for Healthcare Epidemiology of America (SHEA), one of the topmost organizations
for preventing and controlling infections in the medical workplace, has issued
guidelines on health care provider (HCP) attire, except for the attire in the
operating room. Why?
In their paper
published in the journal Infection
Control and Hospital Epidemiology
, researchers evaluated various studies
and they gave reasons and recommendations for the same.
Studies evaluated by
the researchers indicated that doctor's white coat
and nursing uniforms may serve as potential sources of contamination by
pathogens such as Staphylococcus
species, Enterobacteriaceae, and Pseudomonas
species. The worst areas of the white coat are the sleeves, collars and
A study found that in
India, the white coats of medical students and staff in rural dental
were contaminated with Staphylococcus and Pseudomonas
SHEA thus recommended
the following two solutions among others, albeit voluntary -
Wearing short sleeves (bare below the elbows), no wrist watch, no necktie, and
no jewelry during clinical practice.
Possessing two or more white coats and having access to economical and
convenient means to launder white coats.
National Health Service in UK had also adopted the 'bare below the elbows'
attire policy to reduce infections
They also required the doctors to leave their uniforms at the work place where
they were laundered.
evaluated are divided on the patient's preference for white
, surveys show that patients felt most comfortable when their
physicians wore scrubs followed by business suits and last, the white coat.
SHEA does not
recommend either wearing white coat or not wearing one, they did come out with
Patients' preferences for attire had a limited overall impact on patient
satisfaction and confidence in physicians.
When made aware of the potential risks associated with white coat, patients
appear willing to change their preference for physician's attire.
93 percent of the doctors and nurses and 83 percent of the patients thought
physician appearance was important for patient care.
Interestingly, a study
published in the Journal of Experimental
suggested a phenomenon called 'enclothed cognition' to
describe the influence the clothes have on the people's psychological
processes. And the effects depend on two conditions:
The symbolic meaning of the clothing
The actual wearing of the clothing
It gives the doctors
acquired heightened attention and focus. It gives medical professionals the
confidence to not only heal the patient but also to understand that the life of
patients is in their hands.
However, many medical
organizations are not in favor of the white coat. For example, Mayo Clinic
believes that the white coat builds a barrier between the practitioner and the
patient, and makes patients more anxious.
'I find it amusing if not disturbing the idea of wearing, say,
street clothes, instead. Personally, the donning of a white coat establishes a
necessary professional boundary, well understood by patients and physicians
alike, a decorum that is not only physical but psychological as well,' says
Manfred Marcus, a retired physician.
What does the white coat mean to the interns? At the 13th
Annual White Coat Ceremony, Andrew Gibb, a second-year dental student at
University of Alberta, said 'Well,
first of all, it's white. The Latin word for white is 'candidus,' which is also
the origin of the English word 'candor,' meaning openness and honesty in
expression, unstained purity, and freedom from bias, or impartiality. Our white
coats represent what we must be as clinicians: kind, honest and sincere. Our
dedication to our patients will drive us to learn, to develop and improve our
So, are the medical
professionals going to ditch the more than 100-year-old tradition of white
coats? Time will tell.