White coat in psychiatry

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taare

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Do you wear your white coats as residents/attendings?

Some of my thoughts and things i have noticed:

- I notice a big difference in attitudes of patients. Many times, not wearing white coat, i am confused for a psychologist or a social worker on inpatient unit. Not often, but it has happened many times.
- None of the attending psychiatrists I know wear it and there have been instances where many patients didn't even remember seeing a doctor ("Oh i have seen so many people, I don't know which one was the doctor")..Go figure!!
- I like the pockets for ease of organizing.


What are your thoughts?

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I am not a resident yet, but I have always avoided wearing a white-coat...I do not like putting on a persona. Its not a status symbol to me, like it is to many doctors, I guess they even go to bed in their white coats( my friend often joked about his grandfather, a war veteran, who in his older age did not want to go to bed without medal ribbons on his pajamas). If you want to " intimidate" and impress your patients with you being a doctor and not a " psychologist or a social worker" I suggest you place a box of shots on your table:laugh:( walking with them through the halls, would be a bit far-fetched I think:)).
 
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Do you wear your white coats as residents/attendings?

Some of my thoughts and things i have noticed:

- I notice a big difference in attitudes of patients. Many times, not wearing white coat, i am confused for a psychologist or a social worker on inpatient unit. Not often, but it has happened many times.
- None of the attending psychiatrists I know wear it and there have been instances where many patients didn't even remember seeing a doctor ("Oh i have seen so many people, I don't know which one was the doctor")..Go figure!!
- I like the pockets for ease of organizing.


What are your thoughts?

I always wear my coat in to work in the ED. As soon as I get there, I promptly hang it on the back of my chair and use it as a storage bag for all my crap.

On my off-service rotations, though, I almost always wear my white coat. I do this because I don't have a 'home base' to hang my wearable storage bag.
 
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Probably depends on the hospital. Where I work, none of the internists or surgeons wear white coats. Cardiology is a crap shoot. Neurologists all wear the coats. In residency an attending with some admin duties said he would wear his white coat to hospital meetings or else feel somewhat ignored by the other specialties; this was where everyone wore a white coat except psychiatrists.
 
When I was a resident, I remember an attending that told me to wear a white coat in clinic because without it I didn't appear professional enough....
 
I am not a resident yet, but I have always avoided wearing a white-coat...I do not like putting on a persona. Its not a status symbol to me, like it is to many doctors, I guess they even go to bed in their white coats( my friend often joked about his grandfather, a war veteran, who in his older age did not want to go to bed without medal ribbons on his pajamas). If you want to " intimidate" and impress your patients with you being a doctor and not a " psychologist or a social worker" I suggest you place a box of shots on your table:laugh:( walking with them through the halls, would be a bit far-fetched I think:)).

Putting on a "persona"?? to "intimidate"?? Status symbol?? Really??
Firstly, it goes with the profession, why feel guilty about it?

Humility reflects despite the clothes you wear. Read your last sentence again. If I am posting this, its not to show that social workers or psychologists are someone I despise. That would be sad actually. Its because patient doesn't understand the role of the person that is visiting with them. Granted, hasn't happened very often, but enough to warrant a second thought.

Secondly, read the very first line. I wasn't asking this to medical students. Although, you are free to respond, part of the profession involves good reading and comprehension skills, please work on that besides showing some respect on an anonymous forum. Now if you want to take another jab at me behind your computer, have at it.
 
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How you are perceived is up to patients. Many who are vulnerable do see a white coat as intimidating and much less likely to see humility that may be ensconced within.

That is partially why I believe I have never....I'm trying to think of a time actually....maybe never?....seen a psychiatrist in a white coat. It's distancing when you are trying to build rapport with folks who are particularly vulnerable. Could be useful if trying to provoke certain transference? The white coat is of course another tool in the presentation of self and how that will impact the rapport and therapeutic space. Use wisely.
 
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Only when covering our ED and Consult service. And only for the extra pockets.
 
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Putting on a "persona"?? to "intimidate"?? Status symbol?? Really??
Firstly, it goes with the profession, why feel guilty about it?

Humility reflects despite the clothes you wear. Read your last sentence again. If I am posting this, its not to show that social workers or psychologists are someone I despise. That would be sad actually. Its because patient doesn't understand the role of the person that is visiting with them. Granted, hasn't happened very often, but enough to warrant a second thought.

Secondly, read the very first line. I wasn't asking this to medical students. Although, you are free to respond, part of the profession involves good reading and comprehension skills, please work on that besides showing some respect on an anonymous forum. Now if you want to take another jab at me behind your computer, have at it.

I apologize, I did not want to come across as rude or take a jab at " you"( I was speaking generally)...Also, I am not a resident, but since this is not a poll or a statistical study, I thought I could chime in( you can consider it a digression).

Personally I enter a new state of mind( concentrated, attention paying) the moment I enter a hospital, and I do not need a white coat for that...Sure, some patients may view white coat as a symbol of professionalism( " I am in good hands now"), but I believe that with psychiatric patients it is more likely to be intimidating and interfere in a doctor-patient relationship.
 
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Do you wear your white coats as residents/attendings?

Some of my thoughts and things i have noticed:

- I notice a big difference in attitudes of patients. Many times, not wearing white coat, i am confused for a psychologist or a social worker on inpatient unit. Not often, but it has happened many times.
- None of the attending psychiatrists I know wear it and there have been instances where many patients didn't even remember seeing a doctor ("Oh i have seen so many people, I don't know which one was the doctor")..Go figure!!
- I like the pockets for ease of organizing.


What are your thoughts?
I ditched the white coat as soon as I got out of med school and no one made me wear it anymore. Mostly because:
  1. The coat got heavy and hot. And, it can spread pathogens per recent research.
  2. Every other group in the hospital now wants to wear a white coat these days, everyone from pharmacy techs to nutritionists, etc. Like you, I found patients just calling everybody in a white coat "doctor", so it's not much of a status symbol or way to identify people anymore. I have a name badge, and I carry myself as a doctor.
  3. We are specialists as psychiatrists. We are often consultants. Consultants wear white coats less often, and men instead wear a sport coat or suit and tie and women wear business attire. I think it looks more professional, sets us apart a little in the hospital as specialists (unlike the white coat now), and expresses a certain amount of independence from the "system", which is based in fact.
  4. If I want more pockets I can carry a briefcase or bag. Generally psychiatrists don't need to carry a bunch of tools other than a pen and your smart phone. I might carry a MOCA with me or a pad of paper.
  5. I don't really give a rat's patootie if lay people or other professionals think I'm not a "real doctor." Nobody ever says that when they really need my help, and they always eventually do. I always gently educated people and almost no one has ever been less than appreciative to learn what a psychiatrist does.
  6. I don't need a white coat to make me feel like I'm a "real doctor." I've seen psychiatry training programs that make their staff and residents wear white coats and act like their psychiatry outpatient clinic is a family practice or neurology clinic. (Many if not most neurologists don't wear white coats, either.) These programs claim a "neuropsychiatric" focus. It just screams insecurity and discomfort with the less "medical" side of psychiatry. In my humble opinion, if you see a program doing this, run, don't walk away as fast as you can if you have other choices. I'm certain this last point will offend some folks, but it's what I think.
 
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I ditched the white coat as soon as I got out of med school and no one made me wear it anymore. Mostly because:
  1. The coat got heavy and hot. And, it can spread pathogens per recent research.
  2. Every other group in the hospital now wants to wear a white coat these days, everyone from pharmacy techs to nutritionists, etc. Like you, I found patients just calling everybody in a white coat "doctor", so it's not much of a status symbol or way to identify people anymore. I have a name badge, and I carry myself as a doctor.
  3. We are specialists as psychiatrists. We are often consultants. Consultants wear white coats less often, and men instead wear a sport coat or suit and tie and women wear business attire. I think it looks more professional, sets us apart a little in the hospital as specialists (unlike the white coat now), and expresses a certain amount of independence from the "system", which is based in fact.
  4. If I want more pockets I can carry a briefcase or bag. Generally psychiatrists don't need to carry a bunch of tools other than a pen and your smart phone. I might carry a MOCA with me or a pad of paper.
  5. I don't really give a rat's patootie if lay people or other professionals think I'm not a "real doctor." Nobody ever says that when they really need my help, and they always eventually do. I always gently educated people and almost no one has ever been less than appreciative to learn what a psychiatrist does.
  6. I don't need a white coat to make me feel like I'm a "real doctor." I've seen psychiatry training programs that make their staff and residents wear white coats and act like their psychiatry outpatient clinic is a family practice or neurology clinic. (Many if not most neurologists don't wear white coats, either.) These programs claim a "neuropsychiatric" focus. It just screams insecurity and discomfort with the less "medical" side of psychiatry. In my humble opinion, if you see a program doing this, run, don't walk away as fast as you can if you have other choices. I'm certain this last point will offend some folks, but it's what I think.

Offend! Offend!!
 
While I used to think white coats were completely stupid and pretentious, I see a lot of value in them in certain situations.

For example, several older patients expect all physicians to be wearing a white coat. So especially when doing consults wearing a coat breaks down barriers/stigma associated with mental health because your just like any other physician caring for them. (This is assuming the other specialties also wear white coats)

But beside that sort of specific situation, I don't plan on wearing white coats much in the future
 
I ditched the white coat as soon as I got out of med school and no one made me wear it anymore. Mostly because:
  1. The coat got heavy and hot. And, it can spread pathogens per recent research.
  2. Every other group in the hospital now wants to wear a white coat these days, everyone from pharmacy techs to nutritionists, etc. Like you, I found patients just calling everybody in a white coat "doctor", so it's not much of a status symbol or way to identify people anymore. I have a name badge, and I carry myself as a doctor.
  3. We are specialists as psychiatrists. We are often consultants. Consultants wear white coats less often, and men instead wear a sport coat or suit and tie and women wear business attire. I think it looks more professional, sets us apart a little in the hospital as specialists (unlike the white coat now), and expresses a certain amount of independence from the "system", which is based in fact.
  4. If I want more pockets I can carry a briefcase or bag. Generally psychiatrists don't need to carry a bunch of tools other than a pen and your smart phone. I might carry a MOCA with me or a pad of paper.
  5. I don't really give a rat's patootie if lay people or other professionals think I'm not a "real doctor." Nobody ever says that when they really need my help, and they always eventually do. I always gently educated people and almost no one has ever been less than appreciative to learn what a psychiatrist does.
  6. I don't need a white coat to make me feel like I'm a "real doctor." I've seen psychiatry training programs that make their staff and residents wear white coats and act like their psychiatry outpatient clinic is a family practice or neurology clinic. (Many if not most neurologists don't wear white coats, either.) These programs claim a "neuropsychiatric" focus. It just screams insecurity and discomfort with the less "medical" side of psychiatry. In my humble opinion, if you see a program doing this, run, don't walk away as fast as you can if you have other choices. I'm certain this last point will offend some folks, but it's what I think.
You had me at "pathogens".
:love:
 
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Putting on a "persona"?? to "intimidate"?? Status symbol?? Really??
Firstly, it goes with the profession, why feel guilty about it?

Humility reflects despite the clothes you wear. Read your last sentence again. If I am posting this, its not to show that social workers or psychologists are someone I despise. That would be sad actually. Its because patient doesn't understand the role of the person that is visiting with them. Granted, hasn't happened very often, but enough to warrant a second thought.

Secondly, read the very first line. I wasn't asking this to medical students. Although, you are free to respond, part of the profession involves good reading and comprehension skills, please work on that besides showing some respect on an anonymous forum. Now if you want to take another jab at me behind your computer, have at it.

Ok, ok. Take it easy cowboy.

I think the point that others were trying to make is that, if thats what makes patients know that they saw a "doctor"...then i think you have bigger problems to worry about. They seem quite impractical for the routine/day of the average psychiatrist anyway, even inpatient.

I also think they just look "weird" and more like you are about run rats to a goal box than sit and listen to patients inner most emotional experiences.
 
I ditched the white coat as soon as I got out of med school and no one made me wear it anymore. Mostly because:
  1. The coat got heavy and hot. And, it can spread pathogens per recent research.
  2. Every other group in the hospital now wants to wear a white coat these days, everyone from pharmacy techs to nutritionists, etc. Like you, I found patients just calling everybody in a white coat "doctor", so it's not much of a status symbol or way to identify people anymore. I have a name badge, and I carry myself as a doctor.
  3. We are specialists as psychiatrists. We are often consultants. Consultants wear white coats less often, and men instead wear a sport coat or suit and tie and women wear business attire. I think it looks more professional, sets us apart a little in the hospital as specialists (unlike the white coat now), and expresses a certain amount of independence from the "system", which is based in fact.
  4. If I want more pockets I can carry a briefcase or bag. Generally psychiatrists don't need to carry a bunch of tools other than a pen and your smart phone. I might carry a MOCA with me or a pad of paper.
  5. I don't really give a rat's patootie if lay people or other professionals think I'm not a "real doctor." Nobody ever says that when they really need my help, and they always eventually do. I always gently educated people and almost no one has ever been less than appreciative to learn what a psychiatrist does.
  6. I don't need a white coat to make me feel like I'm a "real doctor." I've seen psychiatry training programs that make their staff and residents wear white coats and act like their psychiatry outpatient clinic is a family practice or neurology clinic. (Many if not most neurologists don't wear white coats, either.) These programs claim a "neuropsychiatric" focus. It just screams insecurity and discomfort with the less "medical" side of psychiatry. In my humble opinion, if you see a program doing this, run, don't walk away as fast as you can if you have other choices. I'm certain this last point will offend some folks, but it's what I think.

Plus studies show it carries a lovely amount of crap and spreads it around ;)
 
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Interestingly, I never thought it was pretentious. Just thought, it went along with the profession, just like a pilot's uniform but I can see the the point behind why people don't wish to wear it and certainly including pathogen spread risk but I guess, that hasn't gained wide traction yet.
wolfvgang22's sport coat idea is good though. Appreciate everyone's input.
 
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I never wear my white coat. I wore it for inpatient medicine months because everyone else did and ditched it for everything else. It gets dirty, is covered and germs, and hey, makes me look fat (white coats + being short is a bad combo). Vanity and all but still. As mentioned above, I also like being a little outside of the system, which is where we usually are in psych and where not wearing a white coat puts us. I can see maybe wearing a coat on inpatient services, but I also think wearing a white coat for psychiatry clinic would be seriously weird and outside of the norm (admittedly I've never worked on the east coast and don't do pure medication management).
 
Everyone has a white coat these days...students, RNs, PAs, NPs, DNPs, CRNAs...hell I have even seen PT/OT sport the white coat...whatever meaning it used to have is no longer the case. I just prefer to grow my beard and wear a sweater vest...Voila! No more being easily confused as a psychologist or social worker!

If you are worried about space, I suggest bringing back the fanny pack because 1. People respect the fanny pack 2. People will be so intimidated by the fanny pack that they leave you alone 3. The 80's.
 
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i find the most effective way for people to know who i am is to introduce myself as dr. splik, the resident psychiatrist or if you really want to spell it out "the medical doctor specializing in psychiatry".

regardless some patients are so self-absorbed or psychotically disorganized they wont have a clue who you are or if you even saw them! narcissistic patients can see therapists for years and not know their names! i wouldn't take it personally.

i never wear a white coat, the only time i came close a patient (with lewy body dementia) thought i was a maitre'd!

i gave my white coat to a guy i dated who created art with blow torches and needed something to wear... i never wore it once. its probably cinder and ashes now
 
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Lately I have been wearing polo shirts, khakis, and sketchers. When I wear a red shirt I look just like a target employee! Plus when I say I don't prescribe benzos patients really do believe me lol.
 
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The "white coat" and "how you want to be addressed to others" is a very interesting process that happens in residency, especially as you near the end. It's different for everyone. Some people come from _____ and demand respect, so they want to be called "Dr. ___" and wear their white coat at any opportune time.

Some feel inferior, and therefore don't like being called doctor, or go by "Dr. First Name;" Some do this not out of inferiority, but out of a means to better relate with their patients

There's quite a few combinations of this. It's a bridge we all cross

For me:
1) If we're in front of a patient, Dr. Last Name is how I prefer to be addressed. Why? (a) standard for me, helps set a frame, keeps things professional, I am not your friend, etc

2) Patient directed to me. Dr. Last Name; Exceptions - example: the old demented patient who can at least remember "doctor" some part of my name is fine with, or even just saying hi, works too

3) Staff - first name basis. Why? No need for power differential. Some people still call me "Dr...." and that's really because that's what they've always done, so who am I to change them? We should be on the same team (especially if we work together; staff in a hospital, like, nurse on some medical floor that I don't know, at least a "doctor" is nice, professional courtesy

4) No white coat for me. It's like the "hello, intern" identifier. As a med student, I couldn't wait for my long coat. Once I got it, I found increasing times of trying not to wear it on medicine, then ditching it for the last month. Good riddance lol.

As far as the patient's you "haven't seen a doctor, aren't you a SW/nurse/etc" Whatever. Prolly don't need to be there to begin with. Or, being their super duper lovely versions of themselves. "I've been sitting here for 20 minutes! Are YOU even a DOCTOR? Where's the REAL doctor?"
 
There are exceptions, but I still think that wearing a white coat correlates fairly strongly with insecurity. Don’t get me wrong, I mean justified insecurity as much as any other form of insecurity. PGY-I’s wear them the most, followed by PGY-IIs…ect. There are a few attendings who wear them, mostly on C&L and occasionally in the ER. I get the pockets thing; I have carried less and less reference material over time. Now we can almost give up a pen with EMR. With the web, isn’t one small electronic device all that is needed? Besides there are computers almost everywhere you turn.

Once we did have a press conference with some high up elected official types and we were all asked to rally to a photo op. I was kicked out because I didn’t have a white coat. :shrug:
 
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Once we did have a press conference with some high up elected official types and we were all asked to rally to a photo op. I was kicked out because I didn’t have a white coat. :shrug:
Yeah, they (our state medical & psych assn) practically begged us to wear them to the state capitol when we did an advocacy visit last month...

I subjected myself to a tie for the occasion, but that's about as far as I go.
 
The "white coat" and "how you want to be addressed to others" is a very interesting process that happens in residency, especially as you near the end. It's different for everyone. Some people come from _____ and demand respect, so they want to be called "Dr. ___" and wear their white coat at any opportune time.

Some feel inferior, and therefore don't like being called doctor, or go by "Dr. First Name;" Some do this not out of inferiority, but out of a means to better relate with their patients

This might be a dumb question, but as interns, how have people introduced themselves to patients?

After four years of medical student, I got very comfortable with "My name is _, I'm a medical student working with Dr. _." I'm probably not the only one, but I feel like... a bit of a fraud to finally say "I'm Dr. _" when not a lot will change between now and June! But has anyone found mentioning that you are an intern decreases a patient's trust in you? What have you found to be the best way to explain who you are (as an intern)?
 
There has been a lot of debate about how post graduate unlicensed residents should be allowed to introduce themselves to patients. We educators want to promote taking responsibility for care and would just assume leave at as “I’m doctor so and so”. Risk managers and ACGME types want more detailed disclaimers, but these often just further confuse patients. I suggest saying that you are the intern on the team or “I’m your intern”. Most patients don’t know what this means in detail, but understand that you are a doctor, but a junior one.

After much debate, someone suggested the house staff use air quotes when saying “doctor”. This seemed to have ended the conversations fortunately.:bang:
 
I'm probably not the only one, but I feel like... a bit of a fraud to finally say "I'm Dr. _" when not a lot will change between now and June!
It's maybe not a lot, but one very significant thing will change -- you will actually be a doctor!
 
There has been a lot of debate about how post graduate unlicensed residents should be allowed to introduce themselves to patients. We educators want to promote taking responsibility for care and would just assume leave at as “I’m doctor so and so”. Risk managers and ACGME types want more detailed disclaimers, but these often just further confuse patients. I suggest saying that you are the intern on the team or “I’m your intern”. Most patients don’t know what this means in detail, but understand that you are a doctor, but a junior one.

After much debate, someone suggested the house staff use air quotes when saying “doctor”. This seemed to have ended the conversations fortunately.:bang:

Do patients know that saying you're the intern or resident means you're a doctor? That hasn't been my experience, but then I'm also female, which is another strike against being perceived as the doctor. I've got to admit my favorite thing with being done with residency is that I can introduce myself as a psychiatrist.

I think saying you're one of the doctors on the team would work -- it's honest, and you are a doctor.
 
Is the tie common at a lot of the places you've trained/worked?
We're asked to not wear one during our med school psych rotation.

That's fairly typical at inpatients unit, especially higher acuity ones. Ties are choking hazards. Outpatient is a different world.
 
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If you're not wearing your white coat to your wedding, in the shower, and when you're having sex, you're doing it wrong.

Seriously though, inpatient=coats are awesome, outpatient=coats are alienating.
 
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I've got to admit my favorite thing with being done with residency is that I can introduce myself as a psychiatrist.
I don't see why one has to wait until being done with residency to call themselves a psychiatrist.
 
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I threw all my white coats away when I finished my last medicine rotation.....
 
More and more male physicians do not know how to dress, and it is deplorable. Some common mistakes:
1) Do not leave your dress shirt sleeves rolled up. If you need to roll them up for a procedure, roll them down afterward.
2) Do not wear Sperry Topsiders with dress slacks. (you really shouldn't be wearing them on the wards/clinic in the first place)
3) Your belt should match your shoes.
4) Only use a full windsor knot if you have a thick neck
5) Do not wear oxford shirts with ties (you really shouldn't be wearing them at all while on the wards/in clinic)
 
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More and more male physicians do not know how to dress, and it is deplorable. Some common mistakes:
1) Do not leave your dress shirt sleeves rolled up. If you need to roll them up for a procedure, roll them down afterward.
2) Do not wear Sperry Topsiders with dress slacks. (you really shouldn't be wearing them on the wards/clinic in the first place)
3) Your belt should match your shoes.
4) Only use a full windsor knot if you have a thick neck
5) Do not wear oxford shirts with ties (you really shouldn't be wearing them at all while on the wards/in clinic)

Umm, OK. What not to wear threads/posts/comments always make me depressed. The world won't end if your belt and shoes don't match, and I bet you'll still be a capable psychiatrist with patients who appreciate you.
 
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A psychiatrist in a white coat is about as silly as a surgeon in a bowtie and tweed jacket.

Having said that, things really are not that complicated. I do my thing and don't worry much about what others think. It makes life a little more simple that way.
 
Umm, OK. What not to wear threads/posts/comments always make me depressed.
In fairness, taking a psychiatrist's rules for haberdashery is a bit like taking a dermatologist's rules for auto mechanics.


Sent from my iPhone using Tapatalk
 
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More and more male physicians do not know how to dress, and it is deplorable. Some common mistakes:
1) Do not leave your dress shirt sleeves rolled up. If you need to roll them up for a procedure, roll them down afterward.
2) Do not wear Sperry Topsiders with dress slacks. (you really shouldn't be wearing them on the wards/clinic in the first place)
3) Your belt should match your shoes.
4) Only use a full windsor knot if you have a thick neck
5) Do not wear oxford shirts with ties (you really shouldn't be wearing them at all while on the wards/in clinic)

Harry, most of this is just silly. I mean, "only use a full Windsor knots when...." Get real.
Put it in a book or something, but don't pester med students and residents with this Seville row nonsense.

I would draw the line a neck beards, axe body spray, and "live strong" bracelets.
 
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This might be a dumb question, but as interns, how have people introduced themselves to patients?

After four years of medical student, I got very comfortable with "My name is _, I'm a medical student working with Dr. _." I'm probably not the only one, but I feel like... a bit of a fraud to finally say "I'm Dr. _" when not a lot will change between now and June! But has anyone found mentioning that you are an intern decreases a patient's trust in you? What have you found to be the best way to explain who you are (as an intern)?

While you're in residency worrying about how to introduce yourself, just remember there is a freshly graduated NP with far less training than you doing the same work, but getting paid twice as much, and they probably think they are a doctor. Sorry about that. What I really mean is this: Once you're done with medical school and are working in residency you have no reason to not introduce yourself as Doctor. "Hi I'm Doctor ____, I'm a psychiatry resident."
 
Correct me if I'm wrong but the advent of the whitecoat appeared during the time that as a profession we moved away from lead pills and bloodletting with the appeal to associate with those "more scientific".

Enjoy this photostock (or any random television commercial for a university or Koch Industries to get my meaning):

240_F_79995010_RqNrYos4UVKRS36i0tJ4GLfSheO9we0E.jpg


On your next inpatient rounding adventure I recommend bringing along an erlenmeyer flask filled with blue food coloring + water for maximal effect.
 
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