The Debate over the White Doctor’s Coat

The white lab coat, the semi-official uniform of the physician going back a century, has come under attack by the infection control community.

Until the late 19th century, surgeons wore black coats in the operating room. German doctors were the first to trade the black coats in for white ones. The white coat became a symbol of hygiene and purity, establishing physicians as scientists and differentiating them from the barber. Medical schools hold white coat ceremonies, providing new graduates with their first coat in a rite of passage.

Infectious disease specialists believe that there is enough evidence that the long, loose-fitting sleeves are germ magnets and should be gotten rid of. Studies from the U.S., Britain, and Israel show that pathogens are easily transferred from surfaces to fabric and fabric to skin. Many of the microorganisms found on white coats are antibiotic-resistant, such as MRSA. A 2014 survey found that only 57% of American physicians said they wash their coats once a month or less. The AMA rejected a 2009 recommendation to ban white coats, due to lack of sufficient research on bacteria transmission from coat to patient.

The British National Health Service introduced a new dress code in 2007 of “bare-below-the-elbows”, meaning no fabric, jewelry, or watches. This regulation is also in place in the Netherlands. This was the beginning of the end of the white coat in the U.K. They believe thorough hand washing is easier when the arms are not covered.

The traditional physician attire is still alive and well in most American hospitals and private practice. Atlanta-based dermatologist, Sylvia Wright, is a fourth generation physician and says the white coat represents “the honor, the service, and the commitment of practicing medicine.” European countries are also debating the future of the white lab coat. The German medical association states that older patients who are easily confused cannot identify the doctor without the coat.

Perception counts and tradition is deep in the medical community. Television programs such as E.R., House, and Grey’s Anatomy present the powerful symbol of the white coat. Many patients consider a doctor who wears a white coat to be more professional and trustworthy. Dr. Wright understands the point about collecting germs, but does not agree with it. She likes the deep pockets for holding supplies and protecting her clothing and skin from bodily fluids and surgical prep soap. The white coat still serves as a symbol of the medical profession.

Ridderbusch, Katja. “The doctor’s white coat: A valuable tradition or a dangerously dirty habit?” Latest News. Georgia Health News, 13 Oct 2016. Web. 16 Oct 2016.

One response

A UV light (such as those found in bins used in a barber shop to place scissors and combs in) placed in a locker or closet (and only activated when the door is closed for a brief period of time) would take care of the problems described with wearing long sleeves in a hospital setting. I’ve seen this very same problem discussed regarding the dress ties so commonly worn. My father was an ophthalmologist and always wore a bow tie to “keep it simple”. It was far more hygienic and didn’t get in the way.

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