AS THE uniform of the medical establishment since Victorian times, it has become an symbol of healing and clinical authority. But soon the clinician’s white coat could be little more than a cast-off as doctors strive to improve hygiene in their hospitals.
In a move set to enrage traditionalists, doctors yesterday voted for scrubs — the green outfits made famous by American hospital drama ER — to usurp white coats.
A motion promoting the use of scrubs over coats in all hospitals was passed yesterday by members of the British Medical Association (BMA), in an effort to limit the transmission of superbugs such as MRSA.
Research has identified clothing as a factor in the spread of bugs around hospitals, with white coats, ties and shirt cuffs among the worst offenders. Scrubs, the loose-fitting smocks and baggy trousers given Hollywood glamour by the actor George Clooney, are considered less infectious because they are subjected to regular sterile washes and never leave the hospital.
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A recent study found that a quarter of white coats carried bacteria that could have been passed on to patients, with doctors in surgical specialties the most prone to carrying infection. Coat cuffs and pockets were the most highly contaminated areas, with higher bacteria levels found on coats used by only one doctor.
Supporting the motion to ban the garments, Andrew Butterworth, a junior doctor from Salford, said it was up to health professionals to lead by example in the fight against superbugs. “It is shocking how hospitals are so infected when they are meant to be a very clean environment,” he said. Dr Butterworth said the hospital where he had trained had already banned wearing white coats for fear of them causing infection.
“Given the popularity of hospital-based dramas like ER, it is now acceptable for doctors to wear scrubs in hospital environments. This would not be seen as a lack of professionalism.”
Geoffrey Lewis, a doctor from Leicestershire and member of the BMA Council, proposed the motion deploring the high rate of hospital acquired infections.
He told the conference in Manchester that it was inexcusable that rates of MRSA had risen sixfold in a decade.
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But Andrew Davis, a junior doctor from Cardiff, said it would make more sense to ensure that there were enough sinks on the wards and gloves to wear than investing in a vast wardrobe of scrubs.
“We need more investment in handwashing rather than giving us scrubs,” Dr Davis said.
The white coat was first worn in the 19th century to prevent cross-contamination and keep clean the clothes a doctor wore to and from work.
Improvements in medicine at the time meant that people were starting to be cured in hospitals rather than dying, giving the coat an almost sacred image.
In the United States many medical schools have a formal robing, or white-coat ceremony, when students enter the school, which is usually attended by family and friends.
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The vote on white coats, which was narrowly passed, will now be considered by the BMA council as to whether it should become association policy.
But Jim Johnson, the chairman of the BMA, said that having all medical staff kitted out in scrubs would be enormously difficult to introduce across entire hospitals. It was “a great idea in theory, but enormously difficult in practice,” he said.
Mr Johnson said that any measure that might effect an improvement in hygiene should be considered, however.