Monday, March 18, 2013

The Short White Coat....

      In a few short months I will be ditching my (very dirty) white coat for a long one. It is a rite of passage in a way. Before medical school, I had no idea that you could see the hierarchy of the hospital by simply looking at the white coats of the people working there. A short white coat indicates that the person is a medical student, and a longer one indicates that the person is a full-fledged physician (the person has graduated medical school). Note: the person wearing the long white coat may have been wearing a short one the month before, so do not let the long coat fool you into thinking that the person is a very experienced physician. Another thing to note (if you have time to spend staring at people in the hospital) is that the pockets of people's white coats can be a great clue as to how experienced they are as a physician (or at the very least how many years it has been since they graduated from medical school). A good rule of thumb is: the amount of stuff crammed into the pocket of a person's white coat is indirectly proportional to their years of training. Medical student's pockets are usually the fullest. For example, my white coat pockets are usually stuffed with tissues, gauze, tape, my Maxwell's Quick Medical Reference, a granola bar, a stethoscope, my cell phone, lists of my patients and all of their vitals, etc where as attending physicians typically have empty white coat pockets. I do think that it is interesting that the white coat does not gradually become longer as a person accumulates more years of training. On the interview trail I heard that at Mass General Hospital (Harvard), everyone wears a short white coat because they are all still learning. I agree with the 'still learning part,' but again, that defeats the purpose of the white coat being able to distinguish a medical student from an actual doctor. I do love the symbolism though. Even attendings should constantly be learning new things in medicine. But the white coat confusion is why I like my idea to gradually increase the length of the white coat as the number of post-graduate years increase.
      At the Cleveland Clinic (a hospital that I interviewed at) only resident's wear scrubs in the OR and the attendings wear this weird all white outfit that makes them look like they are painters. There is some sort of tradition behind it, but I just think that they look strange. Wouldn't color coded scrubs be better? At the Mayo Clinic, all of the staff has to dress in a suit every single day (apparently it is a British tradition). I thought that was crazy since I dreaded putting on my suit for interviews so much. When I told Matt about the suit tradition there, he was quick to point out that he wears a suit every single day to work and does not make a big deal about it, but when I reminded him that his job does not involve people vomiting on his expensive outfit, he was quiet pretty quickly. I really hope that they at least allow the doctors there to wear scrubs in the OR. I cannot imagine having to operate with a suit beneath my scrub gear.
     As a side note, not to call out the Cleveland Clinic or anything, because it is an amazing hospital with so much research and innovation, but since  president Obama used them as an example during his campaign this year when speaking about healthcare reform, I feel that I have to point this out. He said that the clinic can be used as an example of how to preserve resources by their utilization of preventative medicine and because they provide great care that is "cheaper than average." After walking through their "sky-way" that connects the different buildings there and observing the way they advertise themselves, I couldn't help but think that maybe they are not actually the best at preserving "resources." There is a different flat screen tv on every single pillar of the walkway that extends for miles, and each has an ad for the Cleveland Clinic. How is that preserving resources? I have a strong feeling that if they took some of the money they put into all of those flat screens, even cutting down to one television for every OTHER pillar of the walkway, and channeled those resources into more free clinics, additional ancillary staff to increase efficiency, or to provide even CHEAPER care, it would be a step in the right direction. I mean, the patient's are AT the clinic if they are in the skyway, so is spending all of that money on flat screens to advertise really necessary?

I couldn't help but take a photo. Note all of the flat screen TVs.


  1. Well..Mass General doesn't advertise much at all..and they are, of course No. 1 .. whatever that really means!!! In any event Mazel Tov on Einstein!!! So proud of you!!! Love, A.L.

  2. Well..Mass General doesn't advertise much at all..and they are, of course No. 1 .. whatever that really means!!! In any event Mazel Tov on Einstein!!! So proud of you!!! Love, A.L.