Thursday, 7 July, 2022
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Demise of the white coats – more casual attire now the trend

With fewer and fewer physicians wearing the traditional white coats these days, there’s an increasing tendency for patients to mis-identify them.

While more doctors now favour the less formal “scrubs” outfits, many of the younger generation also prefer working in casual clothes.

Early in the COVID-19 pandemic, Dr Trisha Pasricha, a gastroenterologist and research fellow at Massachusetts General Hospital in Boston, was talking to a patient in a ward and like others in her institution, was wearing scrubs instead of a white coat.

This was out of concern that the white coat might be more prone to accumulating or transmitting COVID-19 pathogens.

Her badge identified her as a physician, and she introduced herself clearly as “Dr Pasricha”.

“The patient required an emergent procedure, which I discussed with him,” Pasricha told Medscape. “I went over what the procedure entailed, the risks and benefits, and the need for informed consent. The patient nodded and seemed to understand, but at the end of the discussion he said, ‘That all sounds fine, but I need to speak to the doctor first’.”

Pasricha was taken aback. “Who did he think I was the whole time I was reviewing medical concerns, explaining medical concepts, and describing a procedure in a way a physician would describe it?”

She realised the reason he didn’t correctly identify her was that, clad only in scrubs, she was less easily recognisable as a doctor. And while this type of mis-identification happened to physicians of both genders wearing scrubs and no white coat, it was more common for female than for male physicians to be mis-identified as technicians, nurses, physician assistants, or other healthcare professionals, she said, adding she had been the recipient of this “implicit bias” not only from patients but also from members of the healthcare team.

Other female colleagues had suffered similar experiences, especially when they were not wearing white coats.

Changing times, changing trends

“When COVID-19 started spread, there was an initial concern that COVID-19 was passed through surfaces, and concerns about whether white coats could carry viral particles,” said Dr Jordan Steinberg, surgical director of the craniofacial programme at Nicklaus Children’s Paediatric Specialists/Nicklaus Children’s Health System, Miami, Florida.

“Hospitals didn’t want to launder the white coats as frequently as scrubs, due to cost concerns. There was also a worry that a necktie might dangle in patients’ faces, coming in closer contact with pathogens, so more physicians were wearing scrubs.”

Yet even before the pandemic, physician attire in hospital and outpatient settings had started to change. Steinberg, who is also a clinical associate professor at Florida International University Wertheim School of Medicine, told Medscape that in his previous appointment at Johns Hopkins University School of Medicine, he and his colleagues “had noticed in our institution, and other facilities, an increasing trend … from white coats over professional attire toward more casual dress— increased wearing of casual fleece or softshell jackets with the institutional logo”. This was especially true with trainees and the younger generation.

 

Medscape article – Are Physician White Coats Becoming Obsolete? How Docs Dress for Work Now (Open access)

Battling to find archive links but will keep looking!

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