10.22.2007

The White Blue Coat...or better yet, avoid MRSA and wear *no* coat!!


I think physicians should wear long light blue coats (if any coat is worn at all). Where I work, the physicians are the *only* people without a white coat!! (I exaggerate, but only a little). It's unfortunate how obscure our various roles have become to the patients. Isn't it important for the patient to be able to identify their RN vs. housekeeping vs. LVN vs. pharmacist vs. physician? I have patients wandering about the ED, asking everyone from the janitor to the registration folks for pain medications and cups of ice water. When they are subsequently instructed to ask their nurse if it's okay to have food/water, they frequently express frustration in being unable to do so. "Which one is my nurse?" Who are the nurses? I'm not sure either...and I work here.

It's important for patients to know and remember that I am their doctor. That they were, in fact, seen by a doctor, and can ask the doctor questions and follow recommendations. If doctors were the only ones with white coats, this would be easy. I would walk in wearing my coat, and the patient would instantly know that they have been seen by a doctor. As it is, no one has a clue. I remember rounding on my patients one morning as a resident (rotating thru medicine) wearing the white coat, name badge displayed, and always introducing myself as "Dr. Backstage," not allowing others to call me by first name as to not interfere with my efforts to be seen as the doctor...and still, when rounds came with the attending, more than once I've had patients complain "I never see a doctor and I've been in here for 3 days." Of course all eyes turn to me...like, 'you haven't actually seen the patient in 3 days?' At these times I look at the patient and say, "Ma'am, I've been here the last 3 days, multiple times a day...had long conversations with you and your daughter..."

"Oh, you're my doctor? But you look so... young, pretty, nice...(I think the word you're looking for is *female.*)

*sigh*
As a patient, I was very confused laying there on the gurney wondering who's who. Who do I ask for help? Lots of people buzzing around busy, busy, busy...asking me questions and doing things to me. I couldn't remember all their names, and they probably did introduce themselves and stated their role...but...trying to curb my anxiety, cooperate, be well, and remember names/roles is difficult. If the nurses had on a certain color/style/pin it would have been easier to place them. If the doctors were the only ones wearing white coats, I would be able to pick them out. If everyone was proud to display *their* respective roles (instead of everyone pretending to be the physician), it would be easier for the patient, and easier for everyone involved.

This is why I think physicians should wear light blue coats. They are classy, don't look as dirty, complement figures and skin tones better than white, and will allow for easier identification. As more women become physicians, and more men enter nursing the typical gender roles are unreliable predictions of current positions on the healthcare team. Making it that much more important to distinguish who's who for the people we serve.
***

Otherwise, we should opt out of wearing coats altogether - afterall, they impede proper handwashing, are full of MRSA (drug resistant bacteria), and make people sick.

11 comments:

Anonymous said...

Could we like go with a better looking coat while we're at it then? Something that doesn't have buttons down the front? (I do agree it is confusing who is who, but I hate the blue color.)

Noel Hastings said...

I can't say I am for the "light blue" coats, but I can say as a medical student I am also frustrated. In a new hospital in a new city every 6 weeks I find myself asking all sorts of questions and getting all sorts of unsolicited information. I hate spending minutes on every question trying to evaluate who I just heard information from so I can appropriately rate its reliability. Not that all docs are more reliable than other staff, but I can tell you that the info I get from nurses, PA's, MD's and others all varies. I am there to learn to be an MD and I will listen more closely and follow up on MD and perhaps PA info with greater vigilance. Nurses help a lot and I appreciate their advice, but it often pertains to patient care or their experience with a drug. It is not a scientific trial, if anything it is a case series of their own. I would like to know who is who when I walk into the hospital.

I know, how about beanies with little propellers on them for the MD's!!!

Toni Brayer MD said...

I can't imagine working without my white coat with the name on the pocket. I like your idea of color coding. I agree that we need to be identified. Hospitals are crazy places and patients have the right to know who is who. I wear my coat in the office also. Where do you hold your "stuff?" I have my pens, lights, stethoscope,business cards,pda with me all the time in the huge pockets. If you're worried about germs you should be naked and just wash constantly.

Student Doc said...

At the teaching hospital associated with my medical school, attendings do just this.

Surgery and anesthesia wear a light grey coat, and FM, Optho, OB, and a few others wear the light blue. Only the medicine attendings wear white (along with every nurse, nurse assistant, maintenance worker, tom, dick, and harry). The residents also all wear white.

Kate said...

There was some residency program that I interviewed at where the ER physicians wore brown coats... only it was kind of a faded-out cocoa color. Not too flattering.

Anonymous said...

> If you're worried about germs
> you should be naked and just
> wash constantly.

Heck! That would solve all the problems! Who could forget a young, pretty, nice, naked, female doctor? Patient satisfaction ratings would go through the roof — probably up 100% on 50% of patients, but the admins might not like the increasing LOS. But who cares about them anyway?

ER doctor said...

> If you're worried about germs
> you should be naked and just
> wash constantly

I think I'd be too cold...and my skin would be all dry and itchy...

Sven said...

Good Job! :)

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