Should radiologists wear a white coat?

Patients have been identifying physicians by their white coats for many years now, but is such a uniform really necessary in radiology? A new commentary published in the Journal of the American College of Radiology explored that question in great detail, noting that physicians have been wearing these coats now for more than 100 years.

“Physicians transitioned to white attire at the turn of the 20th century, likely to symbolize purity or cleanliness in the wake of the emerging germ theory of disease,” wrote Cory M. Pfeifer, MD, MS, department of radiology at the University of Texas Southwestern Medical Center in Dallas, Texas. “Over time, the white coat became commonplace during both patient encounters and more formal events such as grand rounds. The ‘white coat ceremony’ in which new medical students are ritually cloaked by doctors began in 1993 and is now a common rite of passage at the beginning of medical training.”

Looking specifically at the role of white coats in radiology, the author noted that white coats still make a difference to a lot of specialists within the field.

“Many academic radiology departments, including mine, require the purchase of a white coat using institutional funds regardless of whether the physician agrees with this historical philosophy,” he wrote. “Practices such as these suggest that many physician leaders continue to ascribe some sort of rank or notoriety to the coat.”

Perhaps the greatest single biggest reason radiologists should put on the white coat is that it can help them demonstrate their value. Many patients do not believe radiologists are actual physicians, Pfeifer explained—so if radiologists have the coat on when engaging with patients, it can help emphasize their importance.

In certain scenarios, however, wearing the white coat could actually work against a radiologist.

“Pediatric radiologists may fall more in line with pediatricians who have abandoned the white coat to appear less threatening to children,” Pfeifer wrote. “MRI safety-related dress codes may further inhibit white coat usage for relevant radiologists.”

Whether radiologists should wear the white coat or not “remains a complex topic,” according to the commentary, but Pfeifer did close with some words of wisdom from Don Berwick, MD, a former CMS administrator.

“I assert that although the decision to wear the white coat should belong to each individual radiologist, my hope is that radiologists will remember the advice provided by Dr. Berwick,” Pfeifer concluded. “If radiologists want to improve their visibility as valuable clinicians involved in patient care, communication and trust are ultimately more important than the uniforms that we wear.”