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Demystifying Medicine One Month at a Time

White Coat Vote

ared_trailer_fpoDoes your doctor/health professional wear a traditional white coat?

Do you favor it? Or do you think it creates a barrier that makes it harder to connect with or question her?

What about infection? Studies show that health professionals in general don’t launder their white coats often enough. Other studies show that the garments harbor potentially pathogenic bacteria. But no studies or reports have yet demonstrated specifically that white coats have been a vector of transmission.

There’s been a flurry of media around the topic recently: At various Infectious Diseases society meetings, many member physicians have been advocating for a change in our white coat culture — trying to get health care workers to remove their white coats and go “bare below the elbows.”

I won’t rehash the points of view here; instead, there are several links you can peruse if you’re interested in this topic that I will provide below.

Philip Lederer, an infectious diseases doctor in Boston, has been one of the main advocates against white coats: He wrote about it here, then blogged about it here.

I interviewed Dr. Lederer about the topic for Tulsa Public Radio here; then the Boston Globe ran a front page story about the debate here.

I tried to summarize the viewpoints (and offered a bit of personal narrative) for NPR here; then Dr. Lederer wrote a response here. His website provides a fine array of information about this issue.

What are your thoughts? Vote by leaving a comment here or tweeting me @GlassHospital. If you’re not a tweeter, send a SnapChat (just kidding….kids these days!).

5 Comments

  1. You know my point of view:) Thanks for writing about this, John! best regards, Phil

  2. I am indifferent on the matter. I use three MD’s , two specialists and a GP. The latter wears a white coat, others don’t. I swear that I experience reverse “white coat effect” with BP readings… OK, no discernible effect.
    I like the short sleeves approach as I think about it. Wasn’t there some reporting a few years ago about bacteria hiding in MD neck ties?

    Thank you for your interesting blogs.

  3. I think this just silly… doctors aren’t supposed to be “just people”. The white coat gives them an air of authority, which they SHOULD have. I mean hell, they already have enough trouble as it is with patients that think they know better than the doctor because they read something on WebMD.

  4. Hello Dr John and thanks for bringing this issue up (again!)

    A few years ago, a heart patient wrote a letter to the editor of our local newspaper complaining about a cardiologist she’d met while recently in hospital – whom she described as “looking like the Devil himself … he wore tight jeans, a shirt of some ungodly print and had curly hair hanging down past his bum.” Why, she demanded, don’t all doctors wear nice white coats?

    I immediately sent a letter to the editor in response to hers because I recognized “the Devil himself” as my own cardiologist, the wonderful man who had saved my life during my heart attack at that same hospital. I suggested to the letter writer that she would no doubt much prefer the white coat-clad ER doc who had first misdiagnosed me in mid-heart attack. This white coat-clad doctor did not introduce himself to me, did not make eye contact, and made it clear that I was wasting his and his colleagues’ valuable ER time. He told me very confidently that there was absolutely nothing wrong with my heart, but that I was in “the right demographic for acid reflux”. When he sent me home that morning, I left feeling so embarrassed for having made a big fuss over nothing.

    Later, during a second ER visit (by then, my cardiac symptoms had become truly unbearable) I met that strikingly tall, long-haired man wearing a crazy-print Hawaiian shirt – who held my hand, told me that I had “significant heart disease”, explained what was happening to me, and sent me immediately upstairs for emergency treatment. (Both letters can be read here: http://myheartsisters.org/2009/07/01/devil/ )

    As a patient, I’d much rather encounter competence and caring, no matter what a physician is wearing.

  5. My father,82, always said he suffered from ‘white coat syndrome’ to explain his elevated bp whenever he visited his docs, especially when we moved to Spain. It was only after seeing his medical records (obtained from the UK) on his discharge from a triple bypass that they believed him!

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