On a warm August 2004 day in Philadelphia, I joined 150 first-year medical students on stage at the University of Pennsylvania to celebrate the start of our medical careers. The dean called our names and, one by one, draped short white coats around our shoulders. We then stood together as a class and recited the Hippocratic Oath, reflecting on the importance of becoming humanistic physicians. My parents had driven up from Kentucky and proudly sat in the audience. It was a powerful ritual and a memorable day.
During my four years of medical school, I wore that short white coat on the hospital wards. After graduation, I moved to California and traded in the short white coat for a long one. Residency was exhausting. I was on call for 30 hours every few nights, my coat became sullied, and it was difficult to keep it pristine even with frequent washing. Once, after rounds in the intensive care unit, the attending physician took me aside. “Do a better job washing that coat,” he admonished me. “Patients and their families shouldn’t see you like that.” But even with bleach, my coat never regained its original luster.
Several years later, I am an infectious diseases fellow at Massachusetts General Hospital and Brigham and Women’s Hospital and help teach the Harvard Medical School students when they do their infectious diseases clinical rotations. When I came here, I was given new white coats embroidered with the names of the prestigious institutions where I work. But I have never worn them.
And now, with a few years of experience, I have come to believe that we should get rid of white coats and reorient rite-of-passage ceremonies away from them.
You wouldn’t want to be cared for by a doctor who doesn’t wash his or her hands. You wouldn’t want to be operated on with instruments that weren’t sterilized or stay in a hospital room that wasn’t cleaned regularly. Why would you want to be treated by a doctor wearing a white coat that hasn’t been washed in a week? Many white coats are covered in bacteria like MRSA – they are dirty. And it’s time to hang them up for good.