The Case for Scrubs

When I heard that physicians could choose to wear scrubs into the clinic and hospital instead of the usual professional attire, I was intrigued. This protocol was instituted to facilitate sanitary work clothes in pandemic times. There are many reasons to continue this policy when the dust from COVID-19 settles. It can enhance cleanliness, strengthen working relationships among health care workers, appeal to younger patients, and save students and residents from significant investments in a wardrobe. 

First, scrubs are more sanitary. Made from durable materials, they are designed to be sanitized through a hospital-paid laundry service or washed daily in high temperatures at home. Physicians, residents, and medical students who may have spent time near patients with influenza, pneumonia, or worse can easily sterilize their scrubs and decrease the risk of spreading the pathogen. With asymptomatic individuals possibly infecting others with SARS-CoV-2, and the reality of false-negative tests, decontaminated attire is increasingly important. Scrubs are much easier to clean than dry-clean-only outfits and should remain a fixture in the name of cleanliness. 

Also, younger patients prefer scrubs. One of the most significant hurdles in establishing scrubs as a viable option is that older patients have a preference for formal dress. However, contamination concerns can sway these patients to be more accepting of different attire, and it would be noteworthy to see if these patients come to appreciate the enhanced hygiene that scrubs afford. On the other end, younger patients already demonstrate a preference for physicians in scrubs over formal attire and would likely be more accepting of a universal shift to scrubs. Perhaps a compromise could be wearing scrubs with a white coat, which can be comparable in desirability to a white coat over formal attire.

Additionally, scrubs are less expensive than business casual attire. As medical students incur tens of thousands of dollars in debt to finance their education, it would be exceedingly helpful to pay $40 for a nice set of scrubs instead of $100 for a professional outfit. Being able to use an in-home washer and dryer instead of a costly dry cleaner would also further defray expenses and achieve the desired level of cleanliness mentioned earlier. Prior to COVID-19, it was common to wear the same outfit multiple times before it was sent to the cleaners. Although this practice is particularly unhygienic now, it is also financially unrealistic for both medical students and residents with limited budgets to professionally clean their clothes on a daily basis.

Moreover, wearing scrubs would put all medical students and residents on even footing in terms of appearance — regardless of socioeconomic background — and negate any advantage that any designer shirts or suits may subliminally endow. This is particularly important as more first-generation medical students enter the field. While some patients may perceive medical students to be less professional without a white coat, scrubs could certainly spare the young Millennial learner from irking an older preceptor who may be less comfortable with the increasingly casual and varied nature of this generation’s professional attire. In both of these cases, learners benefit from being evaluated on their delivery of patient care rather than on their clothing style.

While a white coat and formal dress quickly distinguish doctors from other members of a patient’s health care team, that distinction is not paramount when every person on that team is striving for the same outcome. As health care becomes increasingly interprofessional and collaborative, the ubiquitous use of scrubs can signify that everyone’s role is equally important. For example, emergency medicine physicians don scrubs along with others in the emergency department, although they do typically wear a particular color to designate their role. 

I find scrubs comfortable, and I appreciate that they can be paired with impact-absorbing sneakers that are ergonomically sound. Yet the safety of our patients is of utmost importance. The use of scrubs over professional attire greatly aids this goal since they are significantly easier to sterilize. COVID-19 has already dismantled many traditional perceptions about health care and has been transforming the delivery of medicine in many ways. Just as telehealth is evolving into an increasingly accepted practice, the burgeoning use of scrubs should similarly become an enduring norm to enhance patient safety. I, therefore, encourage every hospital to embrace scrubs as acceptable professional attire for all physicians, residents, and students.

Nina Didner is a second-year medical student at the University of North Carolina School of Medicine and previously worked as a management consultant, Gyrotonic instructor, and small business owner.

Carolyn Quinsey, MD, is an Assistant Professor of Neurosurgery and Associate Program Director at the University of North Carolina School of Medicine as well as the Director of the UNC Neurosurgery Skull Base Lab and the UNC Neurosurgery Initiative in Malawi.

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