A few weeks ago, I wrote that the robotic surgery advertisement acceded to by the University of Illinois in support of a private company made inappropriate use of the image of white coats. I argued that it did so to bring greater credibility to the advertisement:
The public . . . views that symbol as emblematic of that sacred trust. We look up to and respect people wearing the white coats. We know they have devoted themselves to our well-being and have engaged in extensive training for our good.
In this ad, for example, an administrative person was clothed in the white garb along with the medical staff.
This point was greeted with disagreement by some. Maria, for example, said:
It [the white coat] seems to have lost some of its meaning. It's not quite the ordeal it's made out to be when other professions/occupations borrow it.
I responded:
I disagree, Maria, when it is used by a commercial firm to make an advertisement appear to be full of clinicians in support of their product.
If you think the white coat has no meaning in that setting, why didn't the firm just show this person wearing regular business clothes? I believe they knew exactly what result they were trying to achieve in the public eye.
But the issue keeps coming up. In a comment on a new Charles Ornstein column on the UI ethics issues, Joannie writes:
I find it amusing that a hospital executive thinks that only physicians* wear white coats. Must have spent most of his time in his office.
Jdr Inca properly responds:
Yes, that's true. But why would the administrative director don a white coat for the picture? Because the white coats are meant to imply that they are all surgeons (the word used 4 times in the text). The administrative director should be holding a pile of paperwork which proves Intuitive's claim that the higher cost of the Da Vinci surgery is offset by better outcomes and fewer days in the hospital. Except that that claim was not supported by this study http://jama.jamanetwork.com/ar... published in JAMA. The add is deliberately deceptive and UI employees should not have participated in it. Furthermore, the add ran in a publication which is not targeted to medical professionals. It was meant to appeal to patients who might be fooled by the white coats.
As usual in the health care world, we can actually find an academic article on a related topic. The Journal of Experimental Social Psychology published one called "Enclothed Cognition," which demonstrated the effect that a white coat has on the wearer!
We introduce the term “enclothed cognition” to describe the systematic influence that clothes have on the wearer's psychological processes.
► We show how clothes systematically influence wearers' psychological processes. ► Three experiments demonstrate that wearing a lab coat increases attention. ► Attention did not increase when the coat was not worn or associated with a painter. ► Attention only increased when the coat was a) worn and b) associated with a doctor. ► The influence of clothes thus depends on wearing them and their symbolic meaning.
If wearing a white coat can have an effect on the psychological processes of the person wearing it, might we extrapolate to the effect it has on an observer? I am not going to attempt to answer that scientific question here. I am, however, going to agree with Jdr Inca:
The add is deliberately deceptive and UI employees should not have participated in it. Furthermore, the add ran in a publication which is not targeted to medical professionals. It was meant to appeal to patients who might be fooled by the white coats.
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* Note: I didn't say "physicians." I said clinicians, which includes all the clinical personnel in the ad.
The public . . . views that symbol as emblematic of that sacred trust. We look up to and respect people wearing the white coats. We know they have devoted themselves to our well-being and have engaged in extensive training for our good.
In this ad, for example, an administrative person was clothed in the white garb along with the medical staff.
This point was greeted with disagreement by some. Maria, for example, said:
It [the white coat] seems to have lost some of its meaning. It's not quite the ordeal it's made out to be when other professions/occupations borrow it.
I responded:
I disagree, Maria, when it is used by a commercial firm to make an advertisement appear to be full of clinicians in support of their product.
If you think the white coat has no meaning in that setting, why didn't the firm just show this person wearing regular business clothes? I believe they knew exactly what result they were trying to achieve in the public eye.
But the issue keeps coming up. In a comment on a new Charles Ornstein column on the UI ethics issues, Joannie writes:
I find it amusing that a hospital executive thinks that only physicians* wear white coats. Must have spent most of his time in his office.
Jdr Inca properly responds:
Yes, that's true. But why would the administrative director don a white coat for the picture? Because the white coats are meant to imply that they are all surgeons (the word used 4 times in the text). The administrative director should be holding a pile of paperwork which proves Intuitive's claim that the higher cost of the Da Vinci surgery is offset by better outcomes and fewer days in the hospital. Except that that claim was not supported by this study http://jama.jamanetwork.com/ar... published in JAMA. The add is deliberately deceptive and UI employees should not have participated in it. Furthermore, the add ran in a publication which is not targeted to medical professionals. It was meant to appeal to patients who might be fooled by the white coats.
As usual in the health care world, we can actually find an academic article on a related topic. The Journal of Experimental Social Psychology published one called "Enclothed Cognition," which demonstrated the effect that a white coat has on the wearer!
We introduce the term “enclothed cognition” to describe the systematic influence that clothes have on the wearer's psychological processes.
► We show how clothes systematically influence wearers' psychological processes. ► Three experiments demonstrate that wearing a lab coat increases attention. ► Attention did not increase when the coat was not worn or associated with a painter. ► Attention only increased when the coat was a) worn and b) associated with a doctor. ► The influence of clothes thus depends on wearing them and their symbolic meaning.
If wearing a white coat can have an effect on the psychological processes of the person wearing it, might we extrapolate to the effect it has on an observer? I am not going to attempt to answer that scientific question here. I am, however, going to agree with Jdr Inca:
The add is deliberately deceptive and UI employees should not have participated in it. Furthermore, the add ran in a publication which is not targeted to medical professionals. It was meant to appeal to patients who might be fooled by the white coats.
---
* Note: I didn't say "physicians." I said clinicians, which includes all the clinical personnel in the ad.
I agree with you about UI. However, a number of commenters on your original post mentioned that the white coat has lost its significance, or is rarely worn anymore. I would like to suggest that the whole issue of how hospital personnel dress is a significant problem for patients in telling them apart. This started when nurses stopped wearing white or a cap (and technicians, etc. started to), and has mushroomed until a poor patient cannot tell if the person entering their room is a doctor or the housekeeper. Verbal introductions do little good when the patient is elderly, sick, and/or hard of hearing, or doesn't understand the title given. I have experienced this problem both as a patient and as a family member.
ReplyDeleteAll of the ego-based controversy over what we wear is really beside the point compared to the patient's needs. I would suggest that it is far more patient-centered for a doctor to wear his/her traditional long white coat (not to mention more sanitary), and for other personnel to wear something else, preferably something standard which makes it easy for the patient to recognize their role. Neither is happening right now.
nonlocal MD