Doctors Should Keep Their White Coats On

I believe in human equality, but that doesn’t mean we should not distinguish ourselves from each other regarding our societal functions.  I bring this up because a medical student named William W. Motley argues that doctors should give up their white coats.  It’s an interesting piece.  From the column (citations omitted):

When presented with short coats, medical students are effectively asked to submit to a dress code that establishes a hierarchy amongst healthcare providers. Medical researchers have conducted studies and shown that breaking down the hierarchical structure through team training exercises and simple checklists reduces surgical error^. Rigid ranks inherently silence the concerns of those lower on the totem pole and result in missed opportunities to identify errors.

Stopping use of white coats can help teach future physicians a valuable lesson in humility. By eliminating attire as a marker of hierarchical importance in the quest to improve care, we will encourage students to realize that doctors, nurses, technicians, and even students play a role in recognizing and stopping medical mistakes.

Leaving aside the sanitary element—which Motley emphasizes and is very important—I disagree.

The white coat marks doctors as learned professionals.  That doesn’t make them better than us, but it does—and should—distinguish them in their fields of expertise.  The “authority” of the doctor has an important place.  That is also why a robust adherence to medical ethics are so important.  Power corrupts.

When I was recently called to jury duty, I knew immediately who the lawyers were—they were the only one in ties.  Should lawyers dress in jeans and rock band T-shirts? No!  It would reduce respect for courts and undermine their professionalism.  The judge wore a robe.  Should he or she dress casually?  No.  The robe adds dignity, majesty, and yes, authority, to the proceeding.

The military wear uniforms.  They should.  So do airline pilots.  They should, too.

Clergy and religious orders these days in some faiths like to blend in, and so they eschew collars, habits, etc.  But that is misguided.  If one has enough faith to be clergy or a nun, why wouldn’t you let it show?  Imagine the opportunities for helping troubled people or answering questions from the inquiring.

Equality is important.  But egalitarianism can go too far.  Doctors should keep their white coats—or their functional equivalent.  Motley understands this, even if he seems to be arguing against professional hierarchical identifiers :

I realize that gaining the trust of a patient is an important part of effective doctoring and that this uniform helps instill confidence. A baby-faced 27-year-old, I would probably benefit from such a strong symbol of authority. But I hope that my communication skills (learned in medical school and before) and knowledge will be more effective tools than an infrequently laundered coat.

I think that more medical schools should start welcoming students with a stethoscope ceremony. White coats are superfluous uniforms; stethoscopes are important diagnostic tools. Stethoscopes also symbolize an even better way to gain the trust of a patient: by listening to them, and by listening to the evidence.

Wearing a stethoscope around one’s neck would be a uniform.  The white coat isn’t what matters, per se.  It is the identifiable professional status that remains important.   If white coats are unhealthy, by all means do away with them.  But my point remains.