The American
Medical Association voted Tuesday on a resolution that would recommend
hospitals ban doctors' iconic white lab coats, citing evidence that the garment
contributes to the spread of infection. (The resolution was referred to a panel
for further consideration.)
Indeed, a number of studies have shown that
the coats harbor potentially harmful bacteria (and may cause "white coat
hypertension"). If white coats are so bad, why do doctors still wear them?
Because a
white lab coat says "I am a scientific healer." The knee-length coat
in medicine crossed over from the laboratory sciences at the turn of the 20th
century.
Before that
time, medicine was generally seen as the haphazard province of quacks and
frauds, and physicians wore street clothes even in the operating room.
As the field
developed into a respected branch of applied science in the early 1900s,
doctors adopted the costume of the laboratory as a way of bolstering their
scientific credibility.
In
pre-white-coat times, physicians used primitive tools and techniques and had
little formal training. (Medical school could be finished in a year.) Early
doctors competed for legitimacy (and patients) with other healing arts like
homeopathy and medical eclecticism.
''But the development of antiseptics and anesthesia, among other things, demonstrated the exceptional power of science to improve health. Doctors strove to become more scientific, in practice and in dress''
The lab coat
served both purposes by providing a (supposedly) sterile work environment and
soothing patients with its air of scientific authority. The traditional lab
coat was beige, but doctors adopted white because the color symbolizes life and
purity.
(In earlier times, doctors were more likely to
wear black, in keeping with the high mortality rates seen at hospitals. The
nuns who served as nurses often wore black habits.)
By 1915, physicians working
in hospitals had for the most part switched from street clothes to white coats
and pants
With their
scientific bona fides firmly in place, doctors today are divided on the
white-coat question. Supporters say the coat instills docs with a humbling
sense of responsibility and puts patients at ease, while detractors see it as
an alienating symbol of medical hubris.
More than
100 medical schools host "white coat ceremonies" where first-year med
students are outfitted with shortened versions of the white coat, and the coats
are ubiquitous at large teaching hospitals where they help differentiate
between doctors and students.
However,
doctors in smaller hospitals and private practice are more likely to wear
regular clothes. A recent study suggests that only 1 in 8 doctors actually
sport a white coat at work.
Perhaps the
most ardent supporters of the garment are patients: In one study, 56 percent of
those surveyed believed doctors should wear coats, compared with only 24
percent of doctors. (Elderly people tend to be most supportive of the white
coat.)
Another study found that patients were much more likely to trust a
doctor if they were wearing a white coat than if they were in scrubs.
If hospitals
followed the AMA resolution and banned the white coat, what would doctors wear?
The Scottish National Health Service outlawed white coats in 2008 and
instituted a uniform of color-coded scrubs for all medical personnel. The Mayo
Clinic doesn't allow white coats; their doctors wear business attire.
Source: Medical Talks