The withering shine of white coat

The white coat has been the most recognizable symbol of our profession since time immemorial. The practice of wearing white coat was first introduced in the 19th century in Canada by Dr. George Armstrong (1855–1933). Back then, the gleaming white coat - in many respects an entirely impractical color, became a symbol of authority and a life-giving profession instead of just preside over its ebbing away. The whiteness of the coat provided a sense of trust, belief and hope for the patients[1] and perhaps that is why it still continues to be the formal dress code in all medical schools. Although the color of the coat still remains white, however, some unseen dirt has gradually been diminishing its sheen. Gray shades have been added to it by some of the unethical practices that have started occurring in the medical profession in modern times. The whiteness of this coat has been faded by the attitude of our younger doctors. This present generation who had struggled hard for admission to medical schools and the associated pride of wearing the symbolic white coat find it unfashionable once they leave the medical school or perhaps they do not want to shoulder the responsibility the coat conveys.[2]

In a cross-sectional study of around 400 patients performed in an outpatient clinic where respondents were asked questions related to their preference for physician dress as well as their trust and willingness to discuss sensitive issues, it was found that 76.3% of the respondents significantly favored the professional attire with white coat. Their trust, confidence and willingness to share social, sexual, and psychological problems was significantly associated with their preference for professional dress.[3] This white coat, which was earlier worn by doctors more as a sign of authority and respect, is now mostly used as a protective barrier from infection. In another study of around 200 patients, it was found that wearing white coat improved all aspects of the patient doctor interaction, and that when doctors wore white coats, they seemed more hygienic, professional, authoritative and scientific.[4]

This withering shine of the white coat could be restored by the collective efforts of the medical fraternity. Doctors should realize that the sanctity of this coat can only be maintained when we wear it with dignity and perform our duty of patient care with compassion and responsibility. The white coat should remind the wearer that medicine is a special kind of profession and that doctors have extraordinary obligations to patients.