Who should wear the white coat?

[lvspro]

I just posted this in another thread, and decided that I'd like some input from the rest of the M3/4's.

I've always thought that docs should be the only ones wearing white coats. Some people may say they want the coat for protection, but they could get a blue coat for the same price. I think the practice of being too lenient on who wears the coat is confusing patients. I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.
Something else that annoys me is that I'm wearing a short coat, while everyone around me is wearing the long coat, be they pro's or not. I always thought that the white coat was a mark of distinction. Don't get me wrong, I don't need MD emblazoned across my forehead to validate myself, but I just thought it was a kinda privelage to wear a white coat. Oh well, maybe I'm just a little old-fashioned.
B4 this turns in to a doc vs para thread, I must say that my colleagues, be they PA's, nurses, or even secretaties are invaluable resources, I just think there is an element of confusion on behalf of the pt. I've always considered doing a study on this, and I'm willing to bet that at least a majority, if not a marginal one, of the patients who are interviewed by para's in long coats are under the impression that they are talking to a doc.
Anyhoo, lemme know what y'all think.

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[Pox in a box]

I just posted this in another thread, and decided that I'd like some input from the rest of the M3/4's.

I've always thought that docs should be the only ones wearing white coats. Some people may say they want the coat for protection, but they could get a blue coat for the same price. I think the practice of being too lenient on who wears the coat is confusing patients. I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.
Something else that annoys me is that I'm wearing a short coat, while everyone around me is wearing the long coat, be they pro's or not. I always thought that the white coat was a mark of distinction. Don't get me wrong, I don't need MD emblazoned across my forehead to validate myself, but I just thought it was a kinda privelage to wear a white coat. Oh well, maybe I'm just a little old-fashioned.
B4 this turns in to a doc vs para thread, I must say that my colleagues, be they PA's, nurses, or even secretaties are invaluable resources, I just think there is an element of confusion on behalf of the pt. I've always considered doing a study on this, and I'm willing to bet that at least a majority, if not a marginal one, of the patients who are interviewed by para's in long coats are under the impression that they are talking to a doc.
Anyhoo, lemme know what y'all think.

Wearing a coat of a different color is just the same confusion as wearing a coat of a different length. I understand your frustration, however. I see this happen all the time too.

 

[Megalofyia]

I personally dont care cause I'd rather not be wearing any coat at all.. be it long or short, white or blue. I think they look kind of geeky and pretentious. They are only good for the multiple large pockets.

 

[tx oms]

I've always thought that docs should be the only ones wearing white coats. Some people may say they want the coat for protection, but they could get a blue coat for the same price. I think the practice of being too lenient on who wears the coat is confusing patients. I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.
Something else that annoys me is that I'm wearing a short coat, while everyone around me is wearing the long coat, be they pro's or not. I always thought that the white coat was a mark of distinction.

You are absolutely correct. If you're not a doctor, don't wear a long white coat. Period.

 

[Pox in a box]

You are absolutely correct. If you're not a doctor, don't wear a long white coat. Period.

Perhaps you should define "doctor."

 

[orientedtoself]

If NP's and PA's are working in the same capacity as physicians, then why shouldn't they get to wear the long coat? I have no problem with it. We have PA's at our hospital, and they function like housestaff.

 

[fantasty]

I'm not against PAs & NPs wearing the coat. My problems is the lack of differentiation for nurses, lab tech / phlebotomists, PT, and other ancillary services wear coats that aren't sufficiently different. The patient is often scared and confused in a hospital, and they only see the coat. If they think everyone they talk to is "doctor", it's intimidating, and often they say things like "I told that young so-and-so doctor about X, and Y didn't happen."

 

[Orange Julius]

I personally dont care cause I'd rather not be wearing any coat at all.. be it long or short, white or blue. I think they look kind of geeky and pretentious. They are only good for the multiple large pockets.

I agree. I especially don't like that little sewn in belt band around the back. That makes them look particularly wussy. I notice that doctor coats on tv never have them and tend to look less dorky.

 

[ears]

You are absolutely correct. If you're not a doctor, don't wear a long white coat. Period.

You might be right; certainly, it's a common complaint among patients that they can't tell who is who in the parade of people wandering in and out of their room and coming to ask them personal questions ("HAVE YOU PASSED ANY GAS YET, MRS. GROVEBOTTOM?"). And maybe something with colors and lengths of lab coats would help that.

But you might as well decide not to get upset about this. Everyone in the hospital who feels like it wears a long white coat, and that's never going to change. The only thing everyone agrees on is that med students have to wear the dorky short white coats. (But if it makes you feel better, plenty of residents wear them, too. Even some attendings.)

BTW, the solution to the "Who are the people in your hospital" problem above is that if you enter a patient's room or approach her to talk to her, you should introduce yourself, pretty much every time. Tell them what your level is, what your role is, and how you're connected to the attending. ("Hi, Mrs. Grovebottom, I'm Dr. Ears, one of the junior doctors on the surgery team. I work with Dr. Attending. HAVE YOU PASSED ANY GAS YET?") Everyone in the hospital should do this, no exceptions (well, maybe a code). You can't make the dietician in her white coat do it, but you can definitely do it yourself.

(FWIW, I hate the white coats, and don't wear one, pretty much ever.)

 

[lvspro]

Just a little follow-up.

I wasn't too clear in my original message about who I feel is negatively impacted. I could care less about who I think should wear a white coat... what really matters is who the patient thinks the doctor is. Just to reiterate what another poster mentioned, the hospital is a scary place for non-docs, and they should clearly know when talking to a doctor.

A word about intros to patients: By and large, most paras don't state their position, just that they're working with the (insert specialty) team with Dr XXXXX. I've seen many more para's do this than saying "HI, I'm a para working with drXXXX."

Yeah, white coats are sometimes a little tedious, especially when the damn AC goes out, or the hospital is just especially warm. Still, it's our ball-n-chain, so to speak.

MD, DO, DDS, PHD, DPM are who I consider doctors. Also, when I say doctor in the hospital setting, it kinda excludes the PhD's. Again, they are outstanding resources, but in the hospital, a doctor is the one who went to a medical school, and can prescribe drugs, make tx decisions etc... I think y'all get where I'm going with this.

Even if paras may function as house staff, there should be less confusing signals for the pt to weed through.

About the color of coats: White is the classic color of a doctors coat. Ages ago, nobody else could wear one, and this was understood by paras, so they started getting different colors.

Just one more thing: I thought about this a little after posting yesterday, and wondered if para's found that patients were more compliant when they wore the white coat, and were vague about rank. I guess I could understand a patient dismissing someone that isn't a doc, and hence a paras need to maybe "one-up" their apparent position. Either way, Keep the responses comin', got some deep people on this board, and I just like pickin' their brains every once in a while.

 

[Museless]

Attendings at institutions where I've rotated don't wear a long white coat - they have long gray or long blue coats for differentiation. No one else wears that color.

I can see how residents and PAs, phlebotomists, dieticians, etc. could be mistaken for each other, and like a pp I think it's incumbent upon the professional to make the proper introduction and have visible, legible ID - not to rely on the coat to speak for him/her.

 

[Hurricane]

I personally dont care cause I'd rather not be wearing any coat at all.. be it long or short, white or blue. I think they look kind of geeky and pretentious. They are only good for the multiple large pockets.

You took the words right outta my mouth!

I also don't like this "student doctor" business. It's geeky and pretentious too. What's wrong with calling a medical student a medical student? Half the patients don't know what the hell "student doctor" means, but everyone knows what "medical student" means. I can recall quite a few instances when the attending introduced me as "student doctor" and then when I went to talk the patient later, it was clear they thought I was a resident. (which I immediately corrected, of course.)

 

[group_theory]

a lot of people can confuse the term "medical student" with a lot of things. The other day, I ran into a bunch of medical assistant students from a local vo-tech school and they refer to themselves (and introduce themselves to others) as "medical students". It just caught my attention but I didn't do or say anything (mostly because I was feeling lazy and also I didn't want to bring up the issue after a long day)

There should be a sign posted for patients that says "your doctor/physician-extenders are the ones who carry beepers/pagers that goes off every 2-5 minutes"
or
"Your physcian is the one with the scratched up/beat up/badly abused beeper/pager"

 

[hospitalistpac]

"""I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.""""
Was the PA performing the thoracentesis? He/She probably informed the pt that they were a PA. But after someone puts a needle in your chest, thanks Doc, is not entriely inappropriate. As discussed in previous threads, "Doc" dropping does imply that the pt thought he was talking to his attending physician. Pt's don't understand all the hoopla.
It is every one;s job to introduce themself appropriately though.
I'm a PA obviously. I get called nurse all the time, despite my pager going off q2 min. and a white coat. That is because I am female. Female trumps white coat.
I do function as house staff, so I am issued a white coat by my bosses.
I do, however, understand all of your frustrations with being a med student. Respiratory, case management, nutrtion, lab, etc all where long coats, but you get stuck with the short ones. Just remember, soon enough you'll be the Doc and get to where or not where any coat you want. And while patients sometomes don't understand what a PA is, when you do in and say I'm Dr. So-So, there is usaully little confusion.

 

[p53]

AREN'T WE SHALLOW? Why do you PERSONALLY even give a danm that a PA was called a doctor?

I'll tell you why, the reason you are focused on STATUS is because you are not excelling in medical school, and you have a psychologic need to maintain your ego. You have to hang your hat on something right? Such as only medical students and physicians should wear white coats because "it is a mark of distinction."

Shouldn't you be focused on other things in the hospital besides such shallow thoughts? THIS JUST IN, you are not special because you are a medical student.

Very pathetic that someone holds a white coat in such a symbolic light. Most often it is an elitist, spoiled child raised with a silver spoon that reflexively seek such distinction.

It is NOT a privilege to wear a "white coat", it is a privilege to have an opportunity to become a physician. NOW stop looking for validation that you are "someone" by wishing that you should be the only one wearing a white coat. It must eat at your delicate, vulnerable soul that you are at the bottom of the totem pole at the hospital in the walk to become a physician.

I say SHUT THE HE*L UP and pay your dues. You are a lowly medical student with a short white coat just like me. You shouldn't give a rat's arse what any of the patient's think about your attire, or other people's "white coat". This whole argument about patient confusion is a poorly constructed, transparent attempt to disguise the true thrust of your complaint. Superficial people are focused on superficial traits.

Physicians and Medical Students are judged by what they say and their knowledge base. NOW stop focusing on "white coats", and focus on KNOWLEDGE to gain more respect.

I just posted this in another thread, and decided that I'd like some input from the rest of the M3/4's.

I've always thought that docs should be the only ones wearing white coats. Some people may say they want the coat for protection, but they could get a blue coat for the same price. I think the practice of being too lenient on who wears the coat is confusing patients. I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.
Something else that annoys me is that I'm wearing a short coat, while everyone around me is wearing the long coat, be they pro's or not. I always thought that the white coat was a mark of distinction. Don't get me wrong, I don't need MD emblazoned across my forehead to validate myself, but I just thought it was a kinda privelage to wear a white coat. Oh well, maybe I'm just a little old-fashioned.
B4 this turns in to a doc vs para thread, I must say that my colleagues, be they PA's, nurses, or even secretaties are invaluable resources, I just think there is an element of confusion on behalf of the pt. I've always considered doing a study on this, and I'm willing to bet that at least a majority, if not a marginal one, of the patients who are interviewed by para's in long coats are under the impression that they are talking to a doc.
Anyhoo, lemme know what y'all think.

 

[Shodddy18]

If NP's and PA's are working in the same capacity as physicians, then why shouldn't they get to wear the long coat? I have no problem with it. We have PA's at our hospital, and they function like housestaff.

I agree with you completely, but I still have complaints.

Im a second year so I havent been out on the wards much yet, but I spent some time in the hospital last week visiting a family member and EVERYONE wore long white coats. Seriously, there were less people without them than with them. Most of the docs didnt wear them. Everyone from the CNAs, dieticians, Therapists, phlebotomists, lab techs, even some housekeepers had white coats. Now dont get me wrong I dont even want to wear a white coat in the future, but it is a pain in the but trying to tell people appart in the hospital. You have to be 6 inches infront of people to read the size 10 font on their ID badges to see who they are. I guess I think it would be more simple if only the clinicians (DOs, MDs, PAs, NPs) wore the coats. Or maybe just color coded scrubs or something.

 

[lvspro]

AREN'T WE SHALLOW? Why do you PERSONALLY even give a danm that a PA was called a doctor?

I don't. This was an indicator of the patients confusion of who the doc is.

I'll tell you why, the reason you are focused on STATUS is because you are not excelling in medical school, and you have a psychologic need to maintain your ego. You have to hang your hat on something right? Such as only medical students and physicians should wear white coats because "it is a mark of distinction."

I did well in med school, and scored mid 90's on step 1. A confused pt has nothing to do with my ego. I personally am not the biggest fan of having to wear a white coat, but consider it a "ball-and-chain," as I'd mentioned in a previous post. I don't have, or ever had, an inflated ego. In fact, I'll continue to introduce myself by first name well beyond residency b/c I don't care what people think of me. I validate myself without external approval.

Shouldn't you be focused on other things in the hospital besides such shallow thoughts? THIS JUST IN, you are not special because you are a medical student.

Very pathetic that someone holds a white coat in such a symbolic light. Most often it is an elitist, spoiled child raised with a silver spoon that reflexively seek such distinction.

I don't think I'm special... in fact, I think as a med student that I am at the bottom of the totem pole... including under experienced nurses.
The symbolism of the white coat is an ingrained thing in my ethnicity. Also, I've always had, and will have the utmost respect for those who go to med school, and finish residency. I never once mentioned that this is how others should see the white coat, it's a personal view of others... not myself. Btw, about the silver spoon, I come from a humble background and had to fight tooth-and-nail for everything my family and I have.

It is NOT a privilege to wear a "white coat", it is a privilege to have an opportunity to become a physician. NOW stop looking for validation that you are "someone" by wishing that you should be the only one wearing a white coat. It must eat at your delicate, vulnerable soul that you are at the bottom of the totem pole at the hospital in the walk to become a physician.

Again, I don't care what others think of me. I'm in the hospital to learn a profession that I've always had respect for. About the validation thing... please see above.

I say SHUT THE HE*L UP and pay your dues. You are a lowly medical student with a short white coat just like me. You shouldn't give a rat's arse what any of the patient's think about your attire, or other people's "white coat". This whole argument about patient confusion is a poorly constructed, transparent attempt to disguise the true thrust of your complaint. Superficial people are focused on superficial traits.

Physicians and Medical Students are judged by what they say and their knowledge base. NOW stop focusing on "white coats", and focus on KNOWLEDGE to gain more respect.

The "argument" about confusion was indeed valid, and representative of my observation. If pt's call those who wear white coats Dr, then it is a valid argument to say that either the intro was improper, or the pt was confused (this negates the fact that some pt's may call everyone who walks in the room doctor.) on who the provider is.
I never posted this for a para hater club thing, or for respect. Apparently I must reiterate that the "thrust" of this post is:1. to see if others have experienced the same type of pt confusion. 2. And to get others opinions on this phenomenon.

 

[HamOnWholeWheat]

AREN'T WE SHALLOW? Why do you PERSONALLY even give a danm that a PA was called a doctor?

I'll tell you why, the reason you are focused on STATUS is because you are not excelling in medical school, and you have a psychologic need to maintain your ego. You have to hang your hat on something right? Such as only medical students and physicians should wear white coats because "it is a mark of distinction."

Shouldn't you be focused on other things in the hospital besides such shallow thoughts? THIS JUST IN, you are not special because you are a medical student.

Very pathetic that someone holds a white coat in such a symbolic light. Most often it is an elitist, spoiled child raised with a silver spoon that reflexively seek such distinction.

It is NOT a privilege to wear a "white coat", it is a privilege to have an opportunity to become a physician. NOW stop looking for validation that you are "someone" by wishing that you should be the only one wearing a white coat. It must eat at your delicate, vulnerable soul that you are at the bottom of the totem pole at the hospital in the walk to become a physician.

I say SHUT THE HE*L UP and pay your dues. You are a lowly medical student with a short white coat just like me. You shouldn't give a rat's arse what any of the patient's think about your attire, or other people's "white coat". This whole argument about patient confusion is a poorly constructed, transparent attempt to disguise the true thrust of your complaint. Superficial people are focused on superficial traits.

Physicians and Medical Students are judged by what they say and their knowledge base. NOW stop focusing on "white coats", and focus on KNOWLEDGE to gain more respect.

Wow. You didn't even read the thread did you?

 

[lvspro]

"""I've seen it in action a few times, and recently with a PA where after a thoracentesis the pt looked directly at the PA and said thanks DOC The thing that makes it even worse is the fact that the PA didn't correct him.""""
Was the PA performing the thoracentesis? He/She probably informed the pt that they were a PA. But after someone puts a needle in your chest, thanks Doc, is not entriely inappropriate. As discussed in previous threads, "Doc" dropping does imply that the pt thought he was talking to his attending physician. Pt's don't understand all the hoopla.
It is every one;s job to introduce themself appropriately though.
I'm a PA obviously. I get called nurse all the time, despite my pager going off q2 min. and a white coat. That is because I am female. Female trumps white coat.
I do function as house staff, so I am issued a white coat by my bosses.
I do, however, understand all of your frustrations with being a med student. Respiratory, case management, nutrtion, lab, etc all where long coats, but you get stuck with the short ones. Just remember, soon enough you'll be the Doc and get to where or not where any coat you want. And while patients sometomes don't understand what a PA is, when you do in and say I'm Dr. So-So, there is usaully little confusion.

I remember him introducing himself as Hi, I'm XXXXX with the pulmonology team, and yes he did perform the procedure. I can see your point though, that after someone shoves a large needle in your back that it's appropriate to call him doc. Also, the fact that your female does trump the white coat... this kinda irks me b/c in this day and age women do it all. Oh well, maybe in a few more years, this old fashioned prejudice will start to fade.
Back to the point, though, this was just one example of the many times I've seen this happen.
Once again, it really is no big deal about me wearing a shortie. I'm applying to a specialty that rarely wears one, so it really is aight w/me.
Just so you know where I stand... I think that all paras are essential to healthcare delivery, and I have learned a ton from them, and especially the PA I'm working with now. I just think that a pt has the right to know who they're talking to. From the sound of it, you prolly do a good job of that.

 

[Shah_Patel_PT]

If NP's and PA's are working in the same capacity as physicians, then why shouldn't they get to wear the long coat? I have no problem with it. We have PA's at our hospital, and they function like housestaff.

I always see these PAs and other allied professionals wear these long coats...the annoying this is they always have there ID card turned backwards...so patients really dont know who the MD is. And like the other poster said earlier..they never correct the patient when they are called doc.

 

[p53]

I STAND BY MY COMMENTS. From your response, I can tell that I have hit a target. You can play this game to deflect my comments, but the fact is that my comments sting because deep inside you know there are elements of truth.

BTW, if you truly didn't care, you wouldn't have started this thread about the "confusion".

Besides, your post stated that only "doctors" should wear white coats. Also your apparent "thrust" is incongruent with the title of this thread, and your opening post. Don't worry it is always hard to cover one's tracks even if one scored in the "mid 90's" on Step 1.

Keep in mind superficial people have a greater tendency to succumb to major depression and mid life crisis because medicine is not about the glory but rather service. There is a reason physicians have one of the highest incidence of suicide, drug abuse, divorce, and alcohol abuse. The people that are in it for the wrong reasons such as status realize it is artificial and are TRAPPED. I hope service and humility become ingrained in your "ethnicity" before it is too late.

I don't. This was an indicator of the patients confusion of who the doc is.



I did well in med school, and scored mid 90's on step 1. A confused pt has nothing to do with my ego. I personally am not the biggest fan of having to wear a white coat, but consider it a "ball-and-chain," as I'd mentioned in a previous post. I don't have, or ever had, an inflated ego. In fact, I'll continue to introduce myself by first name well beyond residency b/c I don't care what people think of me. I validate myself without external approval.



I don't think I'm special... in fact, I think as a med student that I am at the bottom of the totem pole... including under experienced nurses.
The symbolism of the white coat is an ingrained thing in my ethnicity. Also, I've always had, and will have the utmost respect for those who go to med school, and finish residency. I never once mentioned that this is how others should see the white coat, it's a personal view of others... not myself.



Again, I don't care what others think of me. I'm in the hospital to learn a profession that I've always had respect for. About the validation thing... please see above.



The "argument" about confusion was indeed valid, and representative of my observation. If pt's call those who wear white coats Dr, then it is a valid argument to say that either the intro was improper, or the pt was confused (this negates the fact that some pt's may call everyone who walks in the room doctor.) on who the provider is.
I never posted this for a para hater club thing, or for respect. Apparently I must reiterate that the "thrust" of this post is:1. to see if others have experienced the same type of pt confusion. 2. And to get others opinions on this phenomenon.

 

[LSR1979]

Perhaps you should define "doctor."

I do not mean any offense by the following, and maybe I am reading too far into your post, but it comes accross as slander to the poster to whom you are replying. Are you knocking him because he is a "dentist?" Actually he holds both the DDS and MD degree and certainly deserves the distinction of "doctor." Even though I am only a lowly dental student myself, I feel that that OMFS residents deserve the utmost respect and "deserve" to wear the white coat. I apologize in advance if your post was not intended as I have perceived.

 

[Ice-1]

If NP's and PA's are working in the same capacity as physicians, then why shouldn't they get to wear the long coat? I have no problem with it. We have PA's at our hospital, and they function like housestaff.

Because they are not doctors. Period. They didn't go through medical school. They may be very good at whatever they do but they still aren't doctors. There's a reason why Assistant is in the name and not Physician. There's a reason why the title is Nurse Practicioner and not Physician. No matter how politically incorrect it may sound, these para-professionals are not physicians.

 

[orientedtoself]

Keep in mind superficial people have a greater tendency to succumb to major depression and mid life crisis because medicine is not about the glory but rather service.

Last time I checked, being superficial wasn't a risk factor for depression.

 

[p53]

Last time I checked, being superficial wasn't a risk factor for depression.

In medicine, being superficial is a risk factor.

 

[Lesion Of Doom]

Only I should wear the white coat! No one else is worthy!

 

[sdnetrocks]

It's funny - the classic way to recognize an attending at my institution is ABSENCE of a white coat. We students always joke around that if we just take our short coats off and hang a stethoscope around our necks, we could pass as attendings.

I wonder if this is true at other places too.

 

[lvspro]

I STAND BY MY COMMENTS. From your response, I can tell that I have hit a target. You can play this game to deflect my comments, but the fact is that my comments sting because deep inside you know there are elements of truth.

Ok. Where in my responses were you able to logically deduce the conclusion?

BTW, if you truly didn't care, you wouldn't have started this thread about the "confusion".

Besides, your post stated that only "doctors" should wear white coats. Also your apparent "thrust" is incongruent with the title of this thread, and your opening post. Don't worry it is always hard to cover one's tracks even if one scored in the "mid 90's" on Step 1.

Thread name: Who should wear the white coat?
Question in thread: "I think the practice of being too lenient on who wears the coat is confusing patients." Then you, dear reader, are to assume that I'm asking what you think of this practice.

Keep in mind superficial people have a greater tendency to succumb to major depression and mid life crisis because medicine is not about the glory but rather service. There is a reason physicians have one of the highest risk of suicide, drug abuse, divorce, and alcohol abuse. The people that are in it for the wrong reasons such as status realize it is artificial and are TRAPPED. I hope service and humility become ingrained in your "ethnicity" before it is too late.

I recently read an old article in JAMA on a study demonstrating that when the physician population is normalized to the general population, there is no difference in the incidence of suicide. This does not hold true for DDS's though. Anyhow, your argument is pretty much invalidated by said study. Also, do you have any proof of anything you've mentioned? I'm just curious b/c it seems like you're throwing something of a temper tantrum, and throwing out anything that pops into your brilliant mind.

One more thing, can you point out anywhere in my posts where I mentioned anything that resembles a lack of humility or service. Replying to your comments is getting tedious, as they don't seem well thought out, presented, or backed up. I always enjoy a sparring match but your posts just seem a little weak, that's all. Again, they just seem a little
temper-tantrumish.

 

[Pox in a box]

I do not mean any offense by the following, and maybe I am reading too far into your post, but it comes accross as slander to the poster to whom you are replying. Are you knocking him because he is a "dentist?" Actually he holds both the DDS and MD degree and certainly deserves the distinction of "doctor." Even though I am only a lowly dental student myself, I feel that that OMFS residents deserve the utmost respect and "deserve" to wear the white coat. I apologize in advance if your post was not intended as I have perceived.

Doctor can mean many things. Technically, anyone with a Ph.D. is a "doctor." So are veterinarians, dentists, MDs, DOs, etc. That's all I'm saying. Apology accepted.

 

[orientedtoself]

People, these are just crappy cotton/poly blend coats in the color white. I wonder if cheerleaders get this worked up about their uniforms?

 

[Cpt.Hook Hamate]

People, these are just crappy cotton/poly blend coats in the color white. I wonder if cheerleaders get this worked up about their uniforms?

Probably not but I know police officers do.

 

[rpkall]

Because they are not doctors. Period. They didn't go through medical school. They may be very good at whatever they do but they still aren't doctors. There's a reason why Assistant is in the name and not Physician. There's a reason why the title is Nurse Practicioner and not Physician. No matter how politically incorrect it may sound, these para-professionals are not physicians.

This is a little harsh. There is nothing that makes a medical student more qualified than a practicing PA to wear a white coat, of any length. Believe me; I've been to PA school and I've been to medical school. There is also nothing that makes an Intern or PGY-1 more qualified than a practicing PA to wear the longer white coat. Medicine is about taking care of patients--it's learning a trade. Most physicians will tell you (like Osler, and I see it every other time I sign on to SDN) that medicine is learned at the bedside, not in the classroom.

No, PAs are not doctors; however, if I need a thoracentesis, and I can have either 1) the PGY-1 surgery intern, or 2) a 5 year veteran PA on the surgical service, I'll pick the PA every time--and twice on sunday night at 3am, because the PA likely has not been awake for 37 hours straight.
A PA provides the same care to patients that a physician does; in PA school, PA students are trained to know whether or not they can realistically do that. If the case is beyond their scope, they are trained (supposedly, and they actually *were* at my old program, and rather well, too) to get physician advisement.

p.s. PAs are not trying to replace physicians; in the official credo of the entire profession, it is stated that the purpose is to "practice medicine with the supervision of physicians," in the medical model of health care. They will not seek autonomy unless it's actually good for patient care (in the Appalacian mountains or Montana, where there is no other care available). NPs, on the other hand, have a different philosophy, where they practice "advanced nursing" and they actually WILL seek autonomy. Don't get me started with that...

 

[rpkall]

p.p.s. It's RIDICULOUS that there are PAs out there NOT correcting patients when they call them "Doctor." I couldn't stomach that back when I was going to be a PA, and I still can't stomach it now that I'm in med school.

Misrepresentation is NOT taught in PA school. That's just "bad form."

 

[toofache32]

"Doctor" can also be misrepresented. "Doctor" only means you went to school for 4 years, and can imply competence that may not be there....such as an intern.

 

[Hurricane]

a lot of people can confuse the term "medical student" with a lot of things. The other day, I ran into a bunch of medical assistant students from a local vo-tech school and they refer to themselves (and introduce themselves to others) as "medical students". It just caught my attention but I didn't do or say anything (mostly because I was feeling lazy and also I didn't want to bring up the issue after a long day)

That sounds more like they were misusing the term "medical student" rather than patients misunderstanding the term. I bet if you asked 10 people on the street what "medical student" means, none of them would say it means a student in school to be a medical assistant.

I just wish people would just introduce themselves in unambiguous terms, and wear their IDs turned around the right way and without a bunch of crap stuck to it so that people can read them and know who they're talking to. Perhaps everyone should just wear coats with their name and number printed on the back like football players.

 

[p53]

"AMA on a study demonstrating that when the physician population is normalized to the general population"

You are a COMPLETE IDIOT. A physician population normalized to a general population. That is not possible. If you normalize a study, a second variable has to be taken into account.

Secondly, you are a college educated graduate. TALK LIKE IT!! Temper tanturish? Stop talking GIBBERISH. If I heard you talk like that EVEN with a long white coat I would think you are a complete idiot. Furthermore, I would respect a nursing assistant that has a better command of vocabulary than a medical student that doesn't know how to talk like a professional. ONCE AGAIN, YOU ARE JUDGED BY YOUR WORDS AND KNOWLEDGE. A PA with professionalism, medical knowledge, and compassion trumps a physician that lacks these traits EVERY SINGLE TIME. No wonder you get such little respect with your "white coat"

Now, SHUT THE HEL* UP about this meaningless crap about some elitist white coat. RESPECT is earned, and you have a LONG, LONG WAY TO GO.

Ok. Where in my responses were you able to logically deduce the conclusion?



Thread name: Who should wear the white coat?
Question in thread: "I think the practice of being too lenient on who wears the coat is confusing patients." Then you, dear reader, are to assume that I'm asking what you think of this practice.



I recently read an old article in JAMA on a study demonstrating that when the physician population is normalized to the general population, there is no difference in the incidence of suicide. This does not hold true for DDS's though. Anyhow, your argument is pretty much invalidated by said study. Also, do you have any proof of anything you've mentioned? I'm just curious b/c it seems like you're throwing something of a temper tantrum, and throwing out anything that pops into your brilliant mind.

One more thing, can you point out anywhere in my posts where I mentioned anything that resembles a lack of humility or service. Replying to your comments is getting tedious, as they don't seem well thought out, presented, or backed up. I always enjoy a sparring match but your posts just seem a little weak, that's all. Again, they just seem a little
temper-tantrumish.

 

[Shah_Patel_PT]

It's funny - the classic way to recognize an attending at my institution is ABSENCE of a white coat. We students always joke around that if we just take our short coats off and hang a stethoscope around our necks, we could pass as attendings.

I wonder if this is true at other places too.

The attending in a NY hospital I rotate at, DONT wear white coats BUT they do all wear a 2-piece SUIT. So unless the students wear a suit...you aint gonna pass for an attending...wait a couple more years for that buddy!

 

[Shah_Patel_PT]

This is a little harsh. There is nothing that makes a medical student more qualified than a practicing PA to wear a white coat, of any length. Believe me; I've been to PA school and I've been to medical school. There is also nothing that makes an Intern or PGY-1 more qualified than a practicing PA to wear the longer white coat. Medicine is about taking care of patients--it's learning a trade. Most physicians will tell you (like Osler, and I see it every other time I sign on to SDN) that medicine is learned at the bedside, not in the classroom.

No, PAs are not doctors; however, if I need a thoracentesis, and I can have either 1) the PGY-1 surgery intern, or 2) a 5 year veteran PA on the surgical service, I'll pick the PA every time--and twice on sunday night at 3am, because the PA likely has not been awake for 37 hours straight.
A PA provides the same care to patients that a physician does; in PA school, PA students are trained to know whether or not they can realistically do that. If the case is beyond their scope, they are trained (supposedly, and they actually *were* at my old program, and rather well, too) to get physician advisement.

p.s. PAs are not trying to replace physicians; in the official credo of the entire profession, it is stated that the purpose is to "practice medicine with the supervision of physicians," in the medical model of health care. They will not seek autonomy unless it's actually good for patient care (in the Appalacian mountains or Montana, where there is no other care available). NPs, on the other hand, have a different philosophy, where they practice "advanced nursing" and they actually WILL seek autonomy. Don't get me started with that...

"A PA provides the same care to patients that a physician does; in PA school, PA students are trained to know whether or not they can realistically do that. If the case is beyond their scope, they are trained (supposedly, and they actually *were* at my old program, and rather well, too) to get physician advisement."

If this is the case....why is PA school so much (2 years) SHORTER than medical school and residency.

Theoretically it does not make sense to me???? WHat the hell are students/MDs doing for so many years???

 

[lvspro]

"AMA on a study demonstrating that when the physician population is normalized to the general population"

You are a COMPLETE IDIOT. A physician population normalized to a general population. That is not possible. If you normalize a study, a second variable has to be taken into account.

Secondly, you are a college educated graduate. TALK LIKE IT!! Temper tanturish? Stop talking GIBBERISH. If I heard you talk like that EVEN with a long white coat I would think you are a complete idiot. Furthermore, I would respect a nursing assistant that has a better command of vocabulary than a medical student that doesn't know how to talk like a professional. ONCE AGAIN, YOU ARE JUDGED BY YOUR WORDS AND KNOWLEDGE. A PA with professionalism, medical knowledge, and compassion trumps a physician that lacks these traits EVERY SINGLE TIME. No wonder you get such little respect with your "white coat"

Now, SHUT THE HEL* UP about this meaningless crap about some elitist white coat. RESPECT is earned, and you have a LONG, LONG WAY TO GO.

Apparently you're not even reading my replies. You are, however, on some sort of tirade that was unprovoked, and as such, welcome to my ignore list.

 

[SuitsYou]

I always see these PAs and other allied professionals ...the annoying this is they always have there ID card turned backwards

Thats the bit that kills me, backwards or upside down. Why do you go to such lengths to hide your name????

 

[THP]

"AMA on a study demonstrating that when the physician population is normalized to the general population"

You are a COMPLETE IDIOT. A physician population normalized to a general population. That is not possible. If you normalize a study, a second variable has to be taken into account.

Secondly, you are a college educated graduate. TALK LIKE IT!! Temper tanturish? Stop talking GIBBERISH. If I heard you talk like that EVEN with a long white coat I would think you are a complete idiot. Furthermore, I would respect a nursing assistant that has a better command of vocabulary than a medical student that doesn't know how to talk like a professional. ONCE AGAIN, YOU ARE JUDGED BY YOUR WORDS AND KNOWLEDGE. A PA with professionalism, medical knowledge, and compassion trumps a physician that lacks these traits EVERY SINGLE TIME. No wonder you get such little respect with your "white coat"

Now, SHUT THE HEL* UP about this meaningless crap about some elitist white coat. RESPECT is earned, and you have a LONG, LONG WAY TO GO.

Hmmmm. . . My guess. . . . 'roid rage

 

[Gimlet]

Thats the bit that kills me, backwards or upside down. Why do you go to such lengths to hide your name????

If they're turning their badges around intentionally, that is just plain wrong. However, I use one of those clips that's attached to a retractable string for my ID, and it seems like whenever I look down at my badge it's always flipped around the wrong way. No matter which way I attach the badge, it flips around backwards. So maybe we should give them the benefit of the doubt. If you do see someone in the hospital with their badge flipped around, point it out to them and see what their reaction is. If they get pissed then you'll know they were trying to hide something.

 

[Shodddy18]

If they're turning their badges around intentionally, that is just plain wrong. However, I use one of those clips that's attached to a retractable string for my ID, and it seems like whenever I look down at my badge it's always flipped around the wrong way. No matter which way I attach the badge, it flips around backwards. So maybe we should give them the benefit of the doubt. If you do see someone in the hospital with their badge flipped around, point it out to them and see what their reaction is. If they get pissed then you'll know they were trying to hide something.

Thats the truth man. My ID has an alligator clip and regardless of how I put it on I still find it backwards all the time. I think there is a little gnome that lives in my pocket and keeps turning it backwards...

 

[schutzhund]

One word: Envy

People are human. It's in our nature to desire what others have if it's better than ours. This applies to money, material objects, education, power, prestige and so on. Medicine is a field that has many players that are often separated on various levels based by education, scope of practice etc. This system breeds envy. The techs look up to the LPNs, the LPNs look up to the RNs, the RNs look up to the CNSs, etc. There are similarities with PTs and PTAs, RTs and RRTs, MLTs and MTs and on and on.

This does NOT mean that any of these people are better than the others. I'm NOT saying that PAs and the like do not have a place in healthcare or that they are not as smart or can't be good at what they do. The fact is that physicians are the most highly educated and trained people in healthcare and that creates some of these issues.

I'm actually glad that this issue is being brought up. I personally believe that physicians as a group are too passive and have allowed, mostly by neglect, a lot of encroachment in medicine. Virtually every medical specialty has a lesser educated and trained group trying to perform traditionally physician roles. There are tensions involving scope of practice with the CRNAs and anesthesiologists, optometrists and ophthalmologists, psychologists and psychiatrists, midwives and OBs, NPs (and to a lesser extent PAs) with FP, IM, and even EM, physical therapists and PM&R and sports medicine docs.

It may seem like and "ego" issue or some petty clothing gripe, but the fact is that it does reflect some real and potential consequences. I don't mean to over "philosophize" but I think that our generation has become overly passive and we think that hierarchy, which by its nature involves leaders and followers, is wrong.

We are all created equal, and we all are on the same team, but every time needs a captain. In medicine, this is the role of the physician. Medicine has traditionally reserved the long white coat for physicians. The white coat has been a symbol of medical educational achievement and I see nothing wrong with that.

 

[lvspro]

One word: Envy

People are human. It's in our nature to desire what others have if it's better than ours. This applies to money, material objects, education, power, prestige and so on. Medicine is a field that has many players that are often separated on various levels based by education, scope of practice etc. This system breeds envy. The techs look up to the LPNs, the LPNs look up to the RNs, the RNs look up to the CNSs, etc. There are similarities with PTs and PTAs, RTs and RRTs, MLTs and MTs and on and on.

This does NOT mean that any of these people are better than the others. I'm NOT saying that PAs and the like do not have a place in healthcare or that they are not as smart or can't be good at what they do. The fact is that physicians are the most highly educated and trained people in healthcare and that creates some of these issues.

I'm actually glad that this issue is being brought up. I personally believe that physicians as a group are too passive and have allowed, mostly by neglect, a lot of encroachment in medicine. Virtually every medical specialty has a lesser educated and trained group trying to perform traditionally physician roles. There are tensions involving scope of practice with the CRNAs and anesthesiologists, optometrists and ophthalmologists, psychologists and psychiatrists, midwives and OBs, NPs (and to a lesser extent PAs) with FP, IM, and even EM, physical therapists and PM&R and sports medicine docs.

It may seem like and "ego" issue or some petty clothing gripe, but the fact is that it does reflect some real and potential consequences. I don't mean to over "philosophize" but I think that our generation has become overly passive and we think that hierarchy, which by its nature involves leaders and followers, is wrong.

We are all created equal, and we all are on the same team, but every time needs a captain. In medicine, this is the role of the physician. Medicine has traditionally reserved the long white coat for physicians. The white coat has been a symbol of medical educational achievement and I see nothing wrong with that.

Very interesting post, and well thought out if I may add.

Anyhow, the passivity of docs is nowhere better demonstrated than the recent passing of a bill that prohibits an attending anesthesiologist from charging full price for services for a resident running a case, and maintaining the acceptability of full reimbursement for a CRNA running the case. Just to kinda read between the lines a bit, this pretty much penalizes an attending for using resident. This is obviously going to lead to MDA's assigning more cases to CRNA's than residents, just to be able to make ends meet. Hence, a decrease in the quality of the learning environment for residents. Just a little morsel to support your statement.

Also, what do you think of the idea that a patient may not be fully aware of who is involved in his care secondary to non-MD's wearing a white coat? I've actually tried to project myself into a pt's position, and the lack of understanding they have of our convoluted system of healthcare, and found that it is understandable that the modern pt really has no idea who's interviewing them.

Your comment about the white coat as a symbol of achievement has been heavily criticized by others on the board, but I can see where you're coming from.

So... lemme know what you think about the pt confusion issue.

 

[hospitalistpac]

Very interesting post, and well thought out if I may add.

Anyhow, the passivity of docs is nowhere better demonstrated than the recent passing of a bill that prohibits an attending anesthesiologist from charging full price for services for a resident running a case, and maintaining the acceptability of full reimbursement for a CRNA running the case. Just to kinda read between the lines a bit, this pretty much penalizes an attending for using resident. This is obviously going to lead to MDA's assigning more cases to CRNA's than residents, just to be able to make ends meet. Hence, a decrease in the quality of the learning environment for residents. Just a little morsel to support your statement.

Also, what do you think of the idea that a patient may not be fully aware of who is involved in his care secondary to non-MD's wearing a white coat? I've actually tried to project myself into a pt's position, and the lack of understanding they have of our convoluted system of healthcare, and found that it is understandable that the modern pt really has no idea who's interviewing them.

Your comment about the white coat as a symbol of achievement has been heavily criticized by others on the board, but I can see where you're coming from.

So... lemme know what you think about the pt confusion issue.

The truth is, there are alot of reasons why pts are confused.
If someone told me tomorrow that a blue coat would make all pts understand my role, I would wear it. The truth it there is more to it that that. That is why we have threads like this. And again PAs should identify themselves as such.
In the mean time, I wear my white coat with PA embroidered upon it and introduce myself in such a matter. However, I am still regularly misidentifed as either the dr or the nurse. I am not either. But I do my best by my patients. I'm sure you all do too.

 

[fedor]

One word: Envy

People are human. It's in our nature to desire what others have if it's better than ours. This applies to money, material objects, education, power, prestige and so on. Medicine is a field that has many players that are often separated on various levels based by education, scope of practice etc. This system breeds envy. The techs look up to the LPNs, the LPNs look up to the RNs, the RNs look up to the CNSs, etc. There are similarities with PTs and PTAs, RTs and RRTs, MLTs and MTs and on and on.

This does NOT mean that any of these people are better than the others. I'm NOT saying that PAs and the like do not have a place in healthcare or that they are not as smart or can't be good at what they do. The fact is that physicians are the most highly educated and trained people in healthcare and that creates some of these issues.

I'm actually glad that this issue is being brought up. I personally believe that physicians as a group are too passive and have allowed, mostly by neglect, a lot of encroachment in medicine. Virtually every medical specialty has a lesser educated and trained group trying to perform traditionally physician roles. There are tensions involving scope of practice with the CRNAs and anesthesiologists, optometrists and ophthalmologists, psychologists and psychiatrists, midwives and OBs, NPs (and to a lesser extent PAs) with FP, IM, and even EM, physical therapists and PM&R and sports medicine docs.

It may seem like and "ego" issue or some petty clothing gripe, but the fact is that it does reflect some real and potential consequences. I don't mean to over "philosophize" but I think that our generation has become overly passive and we think that hierarchy, which by its nature involves leaders and followers, is wrong.

We are all created equal, and we all are on the same team, but every time needs a captain. In medicine, this is the role of the physician. Medicine has traditionally reserved the long white coat for physicians. The white coat has been a symbol of medical educational achievement and I see nothing wrong with that.

+1

 

[Hurricane]

However, I use one of those clips that's attached to a retractable string for my ID, and it seems like whenever I look down at my badge it's always flipped around the wrong way. No matter which way I attach the badge, it flips around backwards.

We get a different badge for Children's Hospital, so I attach that one back-to-back with my med school badge, so no matter which way it turns, you can see my name and title.

I hate the (mostly women, and I am a woman, so don't jump all over me) who attach so many stickers and pens and keys to the lanyard with their ID badge so that you can't read it. Really, I don't care what coat people are wearing, as long as their name and title are easily seen, and they clearly identify their position to patients and staff. As for me, I can't wait to be an uncoated psych resident

 

[21JumpStreet]

One word: Envy

People are human. It's in our nature to desire what others have if it's better than ours. This applies to money, material objects, education, power, prestige and so on. Medicine is a field that has many players that are often separated on various levels based by education, scope of practice etc. This system breeds envy. The techs look up to the LPNs, the LPNs look up to the RNs, the RNs look up to the CNSs, etc. There are similarities with PTs and PTAs, RTs and RRTs, MLTs and MTs and on and on.

This does NOT mean that any of these people are better than the others. I'm NOT saying that PAs and the like do not have a place in healthcare or that they are not as smart or can't be good at what they do. The fact is that physicians are the most highly educated and trained people in healthcare and that creates some of these issues.

I'm actually glad that this issue is being brought up. I personally believe that physicians as a group are too passive and have allowed, mostly by neglect, a lot of encroachment in medicine. Virtually every medical specialty has a lesser educated and trained group trying to perform traditionally physician roles. There are tensions involving scope of practice with the CRNAs and anesthesiologists, optometrists and ophthalmologists, psychologists and psychiatrists, midwives and OBs, NPs (and to a lesser extent PAs) with FP, IM, and even EM, physical therapists and PM&R and sports medicine docs.

It may seem like and "ego" issue or some petty clothing gripe, but the fact is that it does reflect some real and potential consequences. I don't mean to over "philosophize" but I think that our generation has become overly passive and we think that hierarchy, which by its nature involves leaders and followers, is wrong.

We are all created equal, and we all are on the same team, but every time needs a captain. In medicine, this is the role of the physician. Medicine has traditionally reserved the long white coat for physicians. The white coat has been a symbol of medical educational achievement and I see nothing wrong with that.

A psychologist IS a doctor. They are either phd's or psyd's or Ed's. They are not paraprofessionals.

Also, some of the para's and others wore their name tag backwards because they simply didn't like their picture. No hidden agenda to that. I am glad that we med students don't have our pictures on our tags.

 

[ForbiddenComma]

As a med student, I think the obvious solution is that since everyone now wears white coats, the physician needs something new to differentiate himself. Therefore, I propose that physicians should now wear regal robes and a crown.

This should help secure their place as lords and masters of all they see. Their status as being above the unwashed masses will forever be unassailable. In addition, attendings should get a scepter of ruling to differentiate themselves from the lower residents. The chief should also get that orb thingie, it can even double as a pager. "Excuse me, my orb is going off. Looks like the ED is paging me again."

This would also help MDs deal with title-inflation. Everyone is calling themselves doctors these days, even chiropracters, right? Well, let them. The physician shall now be referred only as Lord. Another perk is getting to use the royal "we" and as everyone knows, the royal "we" rocks.

"Greetings my subject. We are Lord Smith, and we will deign to lay hands upon you to cure your ailments. Now then, have you passed gas today?"

Of course, the upshot for me is that if physicians are the kings, then I am surely the prince. Therefore, I should also be issued regal robes, but just have a crown with slightly fewer jewels.