A memory came to me today out of nowhere, and I immediately had to write down my honest thoughts regarding it. A while ago, a 3rd year medical student and I were speaking and rather nonchalantly the student says, "You know, back in the day when white coats were actually meant for doctors." I remember being taken aback by the comment and being the non-confrontational type (unless I really know my opinion on something) I let it go and said nothing. But indeed, I have a LOT to say in response to that comment.
If you look back in the history of this symbolic piece of clothing, doctors began wearing them as a distinction from non-science based practitioners (read: quacks.) They purposefully started wearing what laboratory scientists wore: white coats. It began also representing a symbol of cleanliness for physicians when hygiene largely became recognized as an essential part of medical care. As we've moved closer to the present, scientists and doctors have continued to wear them, as well as several other professions in the healthcare setting. Pharmacists, nurse practitioners, physician assistants, physical therapists-- these individuals wear them as a representation in their involvement in patient care. Many professional schools will have a white coat ceremony (similar to medical schools) as a symbolic representation of their future career in healthcare.
After this medical student's comment, I remember thinking of other similar attitudes I've overheard. Doctors report that so many people wearing white coats is "confusing" for patients and the belief that there should be a very clear distinction based on how we dress. Others believe that they worked hard for that white coat and it should represent all their years of slaving away, not to be diluted by professions that didn't go through similar training. I choose to respectfully and totally disagree with these thoughts.
Firstly, if your patients are confused and don't know you are their doctor, you're doing something wrong. You're not sitting down and talking to them, explaining to them your role in their care. Maybe you're not introducing yourself correctly. Either way, what other people wear should have no bearing on your physician-patient relationship. Secondly, regardless of how many years a physician trained compared to other professions should have no bearing on the importance in patient care, and a white coat shouldn't be the sole thing representing all those years of hard work. Your expertise and experience, problem-solving abilities, reliability, and bedside manner should speak for all those years, not what you're wearing. A good physician (and a good PA, NP, pharmacist, etc) should be able to walk into a patient's room, communicate effectively and do their job well, regardless of their attire.
If a doctor out there is so concerned about the respect that comes with a white coat, I encourage them to reevaluate why they are in this career. Respect is earned, not passed out at a white coat ceremony. If we all do our jobs well, with intellectual curiosity and compassion, it really won't matter how we're identified.
On another note- while I adore my white coat, it's.. kind of gross. I mean really, despite cleaning them regularly I can't compensate for the exposure considering I wear it into every patient's room. C. diff spores and MRSA abundance? Yep, let's be real. We're reaching an understanding that maybe white coats aren't necessary and may actually be a detriment.
So can we just leave them as a symbolic representation of everyone's hard work and stop worrying who "gets" to wear one? This is not Mean Girls. We can all sit together and wear whatever the F we want.