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Why doctors are returning to the white coat

By Jeremy Laurance

The doctor's white coat, increasingly thought of as outdated, intimidating for patients and an infection risk, is making a comeback.

The garment disappeared from hospitals 20 years ago as doctors sought a more informal relationship with their patients.

Psychiatrists and paediatricians, anxious to be approachable, led the charge and slowly other specialties fell into line.

But egalitarianism has made doctors invisible on the wards and patients now complain they cannot tell a surgeon from a secretary and appear undistinguished, the argument goes.

York Hospitals NHS Foundation Trust is to introduce uniforms for doctors this autumn, Guys and St Thomas' has made white coats mandatory for all junior doctors and medical students. West Middlesex launched its uniform in 2007.

The uniforms, which vary, all have short sleeves to comply with the national “bare below the elbows” policy, a hygiene requirement to make it easier for staff to wash their hands. York and West Middlesex have opted for a blue “scrubs” style garment, as worn in operating theatres, while St Thomas' chose a shortened version of the traditional white coat.

Alastair Turnbull, consultant gastroenterologist and medical director at York, said that before the uniform was introduced he had cut the arms off three of his jackets to comply with the bare below the elbows policy, introduced in 2008. “I thought I would set an example but people said to me, 'Alastair, you are taking the piss.' It didn't work.”

Later a junior doctor at York mislaid confidential patient notes which were passed to the local paper. An investigation concluded they were lost because juniors did not have large enough pockets to carry them in.

“We decided to make it easier for juniors to be bare below the elbow and to carry patient notes and we proposed a pilot of a uniform with large pockets,” Dr Turnbull said. “It was opposed by the local branch of the British Medical Association, and some doctors, who felt coerced. But patients have an expectation that doctors will look smart.

“Other professions such as the military and the law are expected to appear professional and this is no different.”

Source: Independent

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