The first time I wore a white coat was during the white coat ceremony in medical school. It was a beautiful day in New York City. Scores of young, bright-eyed medical students and their proud family members were all congregated in a ballroom, which shared its building with a bowling alley, in the heart of Harlem.
It was particularly warm inside the building, and we were being served hot coffee while receiving our seating assignments for the ceremony. One by one, the budding physicians were presented with their new unscathed and beaming white coats. The sound of joyous applause was at times interrupted by the loud bowling bowls rolling on the floor above us.
After the ceremony, we all posed for pictures wearing our new embellishment. It was a removed and mystical setting where the impending responsibilities and obligations of our chosen career path were not palpable.
The next time I wore the coat was at the hospital as a third-year medical student. I was exhilarated and perplexed at the same time. The short length of the coat highlighted my position as a medical student in the healthcare hierarchy (all the way at the bottom). The color of the coat declared my hefty title as a doctor. No one had explained the significance or the origin of the white coat to me. I felt like an imposter who was expected to conform to tradition without questions. I was not a full-fledged doctor yet, but apparently looked like one to the layperson.
Since then, I just never developed a connection with my white coat. In residency, I rarely adorned myself with it. Now as an attending, I wear my white coat maybe once a year when it’s cold outside. Most of my colleagues wear it for the convenience of pockets or just because they have to. Only a handful of the physicians at my facility exude pride in their coats, which I highly admire.
I asked my patients how they felt about their doctor not wearing a white coat. The majority of my patients admired the idea. One patient said that she felt more comfortable with me because I was not wearing a white coat. She added that the coat may have created a barrier between us and she wouldn’t have hugged me if I had it on.
Another patient with an opposing viewpoint said, “It took me two days to trust you as my doctor. Maybe it wouldn’t have taken this long if you walked in with a white coat the first day we met.”
Interesting thing is that the white coat is not unique to physicians anymore. The coat is worn by a lot of other healthcare personnel at a lot of different levels. It does not bear a unique identity.
Furthermore, white coats can also carry germs. A survey reported that less than 3 percent of physicians launder their white coats regularly. Since it is a loose item of clothing, it makes contact with many surfaces and may transmit infectious pathogens.
Hygiene and uniqueness aside; I do not wear a white coat because I want to be in partnership with my patients. Most patients appreciate my approach, but some remain wary. Wearing a white coat does not make one a better physician. You don’t have to wear a white coat to look professional. In my opinion, it’s a cloak of superiority that creates separation. Ultimately, it remains a personal choice.
Neha Sharma is a hospitalist. This article originally appeared in the El Paso Times.
