Why do doctor's wear white coats? It's unhealthy and some places have banned it!

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Kong Bu

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http://slate.com/id/2220925/?GT1=38001

The American Medical Association voted Tuesday on a resolution that would recommend hospitals ban doctors' iconic white lab coats, citing evidence that the garment contributes to the spread of infection. (The resolution was referred to a panel for further consideration.)* Indeed, a number of studies have shown that the coats harbor potentially harmful bacteria (and may cause "white coat hypertension"). If white coats are so bad, why do doctors still wear them?
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Doctors strove to become more scientific, in practice and in dress. The lab coat served both purposes by providing a (supposedly) sterile work environment and soothing patients with its air of scientific authority. The traditional lab coat was beige, but doctors adopted white because the color symbolizes life and purity.
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With their scientific bona fides firmly in place, doctors today are divided on the white-coat question. Supporters say the coat instills docs with a humbling sense of responsibility and puts patients at ease, while detractors see it as an alienating symbol of medical hubris.
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Perhaps the most ardent supporters of the garment are patients: In one study, 56 percent of those surveyed believed doctors should wear coats, compared with only 24 percent of doctors.
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The Scottish National Health Service outlawed white coats in 2008 and instituted a uniform of color-coded scrubs for all medical personnel.
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What do you think? I'm still in support of a white coat. No matter what, it seems like the eternal symbol of a healer and it should still be used. Too etched in of a tradition to change, right?

(Sorry if this has been posted before? I don't think it has though).
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Yeah I cut down significantly on contamination in my lab when I stopped wearing my coat. It's funny how some students will go through a million precautions to sterilize thier work area, then head to the coatrack and dawna white coat that hasn't been washed yet that semester.

This seems like a crazy idea in medicine though. Can't we agree to keep our coats clean, or wear coats without cuffs? I really doubt it will happen on a meaningful scale any time soon, anyway.
 
Zoom-Zoom said:
Yeah I cut down significantly on contamination in my lab when I stopped wearing my coat. It's funny how some students will go through a million precautions to sterilize thier work area, then head to the coatrack and dawna white coat that hasn't been washed yet that semester.

This seems like a crazy idea in medicine though. Can't we agree to keep our coats clean, or wear coats without cuffs? I really doubt it will happen on a meaningful scale any time soon, anyway.
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I admit that I would've forgotten to change mine because I was really attached to this one coat and I would never get it back after I handed it in to be washed. Weeks would go by before the safety officer snatched it from my chair to save me from myself.

Aren't they cleaned pretty often in the clinical setting, though? The fellows I worked with all had at least 2 white coats from their universities that they swapped out as needed. Although this was at a private practice setting, I imagine that hospitals have even stricter policies regarding washing the lab coats.

This does remind me, though, as a high school kid with few aspirations to be a doctor, one of my most vivid memories of the Holocaust museum in DC was Dr. Mengele's white coat. Even though it's something relatively simple for doctors, to the public, the symbol means so much.
 
no coats. no ties. no beepers. no cell phones. everything is a fomite. you must autoclave your cellphones!!!!

every time a test is done to find presence of bugs on apparel, it is there. also portable medical equipment. not too many studies look at if/how much this is leading to transmission though. im not saying it doesn't, because it probably does. im just saying we all need to work naked to be completely sure. wait, no. that won't work either. 🙄
 
Unless I get to wear scrubs every day, I want to keep the white coat. You know how much stuff gets on your clothes? I don't want to bring that nastiness home. Even in small procedures blood can spray. The coat protects you somewhat.

And why wouldn't people wash it often? My dad had at least 4 or 5 coats, and my mom washed the used ones every week.
 
so what will we wear instead? nothing? haz-mat suits? shower off between every patient?
 
Is there an indication of why the white coats specifically are prone to transferring diseases compared to other garments? (didn't read article)
 
Ashers said:
Unless I get to wear scrubs every day, I want to keep the white coat. You know how much stuff gets on your clothes? I don't want to bring that nastiness home. Even in small procedures blood can spray. The coat protects you somewhat.

And why wouldn't people wash it often? My dad had at least 4 or 5 coats, and my mom washed the used ones every week.
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I would be all about wearing scrubs every day. It would be like working in pajamas! Why can't a company make scrubs (or coats) that things can't grow on?
 
Zoom-Zoom said:
Yeah I cut down significantly on contamination in my lab when I stopped wearing my coat. It's funny how some students will go through a million precautions to sterilize thier work area, then head to the coatrack and dawna white coat that hasn't been washed yet that semester.

This seems like a crazy idea in medicine though. Can't we agree to keep our coats clean, or wear coats without cuffs? I really doubt it will happen on a meaningful scale any time soon, anyway.
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We can't even get people to wash their hand regularly I don't know how we can get people to wash their white coats.
We should keep the white coats but make them short sleeve, a few doctors in my hospital wear short sleeve lab coats.
 
I think it's a practice that predates the germ theory. You can also tell if a coat is "clean" better if it's white. I agree though that this doesn't necessarily mean they are germ free.
 
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Charles English said:
!!

every time a test is done to find presence of bugs on apparel, it is there. also portable medical equipment. not too many studies look at if/how much this is leading to transmission though. im not saying it doesn't, because it probably does. im just saying we all need to work naked to be completely sure. wait, no. that won't work either. 🙄
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Exactly. These studies have basically come to the conclusion that (surprise) our clothing is not magically anti-bacterial. None of them have looked at transmission rates or outcomes, none of them have tried any solid intervention to attempt to reduce transmission. Pretty weak research, but the lay media eats it up.
 
The American Medical Association voted Tuesday on a resolution that would recommend hospitals ban doctors' iconic white lab coats, citing evidence that the garment contributes to the spread of infection. (The resolution was referred to a panel for further consideration.)* Indeed, a number of studies have shown that the coats harbor potentially harmful bacteria (and may cause "white coat hypertension"). If white coats are so bad, why do doctors still wear them?
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What do white coats have to do with white coat hypertension? There's no connection, unless they're claiming that patients become more stressed out when their doctor is wearing a white coat.
 
merryjoulton said:
Do doctors even take blood pressures? At the hospital I worked in BP's were either taken by a nurse, a tech, or a machine running on an automatic cycle....
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All of whom wear white coats nowadays, possibly including the machine.
 
I would get fired so fast if I followed this.
 
So the issue here is really how often the coats should be washed? I'm sure some would probably wear some type of protective clothing to protect from blood, etc. and it would bring up the same problems.

imo, if the coat's dirty, its probably done its job.
 
bigbad said:
So the issue here is really how often the coats should be washed? I'm sure some would probably wear some type of protective clothing to protect from blood, etc. and it would bring up the same problems.

imo, if the coat's dirty, its probably done its job.
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And as a bonus, it enforces positive feedback!
 
thats a shame.

its like removing popcorn from the concession stands at the theatre!
 
Bacchus said:
Well then do the janitor, NPs, PAs, rad techs, CNAs, nurses, etc lose their white coats? What about my butcher? The CVS Photo tech?
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Oh, HELL NO. They better keep that coat on, have you tried removing printer ink?😡 Worse than a Staph infection
 
Zoom-Zoom said:
Yeah I cut down significantly on contamination in my lab when I stopped wearing my coat. It's funny how some students will go through a million precautions to sterilize thier work area, then head to the coatrack and dawna white coat that hasn't been washed yet that semester.

This seems like a crazy idea in medicine though. Can't we agree to keep our coats clean, or wear coats without cuffs? I really doubt it will happen on a meaningful scale any time soon, anyway.
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http://pubs.acs.org/cen/news/87/i04/8704news1.html

Not that physicians will be messing with organics as far as I know, but still. It's a safety issue for practitioners, you don't want to spill (bio)hazardous anything on your bare skin, period. Just wash your friggin' coat more often to prevent contamination.
 
KeyzerSoze said:
What do white coats have to do with white coat hypertension? There's no connection, unless they're claiming that patients become more stressed out when their doctor is wearing a white coat.
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It's a kind of syndrome where a person's blood pressure sky rockets when they are the patient and their doctor is wearing a white coat. It'd kind of an uneasy feeling.
About a month ago when I was riding my shift at my first aid squad, we got a call to a patient who was having difficulty breathing. After putting her on O2 and taking her blood pressure, I saw that it was 220/140 or something. It turns out, she has white coat hypertension just when she is the patient and she's being treated by someone wearing any medical-related uniform. (she was a nurse too, but I guess it only affected her when she's the patient)
 
Omni said:
It's a kind of syndrome where a person's blood pressure sky rockets when they are the patient and their doctor is wearing a white coat. It'd kind of an uneasy feeling.
About a month ago when I was riding my shift at my first aid squad, we got a call to a patient who was having difficulty breathing. After putting her on O2 and taking her blood pressure, I saw that it was 220/140 or something. It turns out, she has white coat hypertension just when she is the patient and she's being treated by someone wearing any medical-related uniform. (she was a nurse too, but I guess it only affected her when she's the patient)
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I think the point was that white coat hypertension is not literally caused by the white coat itself, but rather by the fact that you are nervous about being at the doctor's office/hospital/etc. Removing the coat doesn't get rid of it...
 
This is kind of ridiculous. At the clinical facility that I work at, I was told that wearing a white coat made it easier to clean... you can just bleach it, and remove most harmful bacteria. You can't exactly bleach colored scrubs, dress shirts, ties, skirts, etc. whatever else we'd wear in the hospital.
 
There are anti-microbial material white coats out there and they could always make us run them through the autoclave 1x a week or so.

I'm with the above poster tho- if we can't have white coats we better be allowed to wear scrubs all the time.
 
southernIM said:
I think the point was that white coat hypertension is not literally caused by the white coat itself, but rather by the fact that you are nervous about being at the doctor's office/hospital/etc. Removing the coat doesn't get rid of it...
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No, it does actually. The patient who I had told me this that whenever she'd go to see her doctor, she'd tell her to not wear her white coat. In her case and in others, I guess it's directly related to the coat itself.
 
Omni said:
No, it does actually. The patient who I had told me this that whenever she'd go to see her doctor, she'd tell her to not wear her white coat. In her case and in others, I guess it's directly related to the coat itself.
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In general, the phrase refers to the clinical setting, not the actual coat.

Also, I just read your other post more closely. I seriously hope you didn't just chalk a 220/140 BP up to "white coat hypertension"
 
Omni said:
No, it does actually. The patient who I had told me this that whenever she'd go to see her doctor, she'd tell her to not wear her white coat. In her case and in others, I guess it's directly related to the coat itself.
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Yeah... I was saying what southernIM said, and in general it's related to being in a medical setting, not the coat itself, anecdotal evidence notwithstanding.

http://www.webmd.com/hypertension-h...about-high-blood-pressure-white-coat-syndrome

Although this study suggests that the effect is less pronounced when a nurse takes the blood pressure:

http://www.bmj.com/cgi/content/full/325/7358/254

I don't know if doctors in the UK wear white coats or not.
 
KeyzerSoze said:
Yeah... I was saying what southernIM said, and in general it's related to being in a medical setting, not the coat itself, anecdotal evidence notwithstanding.
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I'm not saying you're wrong or anything, but some cases, like my patient, do happen where it's just related to the uniform or what the person is wearing. "Medical setting" can be defined as a very broad term.


southernIM said:
In general, the phrase refers to the clinical setting, not the actual coat.

Also, I just read your other post more closely. I seriously hope you didn't just chalk a 220/140 BP up to "white coat hypertension"
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lol, I've been doing this for a good 3 years. Albeit not the most experienced, but when I have a patient with this type of bp who chooses not to go to the hospital, I take the word of higher medical authority (in this case, the woman's physician) before I sign them off on an RMA and leave them after much persuading.
Worrying about my actions is a waste of energy because my patients are always in good hands 😛.
 
Some good 'ol soap and water should do the trick!
 
Omni said:
No, it does actually. The patient who I had told me this that whenever she'd go to see her doctor, she'd tell her to not wear her white coat. In her case and in others, I guess it's directly related to the coat itself.
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Sounds like a case of simple classical conditioning to me. Changing the coat's not going to fix the problem b/c the new uniform will simply gain the same effect that the old one had unless you can first figure out what is causing the conditioning and eliminate key factors.
 
apumic said:
Sounds like a case of simple classical conditioning to me. Changing the coat's not going to fix the problem b/c the new uniform will simply gain the same effect that the old one had unless you can first figure out what is causing the conditioning and eliminate key factors.
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I can imagine that taking a turn for the bad. What if the docs not wearing anything underneath?
 
This is beyond ridiculous. Considering Nurses where their uniforms at their houses/outside and then come in to work. They go out and smoke/do whatever in their uniforms and come inside and probably have the most patient contact and we're arguing about a doctors white coat, which they keep in the hospital (for the most part) 🙄
 
Kong Bu said:
while detractors see it as an alienating symbol of medical hubris.
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This sounds like a load of crap to me. The white coat is an alienating symbol of medical hubris??!! What?! Do doctors need to watch out what they wear now because patients might be offended?! This is pure insanity and I think there are much more AMA has to worry about than deciding if doctors should wear pink or purple...
 
gujuDoc said:
So true!! Also the big pockets in the coats allow you to transport extra things and make it easier.

I did read a long time ago that Britain was trying to ban white coats and long sleeves. Healthcare workers had to wear only scrubs. I wonder how that affects women who are religious and don't wear short sleeves i.e. muslim women. Because in Britain they were also banning long sleeves which is why they made the wear scrubs rule.

I think you have to realize that germs spread regardless of what we wear. What must be done mostly is to keep the coats sanitized aka wash it regularly and not come with the same unwashed clothes. Its a hospital so germs are going to spread regardless of whether we are wearing a coat or not.
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I love the pockets. I may complain about the white coat, but I won't get rid of it yet (even though I'm doing a year of peds and it's not required) because of the pockets.

As a phlebotomist, I wore a paper, water resistant white coat. It was annoying because it was sooooooo hot and not breathable. I just hope they don't go to those because they're disposable.
 
Plus, they look ******ed. I will be happy to go without the white coat.
 
I read before that patients felt the most comfortable talking to doctors while wearing their white coats. Just a suit and tie intimidated patients, and casual dress made them nervous as to lack of professionalism.

However, after working in a lab last summer I don't find it hard to believe that they harbor bacteria and other contaminants, but I mean wouldn't any piece of clothing? I mean if anything why not just have them washed after shift?
 
Gallix23 said:
I read before that patients felt the most comfortable talking to doctors while wearing their white coats. Just a suit and tie intimidated patients, and casual dress made them nervous as to lack of professionalism.

However, after working in a lab last summer I don't find it hard to believe that they harbor bacteria and other contaminants, but I mean wouldn't any piece of clothing? I mean if anything why not just have them washed after shift?
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I think that's the problem. People simply don't wash them that often, and they know they wont. On the other hand, most people will wash their dress shirt and pants after they sweated them up.

Ties are bad as well, I rarely wash my ties.
 
Most people don't wash their ties often. It irritates me that we spend 30 minutes doing hand washing tutorials, lose points if we don't illustrate proper hand washing technique and then we adjust our dirty tie and pull out the same pen we used for the last week.
 
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