The Doctor’s Dress

The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating murmurs of controversy.

It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed.

The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to get closer to their little patients and win their cooperation.

Psychiatrists do not like the white coat either. It portrays them as cold insensitive “clinical” people, dissecting human feelings and forcibly dragging their emotionally disturbed patients to the horrific “shock chambers”. They are rebelling against this dress code to break their stereo-typed image.

The ‘white coat’ or the ‘lab coat’ is a knee-length overcoat worn by professionals in the medical field or those involved in laboratory work to protect their street clothes, symbolize professionalism and indicate a closeness to science. The modern white coat was introduced to medicine in Canada by Dr. George Armstrong (1855–1933) who was a surgeon at the Montreal General Hospital and President of the Canadian Medical Association. It was used in the late 19th century by physicians to represent themselves as scientists, from whom they borrowed the dress, in contrast to quacks, faith-healers and butcher-surgeons who wore black coats then.

In sharp contrast to what the mutinous splinters might say of the white coat, opinion of patients and the public is overwhelmingly in its favour. A recent study conducted in the United Kingdom found that the majority of patients preferred their doctors to wear their white coats. They reported feeling more reassured and confident  with doctors who were “professionally” attired than those dressed casually in jeans and T-shirts.

A white coat ceremony (WCC) is a relatively new ritual that marks one's entrance into medical school and, more recently, into a number of related health- professions. It originated in Columbia University’s College of Physicians and Surgeons in 1993 and involves a formal "robing" or "cloaking" in white lab coats.

Over the last century, the white coat has protected not just the clothes of doctors but their stature too, and given them their distinct identity and adulation.

Those who wear it must do so with suitable dignity and uphold what it represents.

As published in HT City ( Hindustan Times) dated 22nd December, 2013.