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Will doctors' white coats get the hook?

A doctor cares for a patient at a hospital in Panorama City, Calif.

TEXT OF STORY

Kai Ryssdal: Imagine if your chosen profession was the subject of heated, sometimes really heated, arguments across the country. That people were debating how much you should get paid. Whether some of the tests you run are really necessary. And whether those white coats you wear are just so much window dressing and ought to be done away with. Jill Barshay reports on the latest problem for doctors.


JILL BARSHAY: Peter Ragusa is a fourth year medical student. It was obvious to him that his sleeves were rubbing against sick patients and spreading germs. But when Ragusa proposed getting rid of the traditional white doctor's coat, he was laughed out of the annual meeting of the American Medical Association.

PETER Ragusa: Unfortunately, it was somewhat dismissive. You know, what will physicians be wearing in the future, will they be scantily clad? Etcetera.

Ragusa's proposal wasn't so racy. He called for short sleeves, and no ties or jewelry. But it touched a nerve.

Stephen Greenberg is a medical historian at the National Institutes of Health. He says doctors have clung to their white coats since the 1880s to be taken seriously as scientific professionals instead of quacks.

STEPHEN Greenberg: It's as much sociology as medicine. I'm the doctor. I have status. I have the uniform. That makes me official.

The irony is that the status of the white coat has already slipped, ever since nurses began wearing them. The more senior the nurse, the longer the coat -- just like a doctor's.

Greenberg: But now everybody wears a white coat in a hospital. The cafeteria people, the librarians, the intake clerks. Everyone wears a white coat. So the idea of 'Hi, I wear a white coat, I'm the doctor,' has kind of gone away.

Still, doctors are a sentimental bunch. White coat ceremonies are a rite of passage at medical schools. Just ask Arlene Miller, the owner of Ja Mil Uniform Company in New York. She's been selling white coats for 47 years.

Arlene Miller: If it's someone that never had a lab coat before, it's like a wedding dress. They try on everything they can. What else you got? You know.

The uniform industry is attached to white coats too. Five months ago, Landau, one of the largest manufacturers, started selling coats -- with long sleeves -- made of a new material that resists germs.

But Peter Ragusa may still get the last laugh. The American Medical Association is studying his proposal.

In New York, I'm Jill Barshay for Marketplace.

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Though ties only function in adding to my uncomfortability as I perform my work(esp procedures), my white coat is an asset. The utility belt of Batman is akin. I fill my many-pocketed flak-jacket with objects and information that will aide in my Hippocratic crusade, and keep it clean and white to remind me of the good intentions I am sworn to uphold. My vote is: Lose the ties; Keep the white utility belt.

My father was a pediatrician back in the !960's. He was a very good physician, who was justifiably proud of his diagnostic abilities. He wore a bow tie. I always assumed it was just to keep the young ones from pulling on it. Now I suspect it was also because he was aware of the potential for transmitting pathogens from one patient to the next via long necktie, as well.

wearing of white coats was originally an antiseptic idea; before Semmelweiss bloody arms and garments were the norm. blood (and other body fluids) were more visible on white coats. perhaps a new space age material to show contamination is more appropriate today. also there was a british study showing definite transmission of germs from physician's ties.

White coats are more than a status symbol. Their origins can be traced back to the inception of antisepsis to fight infection and Semmelweis. Should we doctors make sure our coats are clean? Gee, that is the purpose of them to begin with. We wear them to assure segregation of pathogens away from patients. Seems like an idea whose time has come.

I am a physician in an intensive care unit, and I stopped wearing a white coat & tie about three years ago. Some of my colleagues disagree, but I've never had any negative feedback from patients or their families. Coats & ties are merely affectations that serve no unique purpose (ties serve no useful purpose whatsoever), and a growing body of evidence in the medical literature suggests that they are indeed harbingers of bacteria. I am glad to be rid of them.

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