White coat
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A white coat, also known as a laboratory coat or lab coat, is a knee-length overcoat or smock worn by professionals in the
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
field or by those involved in
laboratory A laboratory (; ; colloquially lab) is a facility that provides controlled conditions in which scientific or technological research, experiments, and measurement may be performed. Laboratory services are provided in a variety of settings: physic ...
work. The coat protects their street clothes and also serves as a simple uniform. The garment is made from white or light-colored
cotton Cotton is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus '' Gossypium'' in the mallow family Malvaceae. The fiber is almost pure cellulose, and can contain minor pe ...
, linen, or cotton polyester blend, allowing it to be washed at high temperature and making it easy to see if it is clean. Similar coats are a symbol of learning in Argentina and Uruguay, where they are worn by both students and teachers in state schools. In
Tunisia ) , image_map = Tunisia location (orthographic projection).svg , map_caption = Location of Tunisia in northern Africa , image_map2 = , capital = Tunis , largest_city = capital , ...
and
Mozambique Mozambique (), officially the Republic of Mozambique ( pt, Moçambique or , ; ny, Mozambiki; sw, Msumbiji; ts, Muzambhiki), is a country located in southeastern Africa bordered by the Indian Ocean to the east, Tanzania to the north, Malawi ...
, teachers wear white coats to protect their street clothes from chalk. Like the word " suit", the phrase "white coat" is sometimes used as a metonym to denote the wearer, such as a scientist working in a high-tech company.


Medicine

White coats are sometimes seen as the distinctive dress of both
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s and surgeons, who have worn them for over 100 years. In the nineteenth century, respect for the certainty of science was in stark contrast to the
quackery Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, ...
and
mysticism Mysticism is popularly known as becoming one with God or the Absolute, but may refer to any kind of ecstasy or altered state of consciousness which is given a religious or spiritual meaning. It may also refer to the attainment of insight in ...
of nineteenth-century medicine. To emphasize the transition to the more scientific approach of modern medicine, physicians began to represent themselves as scientists, donning the most recognizable symbol of the scientist, the white laboratory coat. Recently, white coat ceremonies have become popular amongst those starting medical school. The modern white coat was introduced to medicine in the late 1800s as a symbol of cleanliness.


Patient perceptions

A study conducted in the United Kingdom found that the majority of patients prefer their doctors to wear white coats, but the majority of doctors prefer other clothing, such as scrubs. The study found that psychiatrists were among the least likely to wear white coats and when they are worn, they are typically worn over the scrubs. Some medical doctors view the coats as hot and uncomfortable, and many feel that they spread infection.


White coat hypertension

Some patients who have their blood pressure measured in a clinical setting have higher readings than they do when measured in a home setting. This is apparently a result of patients feeling more relaxed when they are at home. The phenomenon is sometimes called '' white coat hypertension'', in reference to the traditional white coats worn in a clinical setting, though the coats themselves may have nothing to do with the elevated readings.


Psychiatry

The term is also used as verbal shorthand for psychiatric orderlies or other personnel and may be used, in a usually jocular manner, to imply someone's lunacy or
paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy co ...
.


White versus black

Until the mid-1920s, students who were examining cadavers would wear black lab coats to show respect for the dead. Black lab coats were used in early biomedical and microbiology laboratories. The "whiteness" and "pureness" concepts that were established in medicine pervaded that environment at the end of the 19th and beginning of the 20th centuries and physicians changed the black for the white coat.


White coat ceremony

A white coat ceremony is a relatively new ritual that marks one's entrance into medical school and, more recently, into a number of health-related schools and professions. It originated at
University of Chicago The University of Chicago (UChicago, Chicago, U of C, or UChi) is a private university, private research university in Chicago, Illinois. Its main campus is located in Chicago's Hyde Park, Chicago, Hyde Park neighborhood. The University of Chic ...
's
Pritzker School of Medicine The Pritzker School of Medicine is the M.D.-granting unit of the Biological Sciences Division of the University of Chicago. It is located on the university's main campus in the historic Hyde Park neighborhood of Chicago and matriculated its ...
in 1989 and involves a formal "robing" or "cloaking" in white lab coats.


Controversy

Studies have shown that doctor's coats worn in hospitals can harbor contagions including
MRSA Methicillin-resistant ''Staphylococcus aureus'' (MRSA) is a group of Gram-positive bacteria that are genetically distinct from other strains of ''Staphylococcus aureus''. MRSA is responsible for several difficult-to-treat infections in humans. ...
. In 2007, the UK
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
started banning long-sleeved coats. In 2009, the American Medical Association investigated banning coats with long sleeves to protect patients, but did not institute a ban. A study published in 2011 investigating the effectiveness of the NHS ban showed no statistical difference in contamination levels over an 8-hour period between residents wearing long-sleeved coats and those wearing short-sleeved scrubs. In an effort to reduce the contamination of healthcare uniforms,
ASTM International ASTM International, formerly known as American Society for Testing and Materials, is an international standards organization that develops and publishes voluntary consensus technical standards for a wide range of materials, products, systems, ...
is developing standards to specifically address liquid penetration resistance, liquid repellency, bacterial decontamination, and
antimicrobial An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals ar ...
properties of such uniforms. In India, a public health physician Dr. Edmond Fernandes, founder of
CHD Group CHD Group is an Indian non-profit global health organisation based in Mangalore. Founded in 2014, CHD Group works in the field of public health, disaster management, primary healthcare, road safety, women's health, skill development, monitoring a ...
advocated for a ban on white coats particularly full sleeves which was widely debated in the Indian Parliament and published in the ''British Medical Journal''. However this was rejected from a blanket ban later.


In laboratory work

When used in the laboratory, lab coats protect against accidental spills, e.g., acids. In this case, they usually have long sleeves and are made of absorbent material, such as cotton, so that the user can be protected from the chemical. Some lab coats have buttons or elastic at the end of the sleeves, to secure them around the wrist so that they do not hang into containers of chemicals or tip over lab equipment. Higher quality coats use snap-on buttons instead of traditional buttons as these are easier to quickly undo (they allow pulling the coat off directly instead of fumbling with the buttons to unhook each one). This renders taking off the coat in an emergency much faster, so these are the preferred type for laboratory work as opposed to clinical work. Short-sleeved lab coats also exist where protection from substances such as acid is not necessary, and are favored by certain scientists, such as microbiologists, avoiding the problem of hanging sleeves altogether, combined with the ease of washing the forearms (an important consideration in microbiology).


Howie coats

For added safety, a variant of the lab coat called a "Howie" style lab coat is often adopted. It is called such after a 1978 report commissioned by the UK Department of Health and Social Security to codify standard clinical laboratory practices, chaired by James Howie. Among the codified standards was protective clothing; the type of wrap-around full coverage lab coat that had been in use in the UK for over a hundred years was nicknamed the "Howie-Style" coat to indicate its compliance with the provisions of this report. It has the buttons on the left flank, elasticated wrists and a
mandarin collar A mandarin collar, standing collar, band collar or choker collar is a short unfolded stand-up collar style on a shirt or jacket. The style derives its Western name from the mandarin bureaucrats in Qing-era China that employed it as part of th ...
, and is quite similar to a chef's uniform. It is designed to minimize pathogen contact with street clothes.


Use as a school uniform

White coats which resemble lab coats are worn by students and teachers of most public primary schools as a daily uniform in countries like
Argentina Argentina (), officially the Argentine Republic ( es, link=no, República Argentina), is a country in the southern half of South America. Argentina covers an area of , making it the second-largest country in South America after Brazil, th ...
,
Uruguay Uruguay (; ), officially the Oriental Republic of Uruguay ( es, República Oriental del Uruguay), is a country in South America. It shares borders with Argentina to its west and southwest and Brazil to its north and northeast; while bordering ...
,
Spain , image_flag = Bandera de España.svg , image_coat = Escudo de España (mazonado).svg , national_motto = ''Plus ultra'' (Latin)(English: "Further Beyond") , national_anthem = (English: "Royal March") , i ...
, Bolivia and
Morocco Morocco (),, ) officially the Kingdom of Morocco, is the westernmost country in the Maghreb region of North Africa. It overlooks the Mediterranean Sea to the north and the Atlantic Ocean to the west, and has land borders with Algeria t ...
, and in private schools in Colombia. It also was formerly worn during past decades in
Paraguay Paraguay (; ), officially the Republic of Paraguay ( es, República del Paraguay, links=no; gn, Tavakuairetã Paraguái, links=si), is a landlocked country in South America. It is bordered by Argentina to the south and southwest, Brazil to th ...
and
Chile Chile, officially the Republic of Chile, is a country in the western part of South America. It is the southernmost country in the world, and the closest to Antarctica, occupying a long and narrow strip of land between the Andes to the east a ...
.


References


External links


White coats and the medical profession
{{Clothing Academic dress Jackets Coats (clothing) Laboratory equipment Protective gear