And it’s not just tradition that keeps physicians in white coats. Doctors give a variety of reasons for wearing them – to carry papers, because hospitals are cold or for a confidence boost when facing a stressful situation. Female physicians also face the challenge of being misidentified if they don’t wear a white coat.

Yet the situation is notably different in many countries in Europe. In the United Kingdom, for example, physicians simply don’t wear white coats when seeing patients because they have adopted a “bare below the elbows” policy. In the UK, only pathologists and other laboratory based physicians wear them, and those coats don’t leave the lab.

You Are Still a Doctor Without the White Coat

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A few months ago Dr. Vineet Chopra and Dr. Sanjay Saint wrote an article arguing that patients prefer white coats. They suggested that formal attire with long-sleeved shirts and ties for men and business attire for women be worn while they conduct a survey of thousands of patients from the US, Italy, Switzerland and Japan.

I disagree. At least one study from Scotland suggested that patients feel that their doctors’ appearance was not as important as compassion, politeness and knowledge. Only half of patients felt that the style of clothing mattered. And patients felt an impression of cleanliness and good personal hygiene were more important. In fact, patients preferred a “smart casual” style of dress, which conformed with a “bare below the elbows” dress code policy. This would presumably reduce the transmission of bacteria to patients if rigorous handwashing were employed.