White coats

[JadedSurgeon]

Does this bother anyone else?

At the hospital I do clinicals in, all social workers are required to wear white coats just like the doctors.

This shouldn't matter since I hate wearing white coats anyway, but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

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[BigNavyPedsGuy]

but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

Get over yourself

 

[soeagerun2or]

Does this bother anyone else?

At the hospital I do clinicals in, all social workers are required to wear white coats just like the doctors.

This shouldn't matter since I hate wearing white coats anyway, but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

We stole them from lab monkey Ph.D.s anyway..

 

[zimmie256]

I think it can be confusing for patients to understand who's who when everyone dresses so similarly. My husband was recently hospitalized, and he wasn't always sure who his doctors were (despite being a very intelligent and reasonably observant person).

 

[Schaden Freud]

That's why you gotta keep the stethoscope out.

Does this bother anyone else?

At the hospital I do clinicals in, all social workers are required to wear white coats just like the doctors.

This shouldn't matter since I hate wearing white coats anyway, but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

 

[da8s0859q]

but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

 

[PugMD]

Does this bother anyone else?

At the hospital I do clinicals in, all social workers are required to wear white coats just like the doctors.

This shouldn't matter since I hate wearing white coats anyway, but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

You shouldnt worry about this because they are "elevated to the same level as doctors," rather that it might be more confusing for patients trying to distinguish between healthcare professionals. It shouldn't be a BIG deal, but IMO social workers should not dress like clinicians within the hospital system.

 

[Wizard of Oz]

Patients are clueless any which way. How many do you think understand the differences between waist-length med student, staff-length resident, and full-length attending? In my brief life as a phlebotomist, the majority of pts would have let me done a full H/P on them despite my mere two-weeks of training. BTW I had to wear a coat to keep from inadvertantly getting blood on myself. You gonna complain about that too?

As I've noted before, I hate the coats because I think that they cause white coat syndrome, nor do I think I deserve to wear one if they are to represent doctors' status.

I think you need to deal though. I'm grateful that we have social workers. Let 'em wear what they want.

 

[stoic]

get over the white coat thing. everyone wears them.

and remember, the reason to get a good stethoscope is so you look more important than the nurses.

 

[Dr Who]

I agree with the posters who say to get over it. A white coat does not make a doctor. If a patient is confused then simply answer their questions and clarify any doubts about your status in the hospital. I am pretty sure any reasonably intelligent human being will understand the difference after it is explained to them.
If a med student is so worried about status symbols then maybe he/ she should think long and hard about what medicine is all about. Remember that we as med students are on the lowest rung of the ladder, lower than even nurse practitioners. A bit of humility would do some good. Now go study and forget about nonsense such as who gets to wear a white coat and who doesnt.

Dr Who

 

[stoic]

i should add that a lot of how patients and everyone else reacts to you is dependent on how you carry yourself.

if you are a bumbling idiot, with or without a white coat, people will treat you as such.

if you walk into the room like you know what you're talking about, people will treat you well (usually) no matter what you're wearing.

 

[ForbiddenComma]

Which hospital was it that uses color-coded scrubs?

That seems to be the way to go.

I need my white coat, though. It's the only way to carry all my stuff without a manpurse.

 

[Bertelman]

Whew! It's been so long since there was a white coat thread. I was beginning to think the current crew of MS3s had gotten over the prestige thing. Next thing you know, they'll be pissed because the crew that mops the floor makes more money than they do.

listen to what stoic says. As a med student in a short white coat, how you carry yourself says much more than your unifrom. Learn how to do so, and you will earn much more respect than you likely deserve

 

[Flopotomist]

I think the OP brings up a valid concern, and suggestions to "get over it" just miss his point. There are REASONS why there should be NO confusion over who the physician is that is caring for a patient.

Social workers, nurses, lab techs, phlebotomists and other allied health workers all play an important role that must not be minimized, however the reality is that there IS a hierarchy when it comes to patient care, and that hierarchy ends with a physician.

Before somebody says "the white coat is for safety" I say hogwash. There are plenty of other protective pieces of clothing that do not carry the same history as the white coat.

 

[Law2Doc]

get over the white coat thing.

Agree -- everyone knows it's not fashionable to wear white after labor day anyhow.

 

[Bertelman]

I think the OP brings up a valid concern, and suggestions to "get over it" just miss his point. There are REASONS why there should be NO confusion over who the physician is that is caring for a patient.

Social workers, nurses, lab techs, phlebotomists and other allied health workers all play an important role that must not be minimized, however the reality is that there IS a hierarchy when it comes to patient care, and that hierarchy ends with a physician.

Before somebody says "the white coat is for safety" I say hogwash. There are plenty of other protective pieces of clothing that do not carry the same history as the white coat.

I agree the patient should know which monkey is the physician. I don't think that is accomplished by a single, exclusive article of clothing. An I.D. badge is a good start, but an even better bet is for the doc to actually introduce themselves as such. Seems intuitive, but it often does not occur. That's why patients are confused.

I just don't like it when a med student starts calling out ancillary staff and other professionals for an article of clothing when they likely deliver more to the care of the pt. than he/she does.

The part of me that attended my white coat ceremony is saddened that this coat is not as sacred as promised. Of course, I used to work as a phlebotomist and I wore a long one. I promise it was more functional then than my shortie as a med student. I never used half the crap I stuffed in those pockets. What exactly will we do as physicians? Create a campus-wide dress code? That seems silly. Frankly, outside the academic institution, I don't remember seeing too many white coats.

Does this bother anybody else? Maybe...

http://forums.studentdoctor.net/showthread.php?t=238442

 

[Wizard of Oz]

There are plenty of other protective pieces of clothing that do not carry the same history as the white coat.

The wonderful thing about history is that history needn't represent the future.

I love Bertelman's avatar!

 

[soeagerun2or]

I agree the patient should know which monkey is the physician. I don't think that is accomplished by a single, exclusive article of clothing. An I.D. badge is a good start, but an even better bet is for the doc to actually introduce themselves as such. Seems intuitive, but it often does not occur. That's why patients are confused.

It doesn't help when pharmacists, PT/OT, nurse Ph.D.s, psychologists and so on introduce themselves as Dr. so-and-so. True they are a doctor but it's misleading the patient into thinking they are a physician (MD or DO).

 

[Bertelman]

It doesn't help when pharmacists, PT/OT, nurse Ph.D.s, psychologists and so on introduce themselves as Dr. so-and-so. True they are a doctor but it's misleading the patient into thinking they are a physician (MD or DO).

Funny, I'm not protective of things like white coats, but I do wish others would not use the "doctor" title.

 

[Wizard of Oz]

I'd actually prefer a different term than "doctor." Anybody know what they use in the UK or Europe? Is somebody with an MBBS still a "doctor?"

The reason I don't like "doctor" is because it comes from the Latin for "teacher," i.e. it's intended application was for professors.

Really I'd just as soon pts call me by my first name (or "Wizard" is fine too).

 

[ForbiddenComma]

Yes, yes, we all know how good and egalitarian you are.

 

[stoic]

i actually try to get out of wearing my white coat as much as possible. the only time i put it in happily is when i'm cold. it just seems kind of pretencious (sp?) to me. plus people ask you directions and **** when you have the coat on.

 

[StarboardMD]

I'm with Stoic. As an MS1, everyone in the entire building, including the receptionists, have more pertinient knowledge than me. When I see patients with the PA (who introduces me as "Dr. Starboard"), patients often address their questions to me. Little do they know that I'm just standing there trying not to look any more ignorant than absolutely necessary. If white coats are supposed to be so indicative of someone's medical know-how, then why did we get white coats before classes even started?

 

[ForbiddenComma]

Actually we get SHORT white coats. That's how they know the difference.

We are the only people in the hospital who wear the Short White Coat of Shame.

 

[Tired]

I'm with Stoic. As an MS1, everyone in the entire building, including the receptionists, have more pertinient knowledge than me. When I see patients with the PA (who introduces me as "Dr. Starboard"), patients often address their questions to me. Little do they know that I'm just standing there trying not to look any more ignorant than absolutely necessary. If white coats are supposed to be so indicative of someone's medical know-how, then why did we get white coats before classes even started?

I hate it when med students jump on the "Yeah, med students do suck!" bandwagon. You need to get over this real quick, because there will be enough Allied Health people dragging you down over the next four years, you don't need to help them.

The issue with coats is not that they indicate medical knowledge, it is that they indicate medical position. Or at least they did until every other specialty in the house decided they wanted one too. Patients still associate a white coat with medicine, and while they easily recognize the difference between a short and long coat (student vs physician), they have a harder time with long coat and long coat (RN vs SW vs pharmacist vs physician).

And while clear introductions, name badges, and other techniques can help clear up confusion, your average sick patient in the hospital sees dozens of health care professionals, and is unlikely to remember how the 15th person introduced themself.

I'm not particularly bothered by other disciplines wearing the coat, I'm just confused why they want to. Phlebotomists also wear long white coats, but where I am at, they look substantially different from any doctors' coat. I wonder why nursing had to just start wearing ones that look exactly like ours.

 

[soeagerun2or]

I'm with Stoic. As an MS1, everyone in the entire building, including the receptionists, have more pertinient knowledge than me.

Wow! If that's really the case you should go back to high school.

 

[group_theory]

I'd actually prefer a different term than "doctor." Anybody know what they use in the UK or Europe? Is somebody with an MBBS still a "doctor?"

The reason I don't like "doctor" is because it comes from the Latin for "teacher," i.e. it's intended application was for professors.

Really I'd just as soon pts call me by my first name (or "Wizard" is fine too).

The term "doctor" and "physicians" have different uses depending on the country and the culture.

In a lot of countries, physicians are called "doctor" whether they have a doctorate or a MBBS (or equivalent). In some countries, "physicians" are only reserved for those who specialize in Internal Medicine or its subfield, with the term "doctor" used for all others except surgeons.

I believe in Germany, if you graduate from med school before completing a dissertation, you are a physician but can't call yourself a doctor (doktor in german), until you finish the dissertation.

Unfortunately in the US, the term "physician" is not exclusive domain of MDs/DOs ... depending on state laws and Medicare regulations ... chiropractors and naturopaths can call themselves "physicians".


As for the term "doctor" and its latin origin ... I never liked that argument. There are other modern English words for teachers ... such as teachers, professors (in the common use, not as an academic rank), instructor, tutors, sensei, etc. English is a living language and is meant to evolve and its usage change over time. If you want to stick with its roots, doctor should only be used by "church fathers" whom first use the word "doctour" to describe themselves in the 1300s (according to the Oxford English Dictionary, OED). It was not until 1377 that it was used in the sense of "medical doctor," or one who treats illnesses or diseases was found in known written literature (in English). The word "doctor" may have been spoken for many years to refer to medical practitioners before it was written down.

That's over 630 years of common usage of "doctor" to mean medical practitioner.

 

[Wizard of Oz]

As for the term "doctor" and its latin origin ... I never liked that argument. There are other modern English words for teachers ... such as teachers, professors (in the common use, not as an academic rank), instructor, tutors, sensei, etc. English is a living language and is meant to evolve and its usage change over time.

Good enough. Now let's let it evolve back out of medicine. In this day and age, we have licensed practitioners who are not "doctors" and "doctors" who are not licensed to practice medicine. In the current medical arena, pharmacists have become Pharm D.'s (who also have a white coat ceremony), audiologists AuD's, and even physical therapy has mutated into a doctoral program. So do you call a new pharmacist "doctor" and one trained twenty years ago "mister?" They didn't just change the degree programs so that they could charge more for the tuition. They did it to bring more notoriety to their professions.

It's a system that is unnecessarily complicated. It is we who demand that it be complicated because we don't think that anybody else deserves this mighty label or this powerful cloak. While we continue to elbow around with other types of healthcare workers, we're just confusing patients.

 

[group_theory]

I think we're giving up the use of "doctor" a little too quickly ... it has been in use for over 600 years to mean a medical practitioner ... even before it was customary to use "doctor" to denote those who hold academic doctorates

Fair or not, the use of "doctor" to mean medical practitioner is ingrain into our society, culture, language, history, etc. For a elementary school child to say "I want to be a doctor when I grow up" means that he/she wants to be a medical practitioner, not a pharmacist PharmD or an audiologist AuD or a physical therapist DPT, or even a chiropractor DC. (to be fair, the child probably means MD too since most don't know what a DO is). If a grandmother tells her family "i have a doctor's appointment today" she probably means a medical doctor, not an audiologist appointment, or a scheduled clinical counseling apointment with a pharmacist, or physical therapy appointment.

Hey, if the allied health practitioners earned their doctorates, they have every right to use the title. I just don't think the MDs/DOs will necessarily have to give up the rights to "doctor" too. And because doctor is soo ingrained into our society, even if we come up with a new title, patients will never know what it means and the confusion will continue with the multiple "doctors".

Now once you start requiring a "doctor of medical environmental services" to work in a hospital or a "doctor of food preparation, nutrition, and serving" to work in a hospital caffeteria or "doctor of unit managerial tasking" to work as a unit clerk ... well, then I would agree that we've gone too far.

 

[OncoCaP]

We could all start wearing these and that should eliminate all the confusion about who is an MD and who isn't :

The medical students could wear a sleeveless version, I suppose ....

 

[Wizard of Oz]

Tell me how you feel about this scenario. True story.

I go to my workman's comp clinic (Concentra) for a TB skin test and a pulmonary function test. The clerk says, "The nurse will give you your skin test in a minute." The nurse does, and the nurse administers the PFT. He then says, "The doctor will go over your PFT with you in a minute." He does.

Here's the catch. The nurse isn't really a nurse. He's a medical assistant. The doctor isn't really a doctor either. He's a PA. There is no RN, LPN, NP, MD, or DO on site.

Now I honestly don't care because it doesn't matter to me; but if they're using this terminology to me (whom they know is a med tech because of why I'm there), they're using it for everyone who comes in. For the intents and purposes of the clinic, it matters little. There is a legal probability that a licensed physician will review the PA's charts, and you don't have to be a nurse to administer vaccines or TB skin tests.

Is this practice okay with you? Because it's the rule for clinic practice in my state and not the exception.

 

[OncoCaP]

Tell me how you feel about this scenario. True story.

I go to my workman's comp clinic (Concentra) for a TB skin test and a pulmonary function test. The clerk says, "The nurse will give you your skin test in a minute." The nurse does, and the nurse administers the PFT. He then says, "The doctor will go over your PFT with you in a minute." He does.

Here's the catch. The nurse isn't really a nurse. He's a medical assistant. The doctor isn't really a doctor either. He's a PA. There is no RN, LPN, NP, MD, or DO on site.

Now I honestly don't care because it doesn't matter to me; but if they're using this terminology to me (whom they know is a med tech because of why I'm there), they're using it for everyone who comes in. For the intents and purposes of the clinic, it matters little. There is a legal probability that a licensed physician will review the PA's charts, and you don't have to be a nurse to administer vaccines or TB skin tests.

Is this practice okay with you? Because it's the rule for clinic practice in my state and not the exception.

Here's a more bothersome case of mixing the MD's in with the other kinds of doctors. This case got my attention. Read this story (You will need to create a free account to read the original story I have copied & pasted below):

http://www.statesman.com/search/content/news/stories/local/01/06/6roundup.html?COXnetJSessionIDbuild179b=Fg3LiWH5H5bpLA1wAi3fk411nCzA2DAmMrjcAYQQZfJVCFjTmjdk!2142733147&UrAuth=`N`NUOcNZUbTTUWUXUVUZTYU_UWU]U_UZUaU`UcTYWVVZV&urcm=y
************************************************
Doctor accused of sexual assault

Austin police have charged a doctor with sexually assaulting a woman during a procedure.

Investigators said Dr. Thuy Pete Nguyen, 35, assaulted the patient, whom they did not identify, Dec. 29 at the Texas Pain Network on West William Cannon Drive.

Thuy Pete Nguyen Doctor called female patient to apologize, affidavit says.

The woman called police after leaving the doctor's office.

According to an arrest affidavit, Nguyen called the woman and apologized. He told the woman, "I got a little carried away," the affidavit said.

Bail for Nguyen was set at $25,000.

*************************************

You're thinking MD quack, right? Read this version:

http://www.590klbj.com/News/Story.aspx?ID=61937

Doctor accused of sexual assault on patient
1/5/2007

Austin police arrest Dr. Thuy Pete Nguyen after a patient claims he touched her in an inappropriate manner during treatment. The incident allegedly happened on December 29th at the Texas Pain Network clinic on W. William Cannon.

Police say a woman had come in for an electrolysis treatment from Dr. Nguyen, and during that treatment mentioned that she had also been experiencing pain in her lower back. Dr. Nguen, who is a chiropractor, then offered to perform a chiropractic adjustment. But during that treatment, police say Dr. Nguyen touched the woman below the waist in a manner that qualifies as sexual assault. The woman immediately fled the office and called police.

"If there is someone who has been a patient of Dr. Nguyen and has been under any kind of situation where there was inappropriate action, we certainly would like them to notify our sex crimes detectives so that can be investigated," said APD Commander Duane McNeil.

According to police, Dr. Nguyen immediately called the woman on her cell phone to apologize. "It lays out the culpable mental state as to what their thought process was, which certainly strengthens the case," McNeil said of that phone call.

Nguyen is under arrest on a charge of sexual assault and is being held on $25,000 bond. He has been a licensed chiropractor in Texas since 2000 and has no previous record of any disciplinary action from the Texas Board of Chiropractic Examiners.

*****

Now, I realize there are unfortunately several MD's who have done the same thing ... what surprised me is that our local newspaper brief just called him a "doctor" without mentioning that he was a chiropractor (not that it would make the patient feel any better that this was clarified).

 

[ForbiddenComma]

.

 

[MyNameIsOtto]

Does this bother anyone else?

At the hospital I do clinicals in, all social workers are required to wear white coats just like the doctors.

This shouldn't matter since I hate wearing white coats anyway, but I can't stand that fact that social workers are elevated to the same level of doctors as far as uniform is concerned.

Get off your high horse.

 

[Sinnman]

Get off your high horse.

It's NOT high horse. It IS a very well thought out plan by a variety of non-physician providers to diminish the "status" of physicians in order to increase their own agendas.

I've been around healthcare for well over a decade in a variety of capacities and I can assure you that as stupid as you think this white coat issue is it DOES have significance to other providers. I have even been part of a discussion at the college faculty level where the white coat issue was brought up it order to "achieve the same level of authority as the doctors."

You may think people are on a high horse, but I think your perspective will change after you have more invested in the profession. I can almost guarantee you that after three more years of medical school and many more years of residency, when you are being told how to manage your patient by a nurse practitioner you will understand some of the feelings here.

Every inch given will result in a mile taken.

 

[Wizard of Oz]

I have even been part of a discussion at the college faculty level where the white coat issue was brought up it order to "achieve the same level of authority as the doctors."

You may think people are on a high horse, but I think your perspective will change after you have more invested in the profession. I can almost guarantee you that after three more years of medical school and many more years of residency, when you are being told how to manage your patient by a nurse practitioner you will understand some of the feelings here.

Such perspective change is not so common among people who have worn the coat in a different role (PA, nurse, pharmacist, whatever) before going to med school. You can't guarantee the feelings of others, and it is in the doctors' best interest to employ mid-level providers (regardless of what they wear) who are equally respected by patients if they want to make money off of them. Otherwise you can't let them practice unsupervised, and you negate the value of hiring them to cover your easier cases.

The role of the physician and other healthcare team members is determined by state licensing bodies, not college faculty. If you think that the demands of physician training equate to the doctor feeling jaded enough to be the only one worthy of a given status, then you have just created a disruption in the concept of teamwork.

Every inch given will result in a mile taken.

The first sign that someone is on a high horse is a statement like this one.

 

[MacGyver]

it is in the doctors' best interest to employ mid-level providers (regardless of what they wear) who are equally respected by patients if they want to make money off of them.

This is short sighted thinking that has screwed doctors over.

http://www.ohiopa.com/PA%20Bulletin.htm

take a close look at this link. The doctors who were using PAs as hospitalists just lost the ability to supervise and bill for their work. Thats right, in Ohio PA hospitalists NO LONGER NEED DOCTOR SUPERVISION.

This is what happens when doctors ***** their profession to outsiders. All the docs can kiss that money stream goodbye now.

 

[Wizard of Oz]

This is short sighted thinking that has screwed doctors over.

This is what happens when doctors ***** their profession to outsiders. All the docs can kiss that money stream goodbye now.

Well unfortunately this whoring is the doctors' own doing. How many US grads are out there competing to do primary care? AAMC has called on med schools to increase the number of available docs, yet residency program numbers remain stagnant. So we still aren't willing to train new docs to meet demand levels as the baby boomer population in need of healthcare rises. In the meanwhile, docs are RUNNING AWAY from primary care, in part because they fear not making a handsome profit on their educations. Do you want to do primary care in an underserved area? If not, then we need somebody to do it. And if lawmakers see PA's or NP's as a cheaper alternative, then fine by me. Docs obviously wanted them out there or they wouldn't have hired them in the first place. You can rest assured that the trend will reverse back on itself when all of these "bad" providers prove that they're unworthy and cause lawsuits (hence negating the cost effectiveness advantage).

Look, all you have to do is bribe your congressmen if you don't like this stuff. The drug companies engage in this type of lobbying strategy all the time. Alternatively, campaign for lawmakers who support your views and explain to the public why it is necessary that only licensed physicians should be able to practice. And DON'T EVER HIRE PA'S. We can't have people out there thinking that it's okay to prescribe drugs without having been to a bona fide medical school.

 

[Tired]

This is short sighted thinking that has screwed doctors over.

http://www.ohiopa.com/PA Bulletin.htm

take a close look at this link. The doctors who were using PAs as hospitalists just lost the ability to supervise and bill for their work. Thats right, in Ohio PA hospitalists NO LONGER NEED DOCTOR SUPERVISION.

This is what happens when doctors ***** their profession to outsiders. All the docs can kiss that money stream goodbye now.

Absolutely correct.

Of course, we'll see how long the PAs want that responsibility once they start getting sued.

 

[ForbiddenComma]

You can't guarantee the feelings of others,

If you think that the demands of physician training equate to the doctor feeling jaded enough to be the only one worthy of a given status, then you have just created a disruption in the concept of teamwork.

Oh God, there it is. More "empathy." Please, make it stop!

No, Wizard, the physician is not an equal member of the team. He or she just isn't. The physician is the leader and yes, even the superior. I know that is not politically correct and it might hurt someone's feelings, and I know that saying we're all so wonderfully equal makes you look like a moral paragon on this internet forum, but that's just the way it is and that is what we are being trained to do.

That doesn't make doctors better people in any way, any more than a marketing firm's VP is "better" than the secretary. But he does outrank her and he does serve a more vital role.

During surgery, the surgeon orders and the nurses and techs follow. Would you rather have decisions be up to debate when you're having your own colon resected?

 

[OncoCaP]

This is short sighted thinking that has screwed doctors over.

http://www.ohiopa.com/PA%20Bulletin.htm

take a close look at this link. The doctors who were using PAs as hospitalists just lost the ability to supervise and bill for their work. Thats right, in Ohio PA hospitalists NO LONGER NEED DOCTOR SUPERVISION.

This is what happens when doctors ***** their profession to outsiders. All the docs can kiss that money stream goodbye now.

Here is an update on the law, which passed, was signed, and is now in effect:
http://www.bricker.com/publications/articles/962.pdf

As far as I can tell, it will make health care more accessible at comparable cost. We can argue about whether that healthcare will be of comparable quality, but it does appear to make it more available. If our goal is to squeeze as much cash out of patients as possible, then this new law in Ohio is a problem. If it reduces the quality of care, then I would consider that a problem as well. The patients are already being treated by PA's anyway, so I'm not sure it would change the quality of care very much. If our goal is to provide the best care possible to as many patients as possible, it could be part of a solution by increasing availability.

 

[Wizard of Oz]

No, Wizard, the physician is not an equal member of the team. He or she just isn't. The physician is the leader and yes, even the superior. I know that is not politically correct and it might hurt someone's feelings, and I know that saying we're all so wonderfully equal makes you look like a moral paragon on this internet forum, but that's just the way it is and that is what we are being trained to do.

Where did I say "equal?" I didn't. By teamwork, I didn't mean that everybody ought to be considered equal. I just don't see why somebody else wearing a coat undermines MY role.

 

[Bertelman]

A short time ago, I was at a Kiehl's store purchasing a Christmas gift. For those not in the know, they make boutique grooming products. Think $8 for a tube of lip balm, with some vague guarantee of making you a better person.

When the storekeeper came to help me, I noticed he was wearing a long white lab coat. Hmmm...instant respect. All of a sudden, I believed his guarantee. I thought, "This fine young man must have a degree in lip balmology."

Point is, these subtle ploys to command respect occur in every industry, and there is really no way to reign it in. Instead of worrying about who has priveleges to wear a swath of white fabric, let's control what we can. WE need to maintain professionalism. Dress appropriately. Act appropriately. I promise that once the social worker begins to discuss discharge plans and arrange transport, the patient will understand this is not the M.D.

 

[Wizard of Oz]

A short time ago, I was at a Kiehl's store purchasing a Christmas gift. For those not in the know, they make boutique grooming products. Think $8 for a tube of lip balm, with some vague guarantee of making you a better person.

When the storekeeper came to help me, I noticed he was wearing a long white lab coat. Hmmm...instant respect. All of a sudden, I believed his guarantee. I thought, "This fine young man must have a degree in lip balmology."

Point is, these subtle ploys to command respect occur in every industry, and there is really no way to reign it in. Instead of worrying about who has priveleges to wear a swath of white fabric, let's control what we can. WE need to maintain professionalism. Dress appropriately. Act appropriately. I promise that once the social worker begins to discuss discharge plans and arrange transport, the patient will understand this is not the M.D.

Excellent point!

 

[Northerner]

It's sad to say, but the people who are saying the practice of medicine is slipping through our fingers are absolutely correct.

We're reaching a point where physicians will become forced to choose what rights and privileges they want to maintain within the profession and then fight to keep them. It's disappointing to know your sacred profession is being slowly invaded and attacked from all sides (to dramatize it to the maximum extent possible), but I think physicians will need to get over that disappointment and fight. While we were comfortably enjoying our little monopoly, people with less rights and responsibilities in the care of our patients were building up their clout to get things done to suit their interests. All of a sudden we see these groups have the lobbying power to get what they want, which is part of our practice, and now we're scared. Not just for our own livelihood, but for our healthcare system. If we were convinced we were opening up some of our rights and responsibilities to these groups in the best interest of our patients, it'd be easier to bear. Some movements are in the best interest of the patient, some are for financial reasons, some are for political reasons. We need to figure out which issues to fight, and fight them.

 

[Bertelman]

psssst....for the SDN double-fisters, McGyver has bumped the other white coat thread in Clinical Rotations.

 

[da8s0859q]

A short time ago, I was at a Kiehl's store purchasing a Christmas gift. For those not in the know, they make boutique grooming products. Think $8 for a tube of lip balm, with some vague guarantee of making you a better person.

When the storekeeper came to help me, I noticed he was wearing a long white lab coat. Hmmm...instant respect. All of a sudden, I believed his guarantee. I thought, "This fine young man must have a degree in lip balmology."

Point is, these subtle ploys to command respect occur in every industry, and there is really no way to reign it in. Instead of worrying about who has priveleges to wear a swath of white fabric, let's control what we can. WE need to maintain professionalism. Dress appropriately. Act appropriately. I promise that once the social worker begins to discuss discharge plans and arrange transport, the patient will understand this is not the M.D.

Nicely put.

 

[Tired]

Point is, these subtle ploys to command respect occur in every industry, and there is really no way to reign it in. Instead of worrying about who has priveleges to wear a swath of white fabric, let's control what we can. WE need to maintain professionalism. Dress appropriately. Act appropriately. I promise that once the social worker begins to discuss discharge plans and arrange transport, the patient will understand this is not the M.D.

Yes, they will eventually understand. But maybe the larger issue is that physicians have ceded far too much authority over patient care to non-physicians. All the points made here about other disciplines steadily encroaching on domains traditionally determined by medicine are absolutely correct. We have transitioned from a physician-led health care team, to a situation where nurses decide on discharge dates, administrators dictate care plans, PAs perform surgery, and RNs override orders.

The white coat is symptomatic of this general trend. If the long white coat really means nothing, and everyone who thinks it should be reserved for attendings is being pompous, then explain to me why students are not permitted to wear one? Why are students required to wear the short white coat in every clinical encounter?

Ask any faculty member, and they will tell you it is so that students are easily distinguished from residents and attendings. This, however, is not supposed to be an issue when nurses, social workers, and pharmacists wear one? Why, during my MS3 year, was I forced to wear a short coat while the nursing students ran around in long white coats?

The truth is that other disciplines wear the physician's coat because physicians have given up the authority of their position. Med students cannot wear it, because physicians still maintain some degree of control over their own students. However, as a discipline, medicine has become too cowardly to require other members of the "team" to show appropriate respect for doctors and their traditional uniform.

In my mind, this is tragic.

 

[SocialistMD]

A short time ago, I was at a Kiehl's store purchasing a Christmas gift. For those not in the know, they make boutique grooming products. Think $8 for a tube of lip balm, with some vague guarantee of making you a better person.

When the storekeeper came to help me, I noticed he was wearing a long white lab coat.

I found that funny, too. I pointed it out to my wife and we both had a good little laugh. People in the mall were looking at us funny, but we knew what the real joke was, we knew...

Seriously, I think it is interesting that many of you take other people wearing white coats (length aside) as disrespectful to physicians. Most people wear them because they are required to by their departments (lab/pharmacy folks), they help to protect their clothes (nurses/phlebotomists) or because it helps to carry their supplies (PT/OT, social work, etc...). Try to find a cheap coat with big pockets to hold your stuff at the bookstore/scrub shop and then try to find one that will match everything you might wear to work if you don't wear scrubs; the only option is white. It doesn't take away at all what you have done and who you are in the patients' eyes.

As someone said earlier, you always introduce yourself and your role to each patient so the people who actually matter will always know the difference. The only people who won't know your status from that of the lab tech walking next to you are people you pass in the hall, people whose opinion should not even matter to you and people who certainly have nothing to do with patient care.

Trust me, you will get over this when you realize there are many more important things that go on inside the hospital than simply how you look.

 

[osmodiar]

do we do the job we do for the fame?....

or actually by interest.