In December of 2014 I felt invincible. Why? Because I had just received the prestigious white coat in a ceremony attended by my family and friends. Nothing could prevent me from becoming the best PA possible as I donned my new, crisp superhero gear, complete with embroidered name and official arm patch. I was protected by this cloak of greatness.
Twelve years later, things have dramatically changed. I’m no longer the bright-eyed and bushy-tailed student, but rather the experienced PA with dark humor and a new view on health care. And the white coat — the prestigious symbol of entering the world of health care as a clinician — is now dead to me.
I should be clear. The white coat is not just dead for me personally. The white coat has officially earned its spot six feet under. What was once a symbol of medical knowledge has now become a symbol of elitism and distrust. One review by Crutzen and Adam noted the white coat “can create a clear distinction between the patient group (“them”) and the caregiver group (“us”), which can induce a social, psychological and relational distance.” When a medical professional approaches the patient in the clean, pressed, and tightly buttoned white coat, the patient often does not feel a sense of relief, but rather overwhelming fear and judgment. While it may simply be a piece of starched cloth, it seems to now represent a clear separation. The white coat is “associated with authority and power which can induce fear and submission,” and can entrench existing hierarchies that place the patient at the bottom.
Ten years ago, I wore the white coat from room to room, not for status but rather for the many pockets to accommodate my three phones, notebooks, pens, and lists for that day. SO many patients would comment on my attire. Just walking in the room would cause their face to flush, heart rate to sore, and blood pressure to go through the roof. It was not the fact that I was there to discuss their recent spine or brain surgery, but rather the intimidating coat hanging off my shoulders. I even had a patient’s daughter request I remove it before going into their mother’s room. I of course acquiesced, admittedly a bit begrudgingly at first, having to shed my pounds of gear in the hall. But this daughter was right. Her mother responded naturally to my presence without the extreme change in vital signs. We had a thorough and productive conversation without any drama or side-eye.
Over time, my use of the white coat started to fade as I traded it for the embroidered Patagonia. My name, credentials, and organization are still proudly displayed on the right chest; however, this zip-up lacks the coat’s pomp and circumstance. This may be a negative to some — but to me, this is the entire point. Why shouldn’t clinicians be more approachable? Research backs this viewpoint up: Some studies have shown that “not wearing a white coat reflects a more compassionate rather than authoritative image of physicians to patients.” And when a patient encounters a clinician they believe to be compassionate, they are more likely to be attentive and mindful of the information provided, which can lead to higher compliance rates.
Skeptics might question the professionalism of forgoing the white coat. But one doesn’t need to dress in street clothes as an alternative — walking into the patient’s room in scrubs and that Patagonia zip-up is perfectly acceptable and professional.
The fact of the matter is, a clinician does not need to be in heels, dress, and starched white coat in order to provide a medical opinion and advice. And when one does wear a white coat, one runs the risk of frightening or intimidating patients. The relaxed version of the clinician, on the other hand, can put patients at ease. Never have I encountered a patient who requested I wear a white coat. I have however had patients thank me for NOT wearing one.
I know where these patients are coming from — when my role has been reversed and I have become the patient, I personally prefer my clinician not wear a white coat. I find the wearer typically has an air of superiority. Hands are stuffed in pockets, they loom over you in bed, and literally speak down to you. I understand medical terminology and specialties, but even I find this intimidating and feel distrust. I will purposefully not state what I do for a living because once I do, the attitude and way I am treated changes.
Beyond personal preference, there are logistical reasons for abandoning the white coat. In the hospital, we have doctors, PAs, NPs, nurses, pharmacists, physical therapists, phlebotomists, and others. How do we tell them all apart? Once upon a time, only clinicians — doctors, APPs — wore a white coat in the hospital. This is no longer true. Walk down the hall on any unit, and many people are in a white coat. A family could easily talk to someone they assume is the loved one’s physician, when in reality that family has just revealed health information to the unit manager. If the argument in favor of the coat is to identify the clinician (who went to school to earn one), then why distribute them to everyone? Doesn’t everyone wearing one just defeat the supposed purpose of the coat? What is the white coat if it’s just an identifier of someone who works in the hospital?
Another reason to abandon the white coat is more undeniable: infections. A white coat, unlike the frequently washed Patagonia, is a home for bacteria that collects and is distributed from patient to patient. Antibiotic-resistant bacteria is already an issue plaguing the health care system in the U.S., and the white coats are only aiding the germs’ ride. Studies have shown that many white coats test positive for Staph aureus, including MRSA, as well as other pathogens that are often antibiotic-resistant. And in surgical specialties, those wearing white coats have been found to have a higher likelihood of carrying S. aureus and transmission given examination of postsurgical wounds.
Here’s how this works in practice: Imagine your doctor coming into your room in the early morning hours after you underwent spine surgery the day before. They ask you in your half-awake consciousness to roll over so they can see your incision and remove your dressing. You feel the sleeve of their coat rub along your back and brush against your incision, possibly peeling off a portion of scab to expose a few drops of blood. The team quickly assesses you, leaves, and moves on to the next patient. Yes, they all use the hand sanitizer located at the door when they enter and exit, but did the doctor wash the white coat when they left and before seeing the next patient? Highly unlikely. That sleeve then ever so slightly contacts the next patient along their arms and legs while an exam is undertaken. This seems harmless, but it actually just spreads bacteria from one room to the next.
How often are these white coats laundered? Weekly? Monthly? Bi-annually? I have witnessed some white coats go a full year without being sent to the company laundry. This fact alone sends shivers down my spine and I pray no one ever caring for me or my family is wearing one.
On the other hand, we have zip-ups. Simple. Machine washable. No fuss. Take it home at the end of the shift and toss it into the washing machine. Clean, fresh, and ready to go for the next day. No need to find a company drop-off or a dry cleaner. Not to mention most clinicians own a rotation of jackets to wear to work seeing patients.
At the end of the day, the white coat is a no-go. What once represented a proud tradition of earning a white coat and reciting an oath to serve one’s patients and do no harm is now causing direct distress and damage. Some feel looked down upon, as they view the white coat as being worn by someone who thinks they are above them in stature. Some clinicians who travel the halls in the white coat appear egotistical even to other staff, as though the coat gave them permission to talk down to others.
All that said, there are still personal reasons for clinicians to wear the white coat. Some may choose to wear one in order to fully embody their role as a clinician. They may feel it symbolizes hard work and dedication to their profession. One study found “the perception of the white coat among physicians was associated with higher self-reported empathy toward patients.” A white coat could potentially be beneficial if a clinician feels more empathy toward patient-centered care while wearing it.
Despite this, the white coat on its own does not provide the medical knowledge. The white coat does not provide the care. The human wearing the coat is the important portion of this equation. It is time we enter modern society. As Crutzen and Adam write, “The absence of uniforms would establish a relationship of equals and force professionals to humanize their care.” So: Rid the hospitals of white coats from the uniform expected to be worn by clinicians. Welcome and embrace a presence of calmness and humanity. Clinicians and patients need to be reminded that more makes them the same than differentiates them. The white coat is no longer needed as a wall to tell us apart. Instead we need conversations, communication, and a relaxed look.
A decade ago, I was proud and honored to wear the white coat. But years of experience have taught me that some symbols are meant to fade. I’ll gladly don my credentialed zip-up all around the hospital — and wash it daily. The white coat is merely a symbol, and one that is currently evolving. A uniform is not required in a hospital setting in order to provide quality, patient-centered, empathic care to all patients.
The white coat is dead. Do not resuscitate.
What are your thoughts on the white coat? Do you wear it? Share in the comments!
Kristen Cellary is a senior neurosurgical physician assistant in Camden, NJ. She has worked in the field of neurosurgery since graduating from the University of the Sciences in 2016. Prior to becoming a PA, she earned her MPH degree with a focus in health literacy from Thomas Jefferson University and in 2022, she graduated with her doctorate of medical science from the University of Lynchburg. She spends her days in the OR, seeing consults, and caring for patients perioperatively. Outside of work she enjoys running, reading, and her dog Bailey, and is a classic “Disney adult.” She is a 2025–2026 Doximity Op-Med Fellow.
Collage by Jennifer Bogartz / Shutterstock
