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White coat hate

Discussion in 'General Residency Issues' started by cartoondoc, Mar 27, 2010.

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  1. JeffLebowski

    JeffLebowski Just got Nard-dogged

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    Agreed - especially since everyone in our country historically associated white coat with doctor. Nowadays that's changing since everyone and their mother is helping themselves to it, but if you ask someone on the street "hey which profession wears a long white coat" they'll say doctor.

    So people we work with latched on to this identifiable part of our uniform that people/patients see and lend trust, respect, and credibility to (either consciously or unconsciously) and start wearing it themselves to get that themselves, all the while saying "what's the big deal? so what? you don't OWN the rights to it, butchers wear white coats and so do scientists why can't we, stop being so elitist, you think you're better than us?!" and the ultra laid back too cool for school-ites pushing for a more casual uniform code (and work ethic, like it or not) DOCTORS are saying "yeah who cares man I let all my patients call me Jeff and I'm best friends with every nurse in the hospital and the only thing patients care about is results and the kind of doctor I am and gosh I'd have a seizure if I had to wear a silly TIE every day and man those white coats are killing patients with germs and gosh I'm totally awesome everyone loves how laid back I am and man I can work as few or as many hours as I want how dare you suggest my profession is anything more than just a job you can't tell me what to do" so of course we're losing this battle.

    But there are some of us who want to stand up for the integrity of our profession and yeah, stuff like this may sound like a little thing, but it happens to be the most visibly identifiable part of a doctor's uniform and it's a sign of a larger problem, as mentioned above. Do I HAVE to wear a white coat as a doctor? No, of course not. I probably wouldn't care that much if I was never allowed to for the rest of my life. But the fact that other people are just perverting it to serve their own selfish ends just for the sake of their own ego is distressing.
  2. PostCall

    PostCall

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    dude, stop being an elitist. just because you got into med school when most people couldn't and then worked harder than we have ever worked during your years of med school, residency, and fellowship to acquire all that knowledge and skill doesn't make you better than anybody! so check your ego at the door because we're all a "team" here. unless something goes wrong. then it's all your fault (even if it wasn't) cuz it was your patient afterall. but as long as it's easy and smooth sailing we're still a "team", ok. we want it both ways, understand. we want to avoid all the years of education and sacrifice but still want to strut around in the long white coat like we're on the same level, and we expect to be treated as such by both you and the patients. don't you dare pull the "doctor" card or i'll write you up and play passive-aggressive games like waking you up in the middle of the night with b.s. calls to show you how petty i can be! why haven't you ever brought a box of donuts to appease us like the other residents have?
  3. Substance

    Substance

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    That bolded phrase right there is the biggest load of BS that has entered medical practice since Homan's sign.

    We are told that the issue is that all other ancillary services are important, and without them doctors cannot provide patient care effectively. While I respect that, the insidious issue of "team" medicine is that ancillary services are trying to claim more respect, pay, and responsibility than their positions allow. The first step in doing this is to knock doctors down a few pegs(since trying to rise to their level is far too difficult), and to appear equivalent to them in dress and in how they are treated by other staff members. Next thing you know, nurses will say they're doctors...oh...that's already happened.

    Back in the 70s and 80s, there were doctor's lounges that only physicians could enter, because their rigorous training and important responsibility was respected. Nurses would never give doctors attitude, and if a doctor entered the room everyone would listen because the doctor was the leader of the team and the responsibility of the patients was attributed to him. Nurses wore white uniforms with the accompanying hat. The boundaries between leader and follower were respected.

    Now everyone wears the white coat and nurses are trying to be doctors through legislation. We let it get too far.

    Again though I respect ancillary services, they need to gain some perspective. Though they are necessary for patient care, it does not equate that they are important. Every "team" has a coach and a GM who the players answer to.
    Last edited: Mar 29, 2010
  4. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    Where did anyone say that you suck?

    We're not talking about your cartoons, are we? ;)
  5. MossPoh

    MossPoh Textures intrigue me

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    Whether you love it or not probably has more to do with how you looked at them entering into the field more than any research. Aside from not seeing them much growing up, I still feel uncomfortable being surrounded by a ton of people wearing them. The one major benefit to whitecoats for me is that I can't afford to get my shirts dry cleaned often and don't really have the leisurely time or will to starch and iron my shirts, so it does hide the slightly wrinkly shirt well.
  6. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    The Mayo piece you linked to is all about professionalism and a "uniform." The wisdom of their decision to standardize on business attire rather than the traditional white coat is certainly debatable, but there's no mistaking their intent to project a professional image.
    Last edited: Mar 28, 2010
  7. PostCall

    PostCall

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    i was going to give a lengthy rebuttal to your outrageous arrogance but my shift ends in a minute and my commitment to my "team" and patients ends the second my shift does.
  8. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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  9. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    Clowns come to your mind. Is that the only thing? Is that the first thing? The first thing that comes to my mind with "costume" is an actor. If you say "professionalism" and "costume", it's a soldier.

    Do you, LukeWhite, have the guts to tell a US Marine that his costume, which makes him look professional, is, in your mind, equal to that of a clown? I would believe that, since that's the first thing you mention, that's a just statement. I don't think s/he would really split hairs, while splitting your head open.

    I wear a collared shirt and white coat to work; there's no question as to what rôle I play. As all of the nurses - bar none - wear scrubs, the hospitalist without the white coat also is clear.

    And the clothes-as-fomites is something on which I've exposited before. What is a fomite? It transmits disease. Just because these things (ties and white coats) can be culture positive, where is the link showing they cause disease?
  10. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    Doesn't sound like the Mayo Clinic believes it, unless all of their docs are having their suits dry cleaned every day.

    Back to the subject of physician attire, here are a few relevant articles on the subject (attached).

    Attached Files:

    Last edited: Mar 28, 2010
  11. lowbudget

    lowbudget Senior Member

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    BEST run-on sentence. Ev-er.
  12. JeffLebowski

    JeffLebowski Just got Nard-dogged

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    Cocaine is a hell of a drug.
  13. Samoa

    Samoa Step on Lego, Lego cries

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    I like my white coat, so I wear it, for all the reasons listed above: mobile office, general barrier function, easy identification, etc. But I got to pick pretty much every element of it: fabric, style, lettering and font. And then my program bought me three of them. So I don't have much excuse not to wear it, even if wanted to be a white coat rebel.

    The only time I don't wear it is in the middle of the night. The ICU gets so cold that heavy-duty fleece is the only thing that will keep me warm. And when I get called down to the ED at that time of night, even though the staff all know who I am, it can be hard to convince the patients that I'm actually the doctor, and not the nurse. Plus I can't carry as much stuff with me in my fleece.

    I really think we need white coats made of fleece. That would solve the problem nicely.
  14. cartoondoc

    cartoondoc

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    Wow. I'm a little surprised at how a question about whether it's necessary to wear a white coat has elicited the true feelings from a lot of docs here about the ancillary staff.
  15. Rabbit Hole

    Rabbit Hole We're all mad here.

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    I really had no idea that this whole white coat disease spreading thing is essentially a myth.

    Just a general piece of advice for those who want to reclaim the uniform - you have to respect it first. That means you should iron the damn thing, make sure the collar isn't turned up and that it doesn't have pen marks from last week on it.

    The white coat has been symbolic as the doctor's uniform for ages and anyone who says otherwise is either crazy or an ancillary staff member with an identity disorder. I mean, how would they like it if I showed up to the hospital wearing scrubs with multicolored bears and kites on it?

    A few gems from the Mayo article:

    What the hell is this? Someone explain to me why this place goes the extra mile to spreads their butt cheeks so wide for their "customers"? Are you kidding me.. their dress code is BUSINESS ATTIRE? Where's the white coat? I would think patients want/expect to see their doctors in white coats and not like they just stepped out of a cubicle in a megacorp.

    I think this has more to do with pandering to their "customers" than anything else - make the sick moneybag people feel like they're doing the doctors a favor by just being there. Oh thank you sick moneybags! Is there anything else I can do for you? How about a gourmet cappuccino while I shove this catheter up your urethra?

    By the way, a hospital should look like a hospital not a country club. Leave it to Mayo marginalize the profession and throw the dignity of their doctors under the bus. I think they said it best:

  16. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    The great farce about Mayo being customer oriented is the significant dearth of insurance plans they take. In a city like Phoenix where we have very little choice in the matter of tertiary care university hospitals, they no longer take Medicare (system wide decision) or BC/BS, as well as a host of other insurance plans.

    If they really were so customer oriented, they would actually take insurance plans that a large segment of the population was on. Its about the bottom line of course, but I wish they wouldn't pretend that they are solely focused on customer satisfaction.
  17. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    I dunno...it's possible to be patient-oriented and at the same time be selective about the patients you see. We all do that to some extent. True, they do it more than most of us, but if things continue to get bad in the insurance realm, who's to say we won't be doing the same thing?

    The real farce is that the Mayo has been touted as the Holy Grail of integrated health systems by the Obama administration.
  18. fab4fan

    fab4fan TiredRetiredRN Gold Donor

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    :lol:

    This post made my day.
  19. Rabbit Hole

    Rabbit Hole We're all mad here.

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    Why do medical schools even have a white coat ceremony anymore? Seriously, what's the point of anointing new students with something they they have to spend the rest of their careers making excuses for?

    Doctors instantly get accused of being elitist or egotistical for wanting to distinguish themselves amongst other staff in the hospital. If we work in a hierarchical system where doctors bear the ultimate responsibility I think their uniform should match their level of responsibility. Yes, I'd like to have an option of wearing a "uniform" I can be proud of that clearly identifies my role in the hospital and yes, I do feel entitled to that.

    It's like we're fostering new generations of "apologist doctors", always having to appease those around them so nobody gets their feelings hurt. I think the rift between doctors and nurses is due to a vicious cycle lack of respect.. you fill that rift with a healthy dose of resentment & frustration and you have a hostile working environment.

    Do doctors in the military see problems like this? Ultimately, the blame should be awarded to the Suits in the boardroom who think it's okay to have a hospital staff with homogenous/non-existant uniforms. And to the medical schools, either they should stop this BS white coat ceremony or have a white coat burning ceremony at graduation so you can symbolicaly set fire to any notion of entitlement or diginty that you think you deserve for having a medical degree.
  20. Acherona

    Acherona Senior Member

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    patients know i'm a doctor because i introduce myself as such and because of how i interact with them. i also have a nametag that says MD. it hasn't really been a problem. the white coat is a functional item where i can carry my scutlist and pocketmedicine, my cell phone and beeper, and which protects my clothes from body fluids. I'm sure other health care professionals like it for similar reasons. I do think there should be a white coat cleaning service like scrubs so everyone can have a clean one each day. It's kinda gross how long some residents go without washing theirs.
  21. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    They have those...

    http://www.uniformservice.com/

    ...among others.
  22. Winged Scapula

    Winged Scapula Cougariffic! Administrator SDN Senior Moderator Lifetime Donor

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    Point well taken. We DO all do it.

    Sour grapes for me...I just switched to BC/BS and live within a couple of miles of Mayo and now can't go there.:mad:

    They were until they dumped Medicare...now Washington is suddenly quiet on how great Mayo is.
  23. Hernandez

    Hernandez Paranoid and Crotchety...

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    the sad thing is white coats are just as contaminated at 3 hours of use as they are at 3 weeks......
  24. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    If your dry cleaner's nose is colonized with MRSA, it won't even take that long. ;)
  25. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    Count your blessings. You'd probably have contracted necrotizing fasciitis from your doctor's Armani suit jacket, anyway. ;)
  26. PostCall

    PostCall

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    even though you do bear the ultimate responsibility as you said, remember we are a team. i mean as long as things go ok we are a team, but if not then you're on your own. your team's not going to be there to back you up at the malpractice trial, just sayin'. we're more of a "fair weather" team. and yes you need to apologize. or at least feign modesty around your non-doctor teammates or we'll retaliate by making your job difficult in various way that we know how. cuz that's included in our definition of teamwork.
  27. Arcan57

    Arcan57 Junior Member

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    Slightly off topic, but for those of you that have to buy your own whitecoats - where do you get them? I've slowly been transitioning from the scrub top/cargo pants look to collared shirt/dress pants. I'm thinking about taking the next step, but my last white coat was a piece of crap and I'm not sure who makes quality coats.
  28. Moonglow

    Moonglow

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    double post
    Last edited: Mar 30, 2010
  29. Moonglow

    Moonglow

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    You can buy them online and have them sent your office.
  30. Arcan57

    Arcan57 Junior Member

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    I'm aware of the use of the Internet to purchase goods and services. I was looking more for recommendations on what company to go with, or if someone had a particular favorite coat.
  31. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    The general story (which I've also heard myself):

    Me: "So, what brings you here today?"

    Pt (schizo): "The bus."
  32. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    This is the one I wear, #423 (Traditional Knot Button Cotton Lab Coat)

    http://labwear.com/products.asp?CategoryID=MENS_LAB_COATS

    These are pretty much the same as the ones I was given during residency. Many of those old coats are still going strong, so they're very durable.

    The only downside to 100% cotton is that you pretty much have to have them professionally cleaned and pressed, because they wrinkle like crazy. It definitely breathes better than the poly blends, however.
  33. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    Me too. I've had those for residency and fellowship and love them. a little warm in the summer but otherwise great.
  34. Arcan57

    Arcan57 Junior Member

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    Thanks Bluedog, especially for taking the time to throw in the link.

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