Should white coats be only worn by physicians?

Maybe it’s just me, and maybe this is a regional/local phenomenon, but I have noticed a sharp increase in the number of non-physicians who sport their white coats on a daily basis around the hospital.

First, let me preface this piece by saying I have absolutely nothing against any person who partakes in the care of patients; in fact, I commend all the helping hands that routinely dedicate themselves to health care. As a physician, I remember distinctly my white coat ceremony, and having to delineate myself from the residents and attending physicians by wearing a short white coat. Though it was a distinction, it was not a shameful one. Graduating medical school and moving forward to a long white coat was and is a privilege, one that I am proud to have earned through years of hard work and dedication.

My physician colleagues have worked diligently and achieved the ability to wear the long white coat, albeit covered in various germs (I will not enter the subject matter of whether anyone should be allowed to wear a white coat given the surge in infections), and I can truly say there is not a single physician I know, whether resident, fellow or attending, who is not proud of their accomplishments.  And rightfully so.

What’s the point you ask? The point is, it is certainly an honor to don a white coat as it represents my place in medicine as a physician. So how come so many of the case managers, social workers, care coordinators, nurse practitioners, dieticians and various other mid-level providers are also wearing a long white coat on a daily basis? Let me remind you that I harbor no ill will against any caretakers — in fact some of my best friends are nurses I have met along the way — but it is frustrating at times that a simple piece of fabric that I have worked tirelessly for years to earn the right to wear is so easily granted to others.

What irks me further is more gender-specific; as a female physician I often will enter a room and introduce myself as Dr. (last name), and I cannot tell you how many times the patient or family member will remark to another person in the room or on the phone, and say “Oh, the nurse is here.”

I don’t even feel this is insulting because it is also a privilege to be a nurse, which I consider to be a very high step on the health care ladder. But the confusion stems from the fact that nearly all of the other female health care workers involved in patient care are sporting a long white coat. Granted, some people will simply never get it; even if I bluntly state I’m Dr. so-and-so, they will not understand that I could be “their doctor at such a young age,” and then they will proceed to guess my age and ask various personal questions that derail the conversation entirely.

But the bone I pick here is that it seems unfair that as someone who worked exceedingly hard for many, many years to earn the right to wear a long white coat, this ability is simply granted to other practitioners without any significance. This becomes especially problematic and to a small degree demoralizing as a female physician.

I have turned this subject over and over in my head, debating whether or not I should publicize my feelings, as I cannot seem to pose a solution. I do not think it would be fair to strip other health care providers, both literally and figuratively, of their white coat; after all, some people have admitted it is more convenient to wear as it provides pockets to carry various pagers and paperwork around. I have thought about suggesting that non-physician practitioners who choose to or who are required to wear a white coat be allowed to wear a short white coat.

I have deliberated thoughtfully over how nurses and other health care providers would feel knowing some physicians seem to resent their attire. I have discussed this topic with a few of my physician colleagues, and one even remarked to me, “I’ve always felt like that, and I never wanted to say anything because I just feel like everyone would hate me.” I have also considered the fact that I am sure one day via some form of social media this topic will flare up some potentially hostile debates between physicians and other personnel — especially women — and I want to reiterate that in no way do I or would I ever intend to spark those sorts of discussions.

Quite simply, I hope that we all recognize the dedication that every practitioner provides in their daily role in the team, whatever that role may be. But maybe not every person on the team should be wearing a long white coat, which has traditionally been bestowed upon physicians as an honor and privilege after years of training. Maybe that would also sort out the confusion of female doctors walking into a room and being mistaken for anyone else.

The author is an anonymous physician.

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