War on white coats

Abstract

Many of my colleagues read with interest your Editorial1The LancetThe traditional white coat: goodbye, or au revoir?.Lancet. 2007; 370: 1102Scopus (22) Google Scholar about the demise of the white coat and the misguided attempts of the UK's Department of Health to control hospital-acquired infection.First, we would like to add our voices to the many clamouring to support this Editorial as a beacon of sensibility in a fog of posturing, pandering, and pretension.Second, we would like to ask: what has become of the medical profession? When did we become a group of senseless minions who snap to attention and follow blindly the diktats of a political body which have no grounding in fact? We are in an age of evidence-based medicine; PubMed and Cochrane reviews should be guiding us in our work, not quangos and the press.The guidance itself is contradictory: no jewellery except a wedding band, as if to suggest that MRSA, respecting the sanctity of holy matrimony or civil partnership, would colonise all but the circle of metal. Perhaps if surgeons were to wear vestments instead of scrubs all our problems would be solved.The issue, as we see it, is public perception. The press have led us to believe that cuffs and watches spread infection and thus we should be bare below the elbow: it looks good (no evidence, but it looks good). We personally feel that some of our staff should be bare below the neck—no evidence that it would reduce infection but it would surely look good. Our challenge now must be to educate our patients on the facts of hospital-acquired infections and reduce their anxiety.The balance of power is shifting in our profession, and perhaps rightly so, but we fear we are only a few more party conferences away from being reduced to a collection of nodding prescribers in sleeveless tunics, waiting for orders from above.I declare that I have no conflict of interest. Many of my colleagues read with interest your Editorial1The LancetThe traditional white coat: goodbye, or au revoir?.Lancet. 2007; 370: 1102Scopus (22) Google Scholar about the demise of the white coat and the misguided attempts of the UK's Department of Health to control hospital-acquired infection. First, we would like to add our voices to the many clamouring to support this Editorial as a beacon of sensibility in a fog of posturing, pandering, and pretension. Second, we would like to ask: what has become of the medical profession? When did we become a group of senseless minions who snap to attention and follow blindly the diktats of a political body which have no grounding in fact? We are in an age of evidence-based medicine; PubMed and Cochrane reviews should be guiding us in our work, not quangos and the press. The guidance itself is contradictory: no jewellery except a wedding band, as if to suggest that MRSA, respecting the sanctity of holy matrimony or civil partnership, would colonise all but the circle of metal. Perhaps if surgeons were to wear vestments instead of scrubs all our problems would be solved. The issue, as we see it, is public perception. The press have led us to believe that cuffs and watches spread infection and thus we should be bare below the elbow: it looks good (no evidence, but it looks good). We personally feel that some of our staff should be bare below the neck—no evidence that it would reduce infection but it would surely look good. Our challenge now must be to educate our patients on the facts of hospital-acquired infections and reduce their anxiety. The balance of power is shifting in our profession, and perhaps rightly so, but we fear we are only a few more party conferences away from being reduced to a collection of nodding prescribers in sleeveless tunics, waiting for orders from above. I declare that I have no conflict of interest.