The most amazing thing I’ve seen recently involved a nurse trying to start an IV on me prior to outpatient surgery. She donned a new pair of gloves for each try (3 of them before success — I’m a tough stick, so not her fault.) Immediately after putting the new gloves on, she bit the tip off of it covering the index finger she used to feel for a vein.

My observations have led me to wonder if wearing gloves has led to less sanitation for the patient than even less than ideal hand washing.

A more recent study from the UK demonstrated the usual preference for the white coat, but interestingly this study then did a short educational intervention regarding contamination of the coat with hospital pathogens, and when the patients were re-surveyed nearly 2/3 opted for scrubs. Two other recent studies from the UK show that the proportion of patients desiring physicians to wear white coats is falling. And two other controlled studies show that physician attire is not correlated with patient satisfaction with regards to the care they received.

As a hospital epidemiologist, I have thought long and hard about this issue, and I am convinced that even though we don’t have data proving that lab coats can transmit organisms to patients, it’s magical thinking to believe otherwise (see my blog on this). No one has done a clinical trial to prove that jumping out of a plane requires a parachute. Sometimes common sense is enough. Given that 2/3 of physicians wash their white coats at intervals greater than 2 weeks, that some organisms can live on the fabric for more than 3 months, and that the coats are often visibly dirty, it defies logic to somehow think that the beloved white coat cannot be involved in the transfer of organisms to patients. Our in vitro study using pig skin that you cited adds further proof. Plus, removing the coat and long sleeves makes hand washing much easier. For all these reasons, the Infection Control Committee at my hospital has recommended a bare below the elbows approach (no white coat, long sleeves, wrist watch or bracelets).

In a study done in the US, South Carolina, respondents from an internal medicine outpatient clinics overwhelmingly favor professional attire with white coats for physicians. This could be due to a more formal attitude in the south of the US.

So it is also a cultural thing and media also play a role, what would be the effects of House and Grey’s anatomy.

In pictures in the 2 largest medical journals in Sweden over a period of 1 year the majority (64%) of women doctors were dressed in white coats. The majority of male doctors (59%) appeared in civil dress.

Many variables responsible for attire, in The Netherlands most physicians working in a hospital dress in white tenure or coat, out patient departments and general practitioner never wear white coats, how is it in your country?

Psychiatrists definitely don’t wear white coats: http://tinyurl.com/65v46j

Kind regards Dr Shock