Anyone in here have any strong opinions regarding the use of white coats on rounds? I have an attending who is very old school and makes a huge deal out of wearing white coats while rounding. So much so, he has stated that we are no longer allowed to operate with if he catches us without a white coat. I find them often times dirty, cumbersome, and physically painful to wear (neck strain) . I think they do play a role (in clinic or presenting at M&M for example) but don't feel unprofessional if I am seeing patients without one on.
Opinions on White Coats in Surgery
- Thread starter 12-Blade
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Your white coat causes neck strain? How heavy is the darn thing or is it what you have in the pockets? As for dirty, sounds like you need to have yours cleaned more.
My program was old school as well, no rounding without the coat (or in scrubs unless you were on trauma call).
Regardless of what you think, there are several studies that show *patients* prefer the white coat, even for their surgeons.
I don't have a strong opinion other than you do what your attendings tell you to do. This is a very minor issue in the grand scheme of stupid things your attendings want.
My program was old school as well, no rounding without the coat (or in scrubs unless you were on trauma call).
Regardless of what you think, there are several studies that show *patients* prefer the white coat, even for their surgeons.
I don't have a strong opinion other than you do what your attendings tell you to do. This is a very minor issue in the grand scheme of stupid things your attendings want.
Yes. I agree. Over the years, the number of “stupid” things increases exponentially. Just frustrated at the threats and willingness to not train residents over something so petty.
Yeah. Random crap in the pockets. Stethoscope. Lists etc. It’s the added weight on top of having to wear a headlight for long periods of time. Sometimes you just need a little break. As for the cleanliness, we are due for some new ones soon so that should help.
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There is light at the end of the tunnel, my friend.
It is petty to threaten residents over something like wearing white coats; it does sound frustrating.
IRT getting new coats, are you not washing them?
It is petty to threaten residents over something like wearing white coats; it does sound frustrating.
IRT getting new coats, are you not washing them?
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I despise white coats, always have. I don’t wear them. Don’t worry...just suffer through this, and once you’re an attending, you can burn the thing.
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Call me old fashioned, but I do think they can be important. And as WS mentions, the effect they have on patients isn't just theoretical. Though I don't always have it on, I generally make an effort to wear it during times where I'm going to be seeing patients (rounding, consults, etc.) In a field where building trust is important, like it or not appearances can mean a lot. (Though we could have a separate discussion about how I feel that it's unfortunate that a long white coat has lost some of it's symbolism now that so many other health providers roll around in long white coats.)
As for your attending, I'm not so sure I agree with the "I can't believe he could get worked up over something so trivial" angle. For him this clearly is an important part of professionalism, which in turn is viewed as an important aspect of training by the ABS. And I also find it harder to find fault since he's making his expectations clear, and that the expectation is fairly easy to meet. I generally reserve my criticism for those staff who won't tell people what they expect and then take it out on you, or try to avoid working with certain residents without having ever tried to remediate the behavior they find objectionable. In the end, I'd just wear the white coat and be happy it's not a place that requires dress clothes anytime you're outside of the OR.
As for your attending, I'm not so sure I agree with the "I can't believe he could get worked up over something so trivial" angle. For him this clearly is an important part of professionalism, which in turn is viewed as an important aspect of training by the ABS. And I also find it harder to find fault since he's making his expectations clear, and that the expectation is fairly easy to meet. I generally reserve my criticism for those staff who won't tell people what they expect and then take it out on you, or try to avoid working with certain residents without having ever tried to remediate the behavior they find objectionable. In the end, I'd just wear the white coat and be happy it's not a place that requires dress clothes anytime you're outside of the OR.
D
deleted480308
A coat doesn’t cause neck strain, you leaning over a surgery for hours does
Just wash the coat and get to graduation
Just wash the coat and get to graduation
Yes. I agree with most of this. I feel I am very professional. And on formal rounds, clinic etc I don’t mind wearing a white coat. But running around the hospital in-between cases sometimes it’s just not convenient. I do not believe your wearing a white coat or not dictates your level of professionalism. And I’m sure we share similar views on the symbolism aspect of them now that everyone can wear one. It’s really unfortunate. I don’t hate them. And I do feel proud to wear one. Unfortunately I don’t always, and not having it on shouldn’t dictate whether someone graduates or not.
That’s the plan.
I do. You may think I’m weird but the embroidery starts to come out and the stitching fades and starts to look like crap. I have a few that I don’t wear often for presentations and stuff. Maybe ours are just cheap. Haha
Patient attitudes to surgeons' attire in an outpatient clinic setting: substance over style. - PubMed - NCBI
Injecting some literature to further stir the debate.....
Injecting some literature to further stir the debate.....
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My wife was seen at Mayo in Rochester. Everyone was in suits. More than half did not have a readable name tag. Only 2 of 6 (one nurse, one doc) introduced themselves. I don't know who most of them were. There were 3 attending surgeons, and one fellow. Honestly, Mayo seemed like a cluster ****.
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Your attending wants you to wear a clown suit, wear a clown suit. The white coat is the "business suit" for Doctors of Medicine. We have several physicians walking around the wards at our academic hospital in a shirt and slacks. I tell them to their faces that they look like floor salesmen at a Buick dealership.
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Am I the only one who reads all of his posts in Ron Swanson's voice? Please tell me it can't be just me.
To the OP: it's a minor issue, wear the white coat for attending and then do what you want after you're done. I hate wearing mine but I think my new institution is big on them and thus it will be worn.
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Funny, my PD threatened to fire me if he saw me wearing a tie in the hospital when I was a PGY2.
We are expected to wear white coats for our case conference, but other than that no expectation. I wear mine to clinic because it has my doppler and stethoscope in it. When I go into practice, I will likely continue to do the same.
We have a very laid back department. We wear scrubs all day, every day. We also function remarkably like a trauma service in terms of the constant controlled chaos, so that may be part of it.
We are expected to wear white coats for our case conference, but other than that no expectation. I wear mine to clinic because it has my doppler and stethoscope in it. When I go into practice, I will likely continue to do the same.
We have a very laid back department. We wear scrubs all day, every day. We also function remarkably like a trauma service in terms of the constant controlled chaos, so that may be part of it.
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It's true, it does sound kind of petty to not train a resident because they wont wear a white coat. But not nearly as petty as eschewing training because you dont want to wear a white coat.
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You dont believe that wearing the white coat dictates your level of professionalism. Ok, that's fine.
But the patients do. And your attending does. So what, precisely, do you feel privileges your beliefs on professionalism here? Do you have some sort of masters degree in medical professionalism? Or is it just self interest that you are cloaking in some sort of well-reasoned, principled anti-white coat professionalism stand? Is "professionalism" just whatever you believe it is?
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Say what you will, wearing the same white coat in between multiple patients' rooms and the hospital and ICUs and CDiff rooms and at codes is definitely spreading infection. I doubt people are washing their white coats daily.
I like being professional as much as the next person, but do people seriously not think these long white coats are gross?
I like being professional as much as the next person, but do people seriously not think these long white coats are gross?
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Dude, it's a white ffs. white=clean
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Well, then I guess we should take decon showers and change into new paper scrubs between rooms. Because after 8 hours in the hospital, there's no difference between your clothes and that old white coat.
J Hosp Med. 2011 Apr;6(4):177-82. doi: 10.1002/jhm.864. Epub 2011 Feb 10.
Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial.
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Did you mean to use the word "definitely" here?
How about you find data that demonstrates any effect on patient outcomes?
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Here, let me PubMed that for you. And if you mistook my comment to mean it influences "hard" outcomes, I apologize for my imprecision. Of course it doesn't influence the actual medical decisions, but it can influence patients perception of their care and therefore impact their experience. In a field where developing rapport is impoortant, and where hospitals perseverate about HCAHPs that's not trivial.
BMJ Open. 2018 May 29;8(5):e021239. doi: 10.1136/bmjopen-2017-021239.
Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA.
And so that you don't accuse me of cherry picking, a meta-analysis which demonstrates the effect is likely dependent on the population you study.
BMJ Open. 2015 Jan 19;5(1):e006578. doi: 10.1136/bmjopen-2014-006578.
Understanding the role of physician attire on patient perceptions: a systematic review of the literature--targeting attire to improve likelihood of rapport (TAILOR) investigators.
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I'm 99% sure he was referring to the lack of evidence about clothes serving as a vector for infection
My attendings say us to wear a white coat or scrubs at everywhere in hospital, whichever we choose
We must respect them so we are doing it but some attendings are really conservative.
In my opinion a white coat is more elegant but i always wear scrubs, because scrubs are more comfy and i feel more free to move with them
and it's a fact that a white coat causes serious neck pain.
Additionally one of the reasons of hospital-acquired infections is the WHITE coat, especially in ICUs, although we wash it everyday.
Even so when my workload is reduced , i will wear a white coat!
I also agree with the opinion that a white coat gives trust to patients
We must respect them so we are doing it but some attendings are really conservative.
In my opinion a white coat is more elegant but i always wear scrubs, because scrubs are more comfy and i feel more free to move with them
and it's a fact that a white coat causes serious neck pain.
Additionally one of the reasons of hospital-acquired infections is the WHITE coat, especially in ICUs, although we wash it everyday.
Even so when my workload is reduced , i will wear a white coat!
I also agree with the opinion that a white coat gives trust to patients
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My attendings say us to wear a white coat or scrubs at everywhere in hospital, whichever we choose
We must respect them so we are doing it but some attendings are really conservative.
In my opinion a white coat is more elegant but i always wear scrubs, because scrubs are more comfy and i feel more free to move with them
and it's a fact that a white coat causes serious neck pain.
Additionally one of the reasons of hospital-acquired infections is the WHITE coat, especially in ICUs, although we wash it everyday.
Even so when my workload is reduced , i will wear a white coat!
I also agree with the opinion that a white coat gives trust to patients
Where are you from?
I am from Turkey, why do you ask me?
Probably because your English isn't very good for a native speaker. But if you're in Turkey it's probably your second or third language, so it's just fine.
yeap, i had already guessed it
i asked because i just wanna to hear that, maybe he thinks that what a shame for me , sorry for my poor english but i am trying to my best
you know medicine is an international area and i must learn english perfectly and it is the reason of why i joined in this forum
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Your English isn't poor; we've had no problem understanding you.yeap, i had already guessed it
Its just that the phrasing is odd which makes it apparent that English is not your first language.
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yeap, i had already guessed it
Your English is better than my Turkish (which is to say I don’t speak a second language really). No one is coming down on you for your use of English, it’s actually quite good for a second language.
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yeap, i had already guessed it
You are more than welcome here and your English is excellent; i was just curious
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I'm pretty sure there's still no data proving that this is the case...
Soo glad to hear that , thanks
)Thanks a lot
Yes, it is really hard to study for that, maybe we can study on that subject , we have a burn care unit in hospital and you can imagine that infection prevention and control is really important and white coat is forbidden there , so it is hard for me :/
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Yeah you absolutely have to follow your hospital policy no matter how misguided, no argument there.
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I haven't worn a white coat in 15 years since residency, and haven't worn anything other then scrubs for the last 10 in both the office and the hospital. I got tired of ruining nice clothes in clinic with body fluids and betadine. I have several pairs of nice black scrubs with my name embroidered I wear in the office, and just use hospital scrubs at the hospital. People insisting on suits/ties are as out of date in a contemporary medical workspace as someone complaining about how nurses don't wear short white skirts, tights, and pinned up hair
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All possibly true. But the OP is a trainee and you yourself note that you wore your white coat in residency. Until the OP is out of training, he has to follow the rules of those responsible for his training.
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Talk to AORN. They probably have a study where a piece of white material was found to be very infected and extrapolated that to white coats.
That material was probably a dressing for a wound...
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Clearly you know that all solid colored fabrics are germ magnets...only fitted floral patterned scrub material has antiseptic properties
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For all those saying white coats cause neck strain, you do realize no one says you have to fill up those pockets right?
It would be balanced , if there are two more pockets in the backside.We haven't already sit down anytime
