Wearing white coats in public places: pride or parody?

It has become increasingly common to spot doctors sporting white coats and stethoscopes at shopping malls, restaurants, grocery shops, on roads, in buses and other public places. This has become a trend, especially among medical students and junior doctors, with little insight regarding its implications. Doctors may do this because they take pride in identifying themselves as medical professionals, for convenience, or because of laziness.

Medical aprons can serve as vehicles transmitting nosocomial organisms into the community and vice versa. Numerous studies done on white coats have proven this. One such study from southern India revealed that 95% of overcoats were found positive for bacterial isolates like Pseudomonas aeruginosa, Klebsiella sp, Escherichia coli, non-fermenting Gram-negative bacteria and Staphylococcus aures (1).Wearing aprons in public places can only make things worse.

The bond between white coats and the medical profession dates back to the early 1930s. It portrays the image of a doctor in the hospital. Doctors wear white coats so that they are easily recognised by their patients and colleagues; to display cleanliness; to carry equipment and to emphasise the “doctor status” (2). Many surveys have found that patients prefer doctors with aprons (3). At the same time, the general public has always been critical of the practice that some medical professionals have of wearing aprons outside the hospital premises (4).

Although wearing white coats in public is not a crime, as there are no precise rules or regulatory guidelines regarding this issue, we feel it is completely unethical (5). The onus is upon the individual doctor or student to understand the legacy and dignity of these white coats and to decide how they want to project it. This issue should also be addressed while teaching medical ethics to undergraduate students.