Few pieces of clothing carry as much symbolism as the white lab coat.
And it may surprise you to know that lab coats were originally beige – and that doctors weren’t the first ones to don them.
In fact, while many still think of the white coat as the quintessential garb of the medical profession, very few doctors still wear lab coats today.
- Why lab coats are white
- What the white coat stands for
- How the medical profession borrowed the white coat as a sign of their maturing profession – and why they’re now dropping it
- How lab coats have evolved along with science
Let’s get into it!
Why are lab coats white?
White is the colour of hope, purity, and transformation. This was apt for the 19th century, when science was taking off as a profession and lab coats were first used. The 1800’s saw a whirlwind of scientific breakthroughs such as:
- Karl Benz’s first commercial automobile
- Thomas Edison’s first light bulb
- The discovery of the X-ray
- …and many more
But there are also practical reasons for the colour. For one, white was the cheapest fabric available at the time. Dyeing the lab coats any other colour would have cost more.
Two, white makes it easy to spot any fluid or chemical stains.
And three, the colour holds up better under the frequent washing and bleaching the protective apparel would’ve endured.
The simplicity and practicality of lab coats made it an easy fit with the rapidly advancing field of science.
Why did doctors start wearing lab coats?
The symbolism of the white coat and its association with scientific rigor is why doctors adopted it later on.
Before the late 19th century, the field of medicine was little more than quackery and pseudoscience.
People only visited doctors as a last resort. Physicians used to dress in black frock coats both as a symbol of their higher societal status and to reflect the seriousness of their work.
But imagine if a loved one was about to die…and then a grim-looking man in a black coat shows up. Shortly after, your loved one passes away.
Being a doctor in the early 1800’s wasn’t exactly the noble profession it is today. On top of that, these black coats would often be stiff with blood from past operations as a mark of the surgeon’s considerable experience. Yikes!
Source: Eakins’ Classic ‘Gross Clinic Gets Another Look | NPR
Thankfully, all that changed.
A British surgeon named Joseph Lister drew inspiration from Louis Pasteur’s work in germ theory and started pioneering the use of antiseptic surgery. Wanting to shed their previous reputations, surgeons – and later on doctors and general practitioners – donned the white coat.
The humble lab coat began to be associated not just with scientific rigor, but also a fresh start for the medical profession.
By 1889, it was common practice for doctors and nurses to douse their hands in antiseptic agents before surgery. They’d also apply these agents to the patient’s wound and on the surgeon’s gown and drapes.
Thomas Eakins’s The Agnew Clinic (1889) depicts the transformation in the field of medicine:
Source: The medical story behind Thomas Eakins’ gory masterpiece | PBS
The surgeons in the painting aren’t wearing gloves (or masks!)
Gloves only came onto the scene in 1890, when a Johns Hopkins surgeon’s head nurse got a bad rash from repeatedly dunking her hands into the corrosive antiseptic agents. Even then it took a few years to catch on, as surgeons believed that gloves impaired their sense of touch.
Then the Spanish flu hit in 1918. Doctors started wearing cotton masks in surgery to protect themselves from infection. Masks later became part of the standard operating room attire in the 1920’s.
And in the 1940’s, healthcare professionals dropped their white coats for early versions of the medical scrubs and caps we know today.
Incidentally, scrubs were also originally white – only in the 1950’s and 60’s was white abandoned in favour of green as it was easier on the surgeon’s eyes. (Green is opposite red on the colour wheel, so it helps doctors focus better on the red and pink insides of a patient during surgery.)
Who wears a white lab coat?
Scientists were the first ones to wear lab coats in the 1800’s, both for identification and protective purposes.
Physicians adopted the practice later on to mark the change in their ideology, from tradition to sound scientific principles and research.
But in line with that new ideology, doctors are now dropping the practice of wearing lab coats as research reveals that lab coats are frequent culprits for hospital-acquired infections (HAI). (We’ll cover that later on in Why do doctors not wear white coats anymore?)
But even though only 1 in 8 U.S. doctors still wear a white lab coat, medical students still get a short white coat in their first year of schooling.
And many medical, pharmaceutical, dental, and nursing schools globally now hold White Coat Ceremonies as part of a first year’s orientation, where students are presented with their own white coats. These short white coats are then exchanged for long ones when they graduate.
White Coat Ceremonies: A Short History
In 1993, the Gold Foundation established the White Coat Ceremony as a way to induct medical students into the field. During the ceremony, professors adorn students with short white coats, following which the young trainees recite the Hippocratic Oath.
This was a break from the former tradition. Before that, students would only recite the Hippocratic Oath at the end of their gruelling training.
But Dr. Arnold Gold, the originator of the ceremony, thought that was far too late. He wanted the students’ entire course of education to emphasize the humanism and compassion of the field of medicine. The White Coat Ceremony is now an important rite of passage for trainees entering the healthcare profession -- and a way for loved ones to commemorate the hard work and years leading up to it.
In 1995, pharmacy schools also began holding White Coat Ceremonies for first-year students.
In 2006, Pakistan became the first to hold a White Coat Ceremony for dental students.
In 2014, the Gold Foundation partnered with the American Association of Colleges of Nursing to hold White Coat Ceremonies for nursing students.
Source: White Coat Ceremony 2019 | NUS Yong Loo Lin School of Medicine
How have lab coats evolved over the years?
Lab coats made their first appearance in the late 1800’s, at the height of the age of scientific progress.
The nineteenth century will ever be known as the one in which the influences of science were first fully realised in civilised communities; the scientific progress was so gigantic that it seems rash to predict that any of its successors can be more important in the life of any nation.
- Sir Joseph Normal Lockyer, President of the British Association
The lab coat likely evolved from the protective apparel worn in many other industries, like the durable aprons of the blacksmiths or the suits of the beekeepers.
For this reason, lab coat standards today are designed around the type of hazards the wearer may encounter.
Labs with hot plates and open flames, for example, dictate that coats must be 100% cotton or flame-resistant material.
Sleeves must be long to protect the wearer, and these should be tight rather than loose-fitting. Coats must be fully buttoned and wrists covered, unless you aren’t using it for protection in the first place.
When doctors adopted the white coat and the field of medicine gained more credibility, the lab coat took on a new status. Patients linked the lab coat with trustworthiness, authoritativeness, knowledgeability, and compassion.
By the late 20th century though, doctors were using the lab coat more for identification purposes rather than protection.
And a new complication arose:
Not everyone who wore white coats in hospitals were doctors. Nurse practitioners, nurse administrators, care managers, chart compliance reviewers, pharmacists, and many others working in the clinical area wore them too.
This confused patients in hospitals, who often believed that anyone wearing a lab coat was a doctor. Combined with the hygiene issues of lab coats, this led to healthcare professionals rallying to drop the attire.
More recently, as biological and genetic modification procedures have gained prominence, scientists have adopted new styles of lab coats offering better protection against these dangers.
For example, labs handling hazardous chemicals in higher risk procedures may recommend Howie-style lab coats (a wrap-around, full coverage lab coat with elastic cuffs). These minimize the chance of street clothes being contaminated with pathogens.
Why do doctors not wear white coats anymore?
Several studies have proven that doctor’s coats play host to dangerous bacteria and pathogens. Among these are bacteria that can cause sepsis, pneumonia, and other infections.
But it isn’t just limited to white coats. Street clothes may be just as problematic – and neckties may be worse.
One study revealed that most American doctors only wash their white coats every 12 days. Some wait over a month between washes. Ties are rarely washed. It’s easy to understand why. Doctors work very long shifts, and laundry probably isn’t high on their list of priorities.
But anything that isn’t frequently changed and sterilized creates the ideal conditions for bacteria to grow. This increases the risk of Hospital-Acquired Infections (also known as Healthcare-Associated Infections).
To address this, many healthcare institutions have banned the use of lab coats:
- In the U.K., physicians no longer wear white coats and have adopted a “bare below the elbows” policy. This makes sure it’s easy for healthcare professionals to follow proper hand and wrist washing protocols.
- In Sweden, most major hospitals have banned the use of lab coats. Doctors with patient contact cannot wear civilian clothes.
- In Singapore, doctors have not worn white lab coats for decades. Instead, practicing doctors typically wear business casual clothing or scrubs.
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