When you google ‘doctor,’ virtually every image shows a person in a long-sleeved white coat. The crisp white coat with a stethoscope around the neck has long symbolized the profession. However, there is controversy about whether doctors should give up their classic uniform, as described in a recent story in the Boston Globe.
Britain’s National Health Service banned white coats several years ago, requiring doctors to be bare below the elbows to avoid spreading infections. Many clinical departments in the United States have done the same. The argument goes something like this:
- The sleeves of white coats are germ magnets.
- Doctors don’t launder their white coats very often, so deadly infections can be spread from one patient to another.
- Therefore, doctors shouldn’t wear long-sleeved white coats.
As a pediatric infectious disease specialist at Stanford, Charles Prober, MD, supports this theory. He told me during a recent interview: "In terms of the infectious disease risk, there is little question that one can carry bacteria or viruses on your clothing — whether it’s a white coat or the sleeve of your shirt, and one way to lessen that is to wash up to the elbows, especially when you’re going into high-risk environments like the ICU or nursery. Obviously you can only wash up to your elbows if they aren’t covered with something.
William Benitz, MD, division chief of neonatal and developmental medicine, agrees:
I find the summary reports highly credible and accept the contention that the long sleeves of white coats harbor infectious agents and carry them from patient to patient. We banned white coats in our NICU about 5 years ago, along with a mandate for baring arms to the elbow and hand cleansing upon entering any patient room. Part of the reason for the former is to reinforce and provide active visual evidence of the latter. We used to hear ‘but I won’t touch anything’ a lot, but that was often not so. Not an issue now.
However, there are some practical reasons for wearing white coats and not even Prober has given his up. "When I go to the hospital, I wear my white coat over there because it allows me to carry a bunch of stuff in my pockets - otherwise, I’d have to carry it in my hands," he told me. "But I usually take the coat off when I’m seeing patients. It’s said that some children are frightened when they see the white coat. I normally just wear a long-sleeved shirt, tie and pants so I roll my sleeves up to my elbows when I go into the nursery. I wear bow ties and argue that they are less likely to have bacteria than straight ties, plus a child can’t easily grab a bow tie and soil it."
Many doctors aren’t ready to give up their white coats though, so the debate is likely to continue. Prober estimates, “Walking up and down the hall, the number of people wearing white coats at Stanford hospital is probably about 50 percent.”
Jennifer Huber, PhD, is a science writer with extensive technical communications experience as an academic research scientist, freelance science journalist, and writing instructor.