{"id":7835,"date":"2015-11-01T08:17:09","date_gmt":"2015-11-01T13:17:09","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=7835"},"modified":"2019-10-02T06:05:49","modified_gmt":"2019-10-02T10:05:49","slug":"should-doctors-still-be-allowed-to-wear-white-coats-you-decide","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/should-doctors-still-be-allowed-to-wear-white-coats-you-decide\/2015\/11\/01\/","title":{"rendered":"Should Doctors Still Be Allowed to Wear White Coats? You Decide"},"content":{"rendered":"

\"roll<\/a>If you’re\u00a0not immersed in the ID or the Infection Control world, you might not be aware that there’s currently quite the controversy about whether doctors should wear white coats.<\/p>\n

I almost wrote “raging controversy” — but the adjective “raging” doesn’t\u00a0really fit the sort of people who specialize in Infection Control, who are\u00a0some of the most measured, data-driven, and methodical individuals\u00a0in all of medicine. You know the stereotype of the brash, volatile, and cowboy\u00a0surgeon, the person that everyone tiptoes around?<\/p>\n

These Infection Control folks\u00a0are the polar opposite.<\/p>\n

Still, a\u00a0white coat controversy does exist, and it\u00a0goes like this:<\/p>\n

    \n
  1. You can culture all kinds of scary bacteria from\u00a0the sleeves of white coats.<\/li>\n
  2. Doctors don’t launder their white coats\u00a0very often.<\/li>\n
  3. These bacteria could be transmitted to patients.<\/li>\n
  4. Therefore, doctors shouldn’t wear white coats.<\/li>\n<\/ol>\n

    Not surprisingly, some have advocated\u00a0a “bare-below-the-elbows” approach to doctors’ attire, and famously the British National Health Service has made it policy, banishing ties as well \u00a0(and predictably\u00a0not pleasing everyone<\/a>). There\u00a0was a tremendously entertaining debate<\/a>\u00a0on the topic this year year at IDWeek — such a pitched battle it almost met the “raging” criteria, but not quite (you could tell the combatants really liked each other). Right here in Boston,\u00a0one of our current ID fellows feels quite passionately about the issue<\/a>, and writes frequently on the topic.<\/p>\n

    The missing piece in the controversy, of course, is a\u00a0definitive study\u00a0showing that patient infection rates are actually reduced when a bare-below-the-elbows (often abbreviated “BBE”) strategy is adopted. Short of that, we’re all essentially\u00a0hostage to whomever sets these policies wherever we work. And our hospital’s policies basically follow those of\u00a0Society for Healthcare Epidemiology of America (SHEA)<\/a>, which “balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens.”<\/p>\n

    In other words, wear white coats if you want, but keep them clean.<\/p>\n

    This data void, however, gives me permission\u00a0to ruminate over some of the important and not-so-important questions that inevitably come up when contemplating white coats, and our\u00a0ambivalent feelings about\u00a0them.<\/p>\n

    Specifically:<\/p>\n