Question of coats

[muonwhiz]

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Okay, all of you medical history scholars or others in the know! I've been wondering about the following questions, so answer if you know!
1. Is there (or was there ever) any real utility to wearing of white coats by doctors or med students? It seems to be a very impractical garment, especially the color, since patient contact can sometimes be messy!
2. Are doctors or med students required to wear them or is it by custom and/or personal preference?
3. I've seen these things in several lengths: one that looks like an ordinary blazer, one that comes down to mid calf area and one that is longer than that. What is the significance (if any) of this?
4. Who came first, scientists or physicians? It appears that many scientists and lab personnel wear the white coat, and it may have some protective benefits for them. If the white coat is supposed to be an exclusive symbol of physicians (?) then why do scientists also wear them?
Pour forth your knowledge oh wise ones! Thanks!

 

[Billie]

Hi!

For me, wearing the white coat is personal preference. I have never been on a rotation yet where I was "required" by my preceptor to wear it. My school says we are supposed to, but they are not around to get on me about it. For example, when I am suturing in the ER, I take it off as I find it just easier not to have to worry about it or the sleeves contaminating my field. Other times, I wear it cause I can fit lots of stuff in the pockets and I need to carry that info around. As far as lengths, I have only seen two lengths - long and short. Usually the short ones are for med students and the long ones are for docs. But others may have experienced different kinds of distinctions.

Billie

 

[ebola95]

Coat length signifies your level of experience. The shorter waistcoats are for students rotating through departments, longer coats are for residents, attending usually have them down to their heels, and when the coat touches the floor, it is time to retire!

i have noticed that a lot of docs (at least around here in the clinics)have been tending to wear a darker off-grey color now rather then white....anybody have any suggestions? email me too to let me know!

 

[ewagner]

Every hospital I have rotated through in St. Louis REQUIRES students to wear white coats. And actually I believe it is a good thing. I couldn't imagine doing rounds on the floors without having all my handbooks with me. I have wore out my Washington Manual and my Sanford etc. Where would I keep my reflex hammer?
I also remember getting vomit on my coat while doing chest compressions, and blood on my coat while performing compressions another time. My white coat is a necessity.

Regarding the color...I have never seen any other. THat is not to say they don't exist, I know that the University of Illinois at Peoria wear light blue coats.
Personally, I prefer white.

 

[ckent]

A good thing about white coats is that you can immediately tell if it has gotten "contaminated" with patient bodily fluids, and thus needs to be disposed of or cleaned.

 

[ewagner]

Ha! Like I am gonna throw away my white coat! I have one coat for my remaining year...MAYBE I will wash it.

 

[DepressedNYCOMstudent]

The white coat is undoubtedly a very important garment for a doctor. At NYCOM we med students are REQUIRED to wear it all the time. I always wear it but many students of our class don't wear it for some reason I don't know. Especially now that Summer is coming people don't want to put anything on their shoulders. However, I think that as future doctors we must all put our layman's attire aside and dress appropriately with collared shirts, and full pants/skirts and more importantly in our white coat. ( I mean ...when was the last time you saw your doctor in shorts and a beach T-shirt & sunglasses??!! ) This is a very professional career and everytime a med student puts on his white coat he is reminded of his professional ethics and actions. May the white coat always be white.

 

[dieselkid]

The white coat or surgical coat is an old tradition. Doctors in the past would wear coats during surgical procedures to protect their garments. Having bloodstains, fluid stains, etc. on your coat was considered a badge of honor. Physicians would rarely, if ever, wash these garmets. Dr. Joseph(?) Lister (invented listerine!) as a medical student/practitioner noted that some of this dried bodily material would flake off into surgical fields during procedures. He was the one who surmised that the contamination of surgical fields led to post-operative infections. Subsequently, he pioneered the idea of having sterile surgical fields and he did away with his blood stained coat...to the criticism of the old guard. However, his ideas caught on and I would bet the spotless white coat is homage to Dr. Lister himself. If someone has a different version of this, I'd like to hear it and/or be corrected.

 

[melancholy]

DepressedNYCOMstudent- I would have to agree with your comments on the importance of the white coat for a doctor. I mean.. what better to remind yourself of what you are training to become than the white coat while walking in the hospital or health care environment? As far as the dress code goes, I would also think that it is important to dress the part... might as well get used to wearing more professional clothes before you have to wear it every single day/night at work.

At any rate, where would we all be if we didn't have pens/pencils/penlights slipping out of our breast pocket while bending over to pick something up or take a drink at the fountain? 😀

 

[DepressedNYCOMstudent]

Good one melancholy!!! I guess we will need to put the pencils in our leg pockets!!

 

[Billie]

Originally posted by DepressedNYCOMstudent:
•However, I think that as future doctors we must all put our layman's attire aside and dress appropriately with collared shirts, and full pants/skirts and more importantly in our white coat. ( I mean ...when was the last time you saw your doctor in shorts and a beach T-shirt & sunglasses??!! •

The last time I saw a doc like that was last month in my Family Med II rotation. One doc would come in all the time in jeans and tie-dyed t-shirts. Another would come in sandals with her toe rings showing. No, these aren't students, but docs out practicing. Don't get me wrong, I agree with looking and being professional, but just wanted to give you an idea of some of what is out there. 🙂

Billie

 

[muonwhiz]

Hello, NYCOM! If all students are required to wear white coats at school, then how are some getting away with not doing it? Your message implied that it was mandatory....

 

[Firebird]

I've posted this before...

I have shadowed twice in the ER. Both times, the attending has made sure that I've had a white coat. I think it is for the patient's sake. If I was to walk in there behind him in a shirt, tie, and pants, then they would question why I was there. If I come in dressed like him, in a white coat, they know I'm in medicine (or at least they think I am) and that I'm not just some weird guy being nosy.

Anyone agree?

 

[riverweb]

Yeah, I think the white coat is a must in the hospital--it signals who you are (short coat = medical student; medium length coat = resident; long coat = attending.) However I don't plan to wear one in the office. Ever heard of "white coat syndrome"? Some patients' BP goes up at the sight! I find the coat pretentious for the office, but necessary at the hospital.

 

[DepressedNYCOMstudent]

It is mandatory. And the students who are not wearing are not exactly getting away with it...they have all got dress code warning emails from our dean for not wearing the white coats. Our student handbook says that if we get more than two such warning emails from the dean then a note about it will be inserted in our dean's letter of recommendation.

 

[DepressedNYCOMstudent]

Gee...I don't know where these docs you mention were raised but I was raised in a very strict school....If I wore black socks instead of navy blue, the teachers ( in my home country) would send me back home!! If I came to class a minute a late I was sent tothe headteacher's room and not allowed to enter the class. Because of such a strict upbringing I place high importance to appropriate professional clothing and it really bothers me when I see some girls of our class come in whith shoulderless, sleeveless tight blouses ....but I don;t say anything to them because I know that i only feel this way because of my strict upbringing. But hey! This is America. Wear anything!

Originally posted by Billie:
•The last time I saw a doc like that was last month in my Family Med II rotation. One doc would come in all the time in jeans and tie-dyed t-shirts. Another would come in sandals with her toe rings showing. No, these aren't students, but docs out practicing. Don't get me wrong, I agree with looking and being professional, but just wanted to give you an idea of some of what is out there. 🙂

Billie•

 

[Mikado]

I'm going to be a med student in the fall. I don't much like those short blazer type white coats. Do you think it will be alright for me to wear a long coat instead or would I get flak for doing this?

 

[hermanshermits]

Originally posted by DepressedNYCOMstudent:
•The white coat is undoubtedly a very important garment for a doctor. At NYCOM we med students are REQUIRED to wear it all the time. I always wear it but many students of our class don't wear it for some reason I don't know. Especially now that Summer is coming people don't want to put anything on their shoulders. However, I think that as future doctors we must all put our layman's attire aside and dress appropriately with collared shirts, and full pants/skirts and more importantly in our white coat. ( I mean ...when was the last time you saw your doctor in shorts and a beach T-shirt & sunglasses??!! ) This is a very professional career and everytime a med student puts on his white coat he is reminded of his professional ethics and actions. May the white coat always be white.•

Many professionals do not wear white coats or anything special. For the exception of judges, people with professional degrees (ph.d degrees, engineers, lawyers, psychologists, etc.) all wear STREET clothes.

The word lay refers to working class people. It is weird how people in medicine assume that those not in medicine are lay. We will have professionals as patients too. Psychologists, astrophysicists, physical chemists, mathematicians, etc are not lay people.

As much as people in other fields may be lay to medicine, doctors are lay to other fields (engineering, mathematics, technical law stuff, geology, meterology, oceanography).

I know a doctor who has no idea of what high level physical science courses entail. He has no idea of what physical chemistry is. He has no idea of what is covered in linear algebra. He has no idea of what is covered in a geophysics course...Therefore, he considers himself to be lay to the engineering and mathematical sciences.

 

[hermanshermits]

It is not what you wear that makes you stand out, it is how you present yourselves in front of others. I had a gp who was an a@$. He always wore his white coat. But, many people did not respect him. It didn't matter whether or not he wore his coat.

 

[melancholy]

Hermanshermits- I agree with your clarification of using the term "lay" although I had the impression that we were using "lay" in a relative sense.. someone outside of a specific professional field. (i.e. a doctor being lay to higher level quantum mechanics or mathematics).

As far as the dress code for professionals go, I guess it can vary, but I think there is still a standard of dress code for some professionals in the workplace. What do you consider street clothes?

Mikado- hey, I kinda agree with you on the short lab coats. As I've been working in a clinical lab the past two years, I have always worn long lab coats.. so wearing the shorter one may take some getting used to. I'm not sure whether you will get any flak if you wear a longer coat in the hospital as a medical student. Any comments on this folks?

Riverweb- I'm not sure if I've ever felt the stress of "white coat syndrome", but I do remember the ol' bp going up due to "shot syndrome".. heh.

Also, since I work with biohazardous agents, I'm used to shucking the lab coat whenever I walk into an office or non-laboratory part of the building. Is this ever a concern with doctors' labcoats? I recall being in a hospital cafeteria and there are white coats all over. I suppose if there is a potentially hazardous bodily fluid stain, the lab coat would be exchanged for something cleaner.. or not brought into the public area at all, right?

 

[Firebird]

Originally posted by Mikado:
•I'm going to be a med student in the fall. I don't much like those short blazer type white coats. Do you think it will be alright for me to wear a long coat instead or would I get flak for doing this?•

I don't know for sure, but I would say they won't let you. Short coats are used exclusively (I think) to denote student doctors. If you were to wear a long one no one who didn't know you would assume you were a resident or attending...or a PA or something other than a med student.

 

[Firebird]

Originally posted by hermanshermits:
•The word lay refers to working class people. •

I think it would be better defined as someone who has only common knowledge of a specific subject. A person who inherits 100 million dollars is by no means part of the working class. However, they may be a layman in any number of things.

But you sort of said that later on in your post.

Melancholy I would say that if a doctor gets something on their coat they'll take it off as soon as possible and then get it washed (or maybe throw it away, depending on what the stain is). They certainly wouldn't walk around the hospital with blood all over them.

 

[DepressedNYCOMstudent]

Calm down! I didn't mean to hurt any other profession by my use of the word "lay". My cousin is a pHD in physics and that doesn't mean that he is lay. I wear layman's clothes AT HOME in my privacy. Please don't misunderstand my use of the word "lay". I just needed another word for clothes other than the professional dress attire. Fill in your choice of words instead of 'lay'. I am sorry that it upset you..I really didn't think it would!

By the way, my definition of streetclothes includes jeans and tshirts that cover the full body except the head. It does not include beach wear where people were sleeveless, shoulderless tops. If people want to dress like Britney Spears for med school it would be nice that they always have their white coat on to cover themselves professionally. But, hey this is only what I think and I don't control anybody. Everybody is allowed to wear anything they want.
So, calm down everybody. I am sorry for whatever it is that got you so upset.

 

[Hskermdic]

Depressed,
I think having a mandatory rule to wear white coats to school sounds horrible. Thank goodness I don't go to school there I would be miserable. I love the white coat and all of its pockets but other than that I hate it. I am a very warm blooded person, I almost never wear long sleeved shirts and have only worn a coat to school a few times this year, I just get too warm. I can't imagine spending all that time in class wearing things that I was warm in.

I can appreciate your point that we need to learn to act professional while we are still in the classroom but at the same time we need to still have the opportunity to express ourselves and be ourselves. We can learn to act professinally without wearing a white coat every day.

As for white coats in the hospital, where else will you put all of the cool gadgets and books bought during the first year with the excuse that I will need it for rotations. Seriously though I have always though of the short white coat as being there so the nurses knew not to let us hurt any patients or do anything stupid.

 

[Winged Scapula]

Originally posted by Mikado:
•I'm going to be a med student in the fall. I don't much like those short blazer type white coats. Do you think it will be alright for me to wear a long coat instead or would I get flak for doing this?•

Uhh...no. It is NOT alright. The fact is that there is a well-defined hierachy within medicine for the length of one's lab coat. By wearing a long(er) coat you will not only confuse patients (whom, if they are chronically ill probably know the hierarchy as well), but the housestaff and attendings and will *most* likely receive flak from your classmates for "playing resident". It is inappropriate to adopt something which implies you are more experienced than you are.

I'm sure you won't be allowed and even if you were, it would be a mistake, IMHO. Too much potential for confusion, teasing and disparaging comments.

Hope this helps.

 

[premedmijo]

Depressed, you are required to wear the coat to class? Or only on rotations?

 

[dieselkid]

The coat is definately a signifier to the public. I volunteer in an ED and I wear the assigned darkgreen volunteer jacket. Because I am simply wearing a jacket I get asked if I am a doctor, a lot. I guess the nice thing about this is that I then get to give a pitch for the volunteer program.

 

[melancholy]

DepressedNYCOMstudent- Wow.. doctors or potential doctors dressing like Britney Spears under the white coat? That might make being on-call more exciting once in awhile heh.

I don't think any of us were getting ruffled about the "lay" thing.. just that some of us wanted to clarify its use. Hehe.. that'll teach you to think before you use a word like "lay"! 😉

Dieselkid- I remember when I was volunteering, we had an option of either a blue/pink jacket/vest or a polo shirt with a patch. For some reason, it seemed like all the older volunteers (40+) were the ones wearing the jacket so I decided to go with my polo shirt and patch on the arm. Consequently, I didn't really get asked if I was a doctor or not. 😛

 

[hermanshermits]

Ok then...

As many professionals are lay to medicine, many doctors are lay to other fields. Many years ago as an undergraduate my doctor asked me,"what are you studying this semester?" I replied,"Math and Chemistry." He asked, "What type of math and chemistry are you taking?" I answered, "Matrix algebra and physical chemistry." He replied, "what is matrix algebra and what is involved in physical chemistry? They could be food for all I know." I did the best I could to describe the courses.

 

[muonwhiz]

I have heard that only NYCOM and NOVA require students to wear white coats to class. Am I right or do other osteopathic schools require it? A friend of mine interviewed at NOVA and was told that all students must wear white coats and scrubs or professional attire (ties, skirt, etc.). The Dean told his interview group that the professional attire gave the school a special atmosphere and also impressed visitors. I have heard that alot of students like it.

 

[acaban]

Hi muonwhiz: You are right about NSUCOM. I have heard many positive remarks from students regarding the white coat. I think it does help keep a prof. environment. AJC 😀

 

[muonwhiz]

Any schools other than NYCOM and NOVA that require the wearing of these coats?

 

[dieselkid]

Melancholy- Wow. Nope, no choices on what to wear in our volunteer department...county hospital.