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White Lab Coat - Sign of Professionalism or An Infection Risk

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Physician white lab coats worn in the hospital are frequently contaminated with harmful bacteria. The Society for Healthcare Epidemiology of America (SHEA) examined this problem and issued recommendations for hospitals in non-operating room areas. Although believed to enhance professional appearance and despite its historical role in American medicine, as physicians go from patient to patient, the white lab coat transmits bacteria from patient to patient unless careful and rigorous steps are taken to prevent this. Especially in the hospital, there is a real danger of cross-contamination with drug resistant strains of bacteria, such as methicillin resistant staphylococcus aureus (MRSA), vancomycin resistant enterococcus (VRE) and other multi-drug resistant organisms.

Physicians, healthcare providers and patients all need to be aware of the potential infection risk with white coats. For those physicians who wear white coats during direct patient care, they should possess 2 or more coats and have access to an easy cheap way to regularly and frequently launder them, preferably by the medical institution itself. The white lab coat should be removed and hung up before directly encountering the patient. If the physician is expecting to contact blood or other bodily fluids after removing the coat, a gown and gloves should be used. The most important action to prevent infection still remains good hand hygiene directly before and after patient contact. Proper hand and forearm washing with an appropriate anti-bacterial cleaning agent should be done on entering and exiting the room.

Patients report a preference for formal attire, including white lab coats, for their treating physicians, even though physicians and nurses place more importance on formal attire than patients do. Britcher Leone & Roth recognizes that infections can occur as complications but when infection results from preventable causes or there is a delay in diagnosis, the results can be catastrophic. When patients are made aware of the infection risks associated with white coats, they are willing to change their dress code preferences for physicians in white coats. Patients remain their own best advocates and need to insist that physicians, nurses and other people who touch them in the hospital follow proper infection prevention procedures and hand washing.

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