Dr Max questions the logic behind the ban of white coats for UK doctors
Max is a hospital doctor, author and columnist. He currently works full-time in mental health for the NHS. His new book, The Marvellous Adventure of Being Human, is out now
FOR YEARS WHEN you thought of a doctor, you thought of someone in a white coat. Yet this garment has long been consigned to the waste bin. Go on to any hospital ward now and you will see doctors wearing open necked shirts or, sometimes, scrubs. But never, ever a white coat. In fact, they have actually been officially banned in many hospitals and those who dare to try wearing one, risk being rugby-tackled to the ground and having it torn from their backs by a manager. But does the humble white coat really deserve its new-found pariah status? The truth is that the white coat has been politicised and the reason it was banned isn’t as straightforward as we’re led to believe.
White coats were banned, along with things like ties, because it was claimed that they were an infection risk. Many doctors have taken umbrage at this—not because they are being required to abide by rules, but that the rules make no sense.
The initial argument was that most doctors waited until their white coats were so covered in organic matter before washing them that they could have taken themselves off to the laundry. Instead, they have been replaced by plastic aprons for medics, when they have to do a procedure or examine a patient. Yet they still leave a good proportion of your nicely laundered shirt or blouse exposed. So white coats have been replaced with something that, if truth be told, doesn’t really protect the patient from the doctor’s clothes and certainly doesn’t protect the doctor’s clothes from the patient.
In fact, I’d go so far as to say that it’s actually a dangerous policy because it obscures the real problems faced when tackling hospital-acquired infections. This is because, along with hand washing, the only other variable that has been consistently shown to be implicated in hospital-acquired infections are bed occupancy rates. Put simply, the quicker the turnaround in hospitals and the more pressure there is on beds, the more infections there are. So, rather than look critically at the current model for the NHS, which is all about cutting beds and realising that this is directly contributing to hospital infections, it’s far easier to look to the innocent white
