This Mangalore doctor tells you why doctors and medical students should stop wearing white coats

Mangalore based doctor Edmond Fernandes in his article “Doctors and medical students in India should stop wearing white coats” published in British Medical Journal (BMJ) campaigns for bringing a reform in the doctors’ dress code.

What the doctor proposes is medicos in India should stop wearing the professional white coat as it harbours contaminants. While his opinion piece has now triggered a debate, Folomojo lets you in on his views. Here are excerpts from our interview with Dr Edmond Fernandes:

# What are the highlights of your campaign?

It’s a personal view. Though coats with long sleeves should ideally not be used and short sleeves can be considered in some cases, disposal of the white coats is the safe bet.

His research says: White coats harbour potential contaminants and contribute considerably to the burden of disease acquired in hospital by spreading infection. White coats are often contaminated with Staphylococcus aureus, and many isolates are resistant to meticillin. A cross sectional study in Bangalore found that the most contaminated area was the sides of the coat followed by the collar and pocket.

# What are the potential threats?

Medical students and doctors tend to wear the coats, that are washed only every few weeks, to the cafeteria, library, toilet and so many other places. Due to space constraints in Indian hospitals students come wearing them from home. Some are also seen wearing them in cinema halls and shopping malls too. The worst thing is when hospitals acquire infections and get contaminated.

His research says: About 1.7 million hospital acquired infections and 99 000 related deaths occur every year in the US affecting almost 5% of all US hospital patients, and the financial burden may be $10bn a year.

# According to your article white coats give doctors an identity and not any medical remedy to the patients?

Yes. It has to do more with the status. But I believe dressing presentably and sporting a smile can fetch more than what a white coat does. The United Kingdom has banned the long sleeved white coats in 2007. So, it’s now time to rethink this.

His research says: Historically, long sleeved coats, popularly called aprons, were worn by laboratory scientists. But in the 19th century, after scientists showed that remedies bore no results, doctors started wearing the coats. They adopted the colour white to symbolise purity and goodness, hoping to improve their damaged reputation.

# If not for white coats, how will a doctor be visible to patients?

There are many other ways of identification. Name badges and disposable white coats are some of the alternatives.

# What are the other measures you would suggest for maintaining a healthy environment in hospitals?

Though it calls for a separate discussion, I would suggest small things like practising hand hygiene can be an effective way to check hospital acquired infections.

Dr Fernandes is currently doing MD at Yenepoya Medical College in Mangalore. He has published a book “Small Things That Matter Much”. His second book “Workplace Diplomacy” is going to be released soon.

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