White Coats Are About Communicating an Ideal

Physicians haven’t always worn white coats. Until the late 19th century, surgeons operated wearing black coats, as Atul Gawande explained in his fine article, Sharing Slow Ideas.

Although Edinburgh physician Dr. Joseph Lister had discovered that being free of microorganisms (antisepsis) reduced the risk of hospital-acquired infections, it took years for doctors to get rid of their black coats.

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Gawande wrote:

…hand washing was still perfunctory. Surgeons soaked their instruments in carbolic acid, but they continued to operate in black frock coats stiffened with the blood and viscera of previous operations – the badge of a busy practice.

But, Gawande goes on, some surgeons wanted to promote a different vision of their profession.

A few pioneering Germans, however, seized on the idea of the surgeon as scientist. They traded in their black coats for pristine laboratory whites, refashioned their operating rooms to achieve the exacting sterility of a bacteriological lab, and embraced anatomic precision over speed.

And white coats took off. They have always been a symbol, but the white coat ceremony is actually a recent invention, having been developed in 1993 by the Arnold P. Gold Foundation. This ceremony is now a mainstay at the majority of medical schools and many nursing and allied health schools as well, meant to connect student to the “noble tradition of doctoring.”