Marian E. Phinder-Puente and colleagues
The whiteness of white coats is associated with cleanliness, purity, benevolence, and tranquility. Since then, they have become a distinguishing feature of doctors. During the 1990s, white coats were identified as potential sources of hospital-acquired infections. Wong and colleagues examined culture samples taken from 100 doctors and found that the cuffs and pockets of the coats were the most contaminated areas.
It is worth noting that Staphylococcus aureus was isolated from approximately 25% of the gowns examined. Similarly, Banu and colleagues isolated pathogenic microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa from the collars, pockets, and sides of the coats. Furthermore, when examining antimicrobial susceptibility, they found similarities with other nosocomial pathogens in their hospital. The extent of microbial contamination extends far beyond the white coat, as healthcare professionals can also be sources of infection.
In the 19th century, doctors did not regularly wear white. Instead, they wore a black suit very similar to a tuxedo, a garment that conveyed not only a sense of elegance but also the subtle notion that seeking medical attention was a last resort before death. The use of the white coat was popularized by nurses in the early 20th century. This custom was formally introduced in 1910 by Dr. George Armstrong, president of the Canadian Medical Association.
International recommendations
The use of white coats has been banned in UK healthcare facilities since 2007 under the "bare below the elbows" (BBE) policy, which aims to reduce the incidence of hospital-acquired infections. The BBE policy recommends wearing short-sleeved undershirts instead of white coats during patient care activities. Furthermore, jewelry can hinder effective hand hygiene. In 2009, the American Medical Association passed a resolution encouraging the adoption of dress guidelines to minimize the risk of hospital-acquired infections, although they ultimately recommended further research.
The white coat remains a symbol of the medical profession, even though it is a well-known vehicle for nosocomial pathogens. Therefore, its use should be reviewed, especially in developing countries, where the white coat tends to be mandatory under the justification of "looking professional."
There are important recommendations regarding dress codes for healthcare professionals, aimed at preventing nosocomial infections, such as:
1. Wear uniforms with bare forearms, without white coats, ties, long sleeves or accessories such as watches, bracelets or rings.
2. Wash your hands with soap and water or a hand sanitizer. Remember the Five Moments for Hand Hygiene recommended by the World Health Organization.
c) Clean stethoscopes and any physical examination devices after direct contact with the patient using alcohol-based wipes.
In Latin America, there's a popular saying that goes, "You not only have to be a doctor, you have to look like one." However, a doctor's competence has little to do with their attire.