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Why Do Doctors Wear White Coats? (Surprising History Explained)

Why Do Doctors Wear White Coats? (Surprising History Explained)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

The tradition of doctors wearing white coats dates back to the 1800s and has become a widely recognised symbol of medical professionals.

It’s easy to imagine the stereotypical doctor in a white coat with a stethoscope around their neck- but just why do doctors wear them?

Doctors wear white coats in order to convey a sense of cleanliness, authority and professionalism. They also serve a number of useful practical purposes such as protecting a physician’s clothes from stains and offering large pockets to carry pens, notes and bleeps.

As a doctor myself, I personally don’t actually wear a white coat when working in the UK.

White coats were phased out from 2007 in the NHS, due to concerns about the infection risk they posed.

However, white coats are still very much the norm for doctors in the US and around the world, so in this article, I thought I’d delve into both the history of the white coat and why it continues to be so popular across the medical world.

The History Of The White Coat

Although ubiquitous now, doctors didn’t always wear white coats. Doctor’s attire has changed over the years with changing public perceptions of medicine and what a doctor should represent.

Pre-1800s

Prior to the mid-1800s, there was no standardised uniform for medical professionals.

Nurses were drawn from nuns looking after the sick and wounded so their attire generally reflected this- dark robes, a head covering and an apron.

Doctors on the other hand didn’t have this strict vocational background.

There was of course the ‘plague doctor costume’ developed by the French physician Charles de Lorme in the 17th century, but generally, doctors would simply wear the professional clothes of their time.

Mid-1800s

During the mid-1800s, the medical profession began to formalise qualifications, teaching institutions and many of the medical specialty societies were founded.

Medicine in the 1800s was wholly unregulated, with cure-all elixirs, dangerous procedures and contradictory diagnoses available from anyone styling themselves as a medicine man.

Modern doctors of the day tried to distance themselves from barber-surgeons and these quacks, as they moved towards a more evidence-based medicine approach.

In order to symbolise this championing of the scientific method, they began to adopt the attire of scientists working in laboratories- the white lab coat.

The white coat represented cleanliness and sterility, which were essential in restoring public trust in the medical practices of the day.

Around this time, hospitals replaced their dark and dreary garments with white sheets, nurses’ caps, and doctors’ coats to create a more reassuring and formalised environment for patients.

The Modern Day

Today, the white coat remains a powerful symbol in the medical community, highlighting the authority and expertise of those who wear it.

A doctor wearing a long white coat
A doctor wearing a long white coat

It’s a widely recognised symbol of the medical profession, exemplified by the “White Coat Ceremony” at nearly every medical school in the US.

However, white coats not only represent the journey from medical student to physician, but also embody the values of professionalism, caring, and trust that physicians must earn from patients throughout their careers.

White Coat Ceremonies

White coat ceremonies are a relatively modern invention, originating with the American doctor Arnold P. Gold in 1993 at Columbia University’s Vagelos College of Physicians and Surgeons.

The ceremony is typically conducted in the presence of faculty members, peers, and family members and its primary purpose is to symbolise the students’ transition from the preclinical phase of their education to the clinical phase, where they begin working directly with patients.

During the ceremony, students don white coats, which are symbolic of the healthcare profession and traditionally worn by medical professionals.

The act of donning the white coat represents the assumption of professional responsibilities, ethics, and the commitment to provide compassionate care to patients.

It serves as a visual reminder of the trust and confidence placed in healthcare professionals by society.

The white coat ceremony is also often accompanied by speeches from distinguished individuals, including faculty members, alumni, or guest speakers who share their experiences and insights with the aspiring healthcare professionals.

The ceremony is also an opportunity for students to recite an oath or take a pledge, affirming their dedication to upholding the highest standards of patient care, respect, and professionalism.

The Practical Reasons Behind White Coats

In addition to its symbolism, there are a number of important practical reasons why doctors continue to wear white coats in their work.

Why Doctors Wear White Coats Pixel Infographic

Hygiene

One of the key practical reasons that doctors wear white coats is for sanitary purposes. 

The white colour of the coat makes it easy to spot any dirt or stains, which could indicate the presence of contaminants or potential infection sources.

By maintaining a clean appearance, doctors are able to reduce the risk of spreading harmful substances or germs during their daily duties.

Furthermore, white coats can be washed at high temperatures to effectively remove bacteria and stains, ensuring they’re clean for use.

Pockets And Storage

Another practical reason for doctors wearing white coats is the ample pockets and storage space they provide.

Doctors need to carry a variety of clinical tools, such as stethoscopes, pens, prescription pads, bleeps/pagers, and other important items when attending to their patients.

White coats offer numerous pockets, making it convenient for doctors to store and easily access these essential items during their workday.

It’s a horrible feeling if you’re on a busy shift and suddenly can’t find your to-do list for your patients.

Having the big pockets of a white coat makes it much less likely your notes and reminders will fall out of your clothes as you move through the hospital.

Protection For Clothing

Wearing a white coat also serves as a protective layer for doctors’ clothing.

Medical professionals are often exposed to various substances like blood, bodily fluids, or chemicals during their daily interactions with patients.

Nearly every nurse and doctor will have a story of something horrible being spilt over them or their shoes…

Wearing a white coat helps to shield doctors’ clothing from potential damage or contamination, ensuring a professional and tidy appearance throughout the day.

If something is spilt on the white coat, it can also easily be removed and washed while you continue about your day.

The Psychological Effects Of White Coats

Arguably, in the modern day, psychology plays a bigger role in the continued popularity of white coats over their practical advantages.

Patient Trust

White coats are synonymous with the medical profession, which can help increase patient trust in doctors.

The distinctiveness of the white coat inspires confidence and represents competence in the eyes of patients.

The reality is patients want to be treated by what they think is a stereotypical doctor- and by wearing a white coat medical professionals can more closely conform to this image.

You might be surprised by how much a patient’s impression of an interaction can have on their satisfaction with their treatment,

Often, it’s less about what a doctor actually says during a consultation but more about how they say it, their body language and how they’re dressed.

Doctor’s Confidence

Wearing a white coat can also have a significant impact on the doctor’s confidence.

Research has shown that when someone wears a white coat they believe belongs to a doctor, their attention and cognitive abilities improve.

This suggests that the white coat might not only affect patients’ trust but also improve the doctors’ performance while wearing it.

By donning a white coat, doctors may experience a surge in their overall self-perception and performance.

Challenges And Controversies

Doctors in countries such as the UK or Denmark are rarely seen wearing a traditional white coat. The reason behind this is due to some of the challenges and controversies that surround them.

A foundation doctor working on a surgical ward
A doctor wearing a white coat at a patient’s bedside

Infection Control

One of the major challenges and controversies associated with doctors wearing white coats is the potential for harbouring and spreading pathogens.

Research has shown that a significant percentage of white coats tested positive for harmful bacteria such as MRSA and Gram-negative rods.

These bacteria can cause serious health problems, including skin infections and pneumonia.

Some experts argue that the potential risks of infection outweigh the symbolic benefits and professional appearance of white coats.

This is the main reason that white coats were phased out of the NHS from 2007.

As a doctor in the UK, it’s now against infection control policy to wear a white coat in clinical environments such as on a ward in hospital.

White Coat Syndrome

Another, more minor, issue related to doctors wearing white coats is “white coat syndrome” or “white coat hypertension”.

This phenomenon describes the elevated blood pressure that some patients experience when they see a doctor in a clinical setting.

The white coat may be a trigger for anxiety, leading to increased stress levels and a temporary spike in blood pressure.

This can potentially lead to false or inaccurate diagnoses and treatment plans for patients with hypertension.

Compared to the infection control risks it’s a relatively minor issue, that isn’t always combatted by the doctor simply not wearing a white coat- but one that’s worth noting!

Alternatives To White Coats

While the traditional white coat has long been a symbol of medical professionals, there are alternatives that some doctors and patients prefer.

These alternative options may offer benefits such as increased comfort for both the patient and the doctor, reduced risk of spreading infection, and the creation of a less formal atmosphere in the clinical setting.

Scrubs

Scrubs are a popular choice for many medical professionals, especially in hospitals and surgical environments.

They are made from lightweight, breathable materials that offer ease of movement while still maintaining a professional appearance.

Scrubs also reduce the risk of cross-contamination, as they can be easily changed between patients and are specifically designed for frequent laundering.

Smart Casual Attire

Smart casual attire is another alternative to the traditional white coat.

Some doctors choose to dress in professional clothing that reflects their personal style while maintaining a sense of trust and confidence in their patients.

Wearing clothing that is more relatable to patients may also help reduce anxiety and promote a sense of comfort during consultations.

A standard outfit for male doctors in the UK is a collared shirt with a pair of chinos. This broadly gets the balance right between comfort and professionalism.

Some doctors may choose to go more formal, by wearing a full suit, but in my experience, younger generations rarely wear this in hospitals.

Do Doctors Ever Wear White Coats In The UK?

As I mentioned earlier, I don’t personally wear a white coat as a junior doctor working in the UK.

But do doctors ever wear white coats in the NHS?

Doctors in the UK generally do not wear white coats. The NHS phased white coats out in 2007 due to concerns about their potential to spread infection between patients as a result of their long sleeves and trailing tails. However, outside of clinical environments, some British doctors do still choose to wear them.

Doctors who you might still find wearing a white coat include microbiologists and more old-school physicians.

Microbiologists spend a lot of their time in a laboratory analysing patient samples- so may wear a white coat in this environment.

Other, generally older doctors may still wear a white coat out of habit- as it is only relatively recently that they stopped being the norm.

Although they can’t wear them on a ward in hospital anymore, they can be worn when conducting clinics or other lower-risk activities when it comes to infection.

Final Thoughts

In conclusion, the tradition of doctors wearing white coats has a rich history and serves various purposes.

From its large pockets, smart appearance and confidence-boosting qualities, it’s easy to understand why it became ubiquitous with the professional doctor.

The white coat represents cleanliness, professionalism, and authority and has been a symbol of the medical profession for many years and continues to be widely recognised as such.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.