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Might be time for doctors to lose the white coats

Doctors HandsBy Alan Lyndon

Medical schools like them for the traditional drama of the graduation ceremony. Patients like them for a level of confidence they display in their physician. But it might be time to say goodbye to the white coats.

The Society for Healthcare Epidemiology of America (SHEA) looked at several studies that indicated physician white coats and nursing uniforms may serve as potential sources of colonization and cross-transmission, according to new research published online last week in the journal Infection Control and Hospital Epidemiology.

Researchers found “the degree of contamination was correlated with more frequent usage of the coat,” and that “higher bacterial loads were found on areas of clothing that were more likely to come into contact with the patient, such as the sleeve.”

The new study found that “physician white coats and nursing uniforms may serve as potential sources of colonization and cross-transmission. Several studies described contamination of apparel with Staphylococcus aureus in the range of 5% to 29%.”

The SHEA issued new recommendations that, while not mandated as formal guidelines, should be considered as “common sense.” Some of those recommendations are:

Bare below the elbows” (BBE): Health Care Providers (HCP’s) should wear short sleeves, no wristwatch, no jewelry, and no ties during clinical practice. “Facilities may consider adoption of a BBE approach to inpatient care as an infection prevention adjunct.”

White coats: Facilities that require docs to wear white coats for professional appearance should institute one or more of the following measures:

  • Offer to, or require, all HCP engaged in direct patient care to possess two or more white coats and have access to a convenient and economical means to wash the white coats — such as an in-house laundry facility — at least once a week.
  • Institutions should provide coat hooks that would allow HCP to remove their white coat (or other long-sleeved outerwear) prior to contact with patients.

“Overall, patients express preferences for certain types of attire, with most surveys indicating a preference for formal attire, including a preference for a white coat,” say the researchers. “However, patient comfort, satisfaction, trust, and confidence in their physicians is unlikely to be affected by the practitioner’s attire choice.”

So, docs, what do you think?  Are you ready to lose the white coats?

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