White coats and the medical profession Time to rediscover the symbol of our purpose and our pride?
MJA 2001; 174: 324-325
Ask doctors to nominate the symbols of their profession and many will select the Hippocratic Oath or the serpented staff of Aesculapius. Ask the same question of a person in the street and the stethoscope or the doctor’s black bag are common responses. However, the most recognisable symbol of the profession is the white coat.1 Indeed, media portrayal of doctors in Marcus Welby MD or ER showcases the obligatory white coat and dangling stethoscope. Doctors first wore white coats in the late 19th century when science began to make significant inroads into medicine and physicians adopted the laboratory coat as their own.1 Its initial purpose was to protect the patient and physician from cross-contamination, but, as the partnership between science and medicine2 transformed hospitals from institutions for the dying to centres for curing the sick, the white coat became a potent symbol of the authority of science and the art of healing. Superimpose on this metamorphosis Western cultural connotations of whiteness — "life, purity, innocence, superhuman power, goodness — and it is easy to see how the white coat became the favored garment for physicians".1,3
However, as the 20th century advanced, and sociologists turned their attention to medicine4,5 and the dynamics of the patient-doctor relationship, the white coat was seen increasingly as a barrier to effective communication. In an attempt to dispel this perception, paediatricians, psychiatrists and doctors in private practice shed the white coat. Furthermore, the changes in society and healthcare that turned doctors into "healthcare providers" and patients into "clients, consumers or customers" also witnessed the extinction of the white-coated doctor. Today, doctors in our hospitals have become a hidden species, virtually indistinguishable from other hospital personnel or even patients’ visitors.
But what do Australian patients want doctors to wear? In this issue of the Journal, Harnett explores this question.6 Among patients attending oncology clinics, a clear majority preferred junior doctors to wear white coats "for identification purposes" or because "it looked more professional". For senior doctors, the issue was not as clear-cut, but many of the patients still preferred these doctors to wear white coats.
These findings are not surprising. There is now substantive information that adult patients prefer doctors in clinics and hospitals to be traditionally, or at least smartly, dressed;7-12 to wear a necktie;7-9,11,12 to have short hair;8,10,12 and to wear white coats with a name tag.7,8,10-12
Does all this foreshadow a rebirth of doctors in white coats? Probably not. Most of the current information on patients’ preferences for doctors’ attire is derived from limited cross-sectional surveys. In the current era of evidence-based healthcare, any return of the white coat awaits the outcome of a randomised controlled trial to settle the question: to be or not to be in a white coat!
And yet, the practice of medicine involves more than its subservience to evidence or science. It also involves issues such as the meaning of service and feelings of professional pride. In this context, the white coat has become a symbol for the humane face of medicine and its professionalism in the newly discovered white coat ceremonies.13 To date a uniquely North American phenomenon, these ceremonies are performed each year for students entering US medical schools. The students (accompanied by friends and families) are welcomed into the profession by the assembled faculty of the medical school. After an address by an eminent member of the profession, each student is presented with, and helped into, his or her white coat by the dean and other faculty members. This robing ceremony is followed by a public proclamation by the students of their professional commitment akin to the Hippocratic Oath. Inaugurated in 1993 by the Arnold P Gold Foundation, the white coat ceremony had already been adopted by 93 US medical schools some five years later,14 suggesting a groundswell in the search for meaning in service to the community in medicine and in professionalism.
The Foundation has identified six components of the ceremony to "help create an environment which fosters a psychological contract for professionalism and empathy in medicine".13 These include
•The presence of friends and families "representing the support and value system closest to the student";
•The welcome by the dean and faculty of the school and its hospitals "representing the value system of the school and the new profession they are about to enter";
•An inspiring address by a physician role-model;
•The personal robing with the white coat through which senior doctors "demonstrate their
i can translate the whole thing myself, but i got more like 14 other pages im working on so i thought i would be saving time.. if you cant translate it then i dont need your big mouth on here so do that somewhere else.. thank you^^

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Read more on please help translate this (english to arabic)?…

My family and I (there are 5 of us…2 adults and 3 kids..17 years, 16 years and 14 years) need to find the cheapest return airfare possible flying from:

Departing: Flying to/ Arriving
Perth, Australia on 29th June 2007 Los Angeles, USA

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I’ve heard some of my Aussie friends complaining that a lot of people from all over the world are coming to their country. They say that some of them commit crimes, and live on welfare. I think it would be a mistake to categorize all new immigrants to Australia as criminals, or welfare cases. But some of my friends are really upset with this topic.

Read more on How can some of the problems with Australia’s immigration be solved, and Americas problems as well?…

I’ve heard some of my Aussie friends complaining that a lot of people from all over the world are coming to their country. They say that some of them commit crimes, and live on welfare. I think it would be a mistake to categorize all new immigrants to Australia as criminals, or welfare cases. But some of my friends are really upset with this topic.

Read more on How can some of the problems with Australia’s immigration be solved, and Americas problems as well?…

on the 27th July 2007 (arriving back in Perth on the sunday the 29th of July of course). I’ve tried cheap flights, best flights, webjet, zuji, qantas etc and the cheapest I can find with tax etc is $2800AUD (australian dollars).

Read more on Where can I get the cheapest airfare from Perth, Australia to Los Angeles return going on 29th Jun, returning?…

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