Why a Doctor Wears a White Coat And Its Meaning

IN A NUTSHELL:

• Doctors have worn white coats since the 1800s
• Some specialties prefer not to wear them
• Patient perspective one of the main reasons white coats worn

You may see many workers in a health care facility and they all may be wearing different outfits, but one fact is for sure—there is no workplace clothing as symbolic or common as when a doctor wears a white coat.

Those who work in health care administration or in the office conducting clerical duties may be wearing professional attire, nurses often can be seen in scrubs of various colors each with their own meaning, but when you see the physician he or she is bound to be wearing a white coat.

In fact, one study found that 72 percent of all hospital doctors and medical students wear white coats and most of them wear the coats more than 75 percent of the time.

The question remains, why does a doctor wear a white coat?

The No. 1 reason why a doctor chooses to wear white is for easy recognition by colleagues and patients. The tradition began in the late 1800s, when trained surgeons, followed by physicians not too long thereafter, began wearing white lab coats as a way to distinguish themselves from the fraudulent health care providers who those attempting to pawn off miracle cures and  did not practice traditional, evidence-based medicine.

Nowadays, the reasons range from a symbol of professionalism, integrity, and the highest commitment to caring for the sick and suffering. It starts almost immediately after a student graduates from medical and receives their degree, as approximately 97% of medical schools have a “white coat ceremony,” a rite of passage and transition from being a student to becoming a physician.

Patient Perspective of a Physician:

Researchers at the University of Michigan surveyed 4,000 patients at 10 U.S. academic medical centers and discovered that a physician’s clothing affects how patients view their doctor and their overall satisfaction of their care.

However, the importance of attire is not only about the coat itself, but also what is worn beneath. Physicians who wore a white coat over business attire were seen by patients as more knowledgeable, trustworthy, caring, and approachable. This viewpoint is even more common in older patients above the age of 65.

Physicians who wore medical scrubs beneath a white coat scored next-highest in patient satisfaction and approval. Physicians that only wore business attire with no white coat ranked No. 3 in the study.

White Coats Are Not For Everyone:

A doctor wearing a white coat is not necessarily set in stone—in emergency rooms as well as operating rooms patients preferred doctors to only wear medical scrubs.

While that preference could be an indication of what is considered to be “professional” for that particular setting, some argue that white coats present an increased risk of Hospital Acquired Infection (HAI). In 2009 the American Medical Association considered banding white coats in hospitals—the resolution did not pass.

While almost everything else that comes in contact with a patient is sanitized or thrown away, one study found that while hospital workers washed scrubs every one to two days, they washed lab coats every 12 days.

Taking extra measures have been encouraged in the health care industry, from washing or disinfecting the coats more often, or even rolling up the sleeves.

A white coat is not necessarily ideal for all doctors and physicians. Psychiatrists and pediatricians, for example, report that they prefer business attire to make their patents feel more at ease. The century-old “white coat syndrome,” first documented in 1896, shows that patient anxiety about a doctor can cause high blood pressure readings in as many as 30 percent of patients.

While it may seem minor on the surface, research proves that “white coat syndrome” can be severe. A study published in the New England Journal of Medicine found that the risk of death for patients with high blood pressure and white coat syndrome is twice as high hypertension as it is for patients with normal blood pressure and white coat syndrome.

Aside from the possibility of spreading infection, or out of concern for patients that may suffer from a legitimate phobia, some physicians may choose to not wear a white coat simply out of comfort.

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