much more comfortable sharing their lives. Probably couldn’t have pulled this off just starting my career but having the goodwill of over a decade of work helps.
ReplyDeleteAt this point, even when the practice administrator from the large academic hospital comes by once or twice a month in his suit etc, I just smile as I chart in my jeans and sometimes a sweatshirt. As long as patients are happy with my care, and they generally are, I’m sure he doesn’t care that much how I dress either. Thanks for an interesting article!
In these times when outside forces try to diminish the medical profession due to economic interests or political naïveté, we should be the first to preserve our traditions and professional profile. I also resonate wit the challenges to female and colored professionals.
ReplyDeleteWe tend not to refer to minorities as “colored” anymore, at least in the US. Patients seeing us that way is the reason why some still cling to their white coat.
DeleteSo who should wear the white coats? Just physicians? Or all "Providers"?
ReplyDeleteI think you can say this because you are a white male.
ReplyDeleteThe French physician Louis Ferdinand Celine said that when we started dressing like gas station attendants (for you youngsters, he meant the white coat) people started to treat us like gas station attendants
ReplyDeleteunfortunately bias against women is pervasive. I have been ordered to wear my white coat while in hospital when I was in the minority wearing business casual wear - including hosiery. Now that I wear scrubs like everyone else that order has not been rescinded. Nor am I the only female physician to receive this order from administration sadly even for female physicians wearing scrubs. Men can go against the dress code and wear jeans or whatever they wish. Women are not subject to the same rules and perks that men enjoy.
ReplyDeleteWhen I was a senior resident in my Emergency Dept in the early 90s, when I was in charge I told all residents to lose the coats , ties and tennis shoes .When I was challenged by a resident about "proper dress" , I pulled out a swab and swabbed his tie, then 2 days later showed him how many bacteria he was contaminating his patients with . Slip on shoes only ( shoelaces were the worst!).And all white coats did was show you who sneezed, bled , or threw up on you.
ReplyDeleteBut did you swab your “non-white coat” attire at the same time? That may have grown plenty, as well.
DeleteI don’t think this takes into account the experience of minorities. I wear my white coat. It helps prevent me from getting identified as transport, X-ray tech etc.
ReplyDeleteEveryone is wearing the white coat. They have stolen our uniform. Just like many advanced practitioners who want to be doctors without doing all the work to become one. It’s not that cool. But we as doctors could t actually stand up for ourselves now could we?
ReplyDeleteI was taught not to wear a white coat in my child psychiatry fellowship, now over forty years ago—the idea was the many young children would think “pediatrician = shot.” It did seem to help.
ReplyDeleteBeing a pediatrician I do not wear a white coat but I am totally outpatient since our hospital hired pediatric hospitalists so everyone knows I'm the doctor. My colleagues have taken to wearing scrubs since Covid but I feel being dressed professionally in regular clothes makes me more distiguishable as a doctor in the office.
ReplyDeleteWould it be nice if we showed up in court for a court matter and the clerk, the bayliff, and all counsel were wearing black capes? Will the real judge please rise?
ReplyDeleteI wear a clean white coat because I want to, and although everyone’s opinions are amusing or interesting, I really don’t care.🤷♂️
ReplyDeleteI wear a clean white coat mainly because I like to have my scripts ready and ample supply of stickers and small toys ready for my pediatric patients immediately after any annoying procedure that I have to perform on them. They appreciate it and I don't have to rely on an over taxed MA or RA to hand out the goods! Works for me and I keep my little patients very happy.
DeleteHaven't worn a white coat since leaving residency. Stopped wearing coat and tie ages ago. Have actually had patients tell me they appreciated the more casual look; put them at ease and made me more identifiable as a fellow human being.
ReplyDeleteA white coat has at least 3 other uses that we should recognize. 1) pocket space for all things we use on a daily basis. 2) It covers our clothes so that when we are finished for the day we do not need to immediately change to avoid having our families have contact with whatever bodily fluids or aerosols we may have encountered. 3) A clean, pristine white coat projects the idea that the practitioner is meticulous. This boosts the confidence of many patients. As an ob/gyn with these issues in mind, I will continue to wear a clean, crisp white coat.
ReplyDeleteI too wear my white coat for the pockets, (women's clothes hardly have any and if they do, they are too small for a phone/reading glasses), keep the patient's excretions/secretions on my coat and not brought into my home, and it is kept clean and presentable. To me, wrinkled "business casual clothes" carry all of the hospital home "with them" or to a restaurant or to a theater or a grocery. How often are the fleece vests cleaned? If the hospital is caring for the cleaning/pressing of my coats, a heartfelt, THANK YOU! No demands for my respect; just MY needs.
DeleteI am a Med Peds physician - i stopped wearing the white coat about 10 years ago. I dress professionally, in clothes that are easily cleaned. i find only my older male patients are disturbed by that. The children all behave better when i am not wearing it. They start crying when they see the white coat. In addition, parents love that I am responsive and respectful of their children's fear and need for me to be without the white coat while sitting and playing with them. Older women open up more when i forego the coat as we talk like sisters. So i won't be donning the coat again just for a small subset of patients that seem to need an external trigger to demand their respect.
ReplyDeleteCertain European countries have banned white coats for physicians as well as ties and are mandating bare-below-the-elbow practice. Reason behind this is infection control as they found out that doctors don’t wash their white coats and ties. Also any watches and jewellery are perfectly designed to harbour bacteria and hence carry them from one patient to another. Another benefit they claim is removal of presumed hierarchical elitism between the doctor and the patient which purportedly translates into better patient care as doctors appear more approachable.
ReplyDeleteWow good for you. Who cares? Dead topic that needs to stay dead. Waste of server space.
ReplyDeletei wear diffrent color coats and that too medical student style and not knee length as a FP.We deal with sick and depressed clients they appreciate colors ascolors can lift moods and spiritsI wish we can wear royal emblems / cartoons etc as well.life should be fun as there is enough negativity all around
ReplyDeleteIt is shameful that we, doctors, do not wash our white coats regularly. I remove my white coat when seeing patients under 18. I also ask elderly patients in Rehab and nursing home to read my white coat headings to test their vision and literacy level: I will say: seeing is believing. This helps me a lot in having our 1st interaction and bit of neurological exam. I should have had the letters in prints for easier reading.
ReplyDelete