DOING THE ROUNDS

White coat effects

^a University Department of Dermatology, Royal Infirmary, Edinburgh EH3 9YW

Correspondence to: Dr Gordon.

To many patients, the hospital doctor is epitomised by the white coat. What patients think of the way their doctor dresses has generated considerable interest.^{1 2} Of further interest is the actual contents of the white coat, and indeed senior hospital doctors may be aware of a "lightening" of the weight of their white coat with a concomitant increase in clinical responsibilities. This is not a phenomenon unique to obstetricians. The new house officer, weighed down with the essential items (tendon hammer, ophthalmoscope, handbook of medical emergencies, etc) to ensure survival as a junior house officer, contrasts heavily with the more senior doctor who seems to cope effortlessly with a single fountain pen (non-pharmaceutical) and stethoscope. The aim of this study was to investigate the possible relation between the weights of doctors' white coats and their clinical grades.

Subjects, methods, and results

In the week preceding Christmas, during lunchtime in the dining room of the Royal Infirmary, Edinburgh, hospital doctors were approached and asked if their white coats and contents could be weighed. They were further divided into specialty (medical or surgical) and clinical grade (junior house officer, senior house officer, registrar, senior registrar, consultant). Measurement was with a hand held spring balance.

Of the 49 doctors (27 male, 22 female) who were approached, all agreed to have their coats weighed. The following grades were represented: junior house officer, 15; senior house officer, 14; registrar, 6; senior registrar, 5; consultant, 9. A total of 30 medical and 19 surgical coats were weighed. The weight of a control white coat was 0.6 kg; measured coat weights ranged from 0.6 to 3.5 kg.

View larger version (10K): [in this window] [in a new window]   Relation between mean weight of white coat and grade of doctor

No significant difference was found between male and female doctors' mean coat weights (1.33 v 1.69 kg, respectively). There was no significant difference between mean weight of physicians' and surgeons' coats (1.4 kg v 1.50 kg). A multiple regression analysis showed that the difference in weight could all be accounted for by the reduction in weight with increasing seniority (P=0.002). Age, sex, and specialty did not contribute significantly to the equation.

There was a highly significant (P=0.0002) association between increasing seniority and coat weight (figure). The heaviest coat (3.5 kg) was attached to a perimembership candidate. Somewhat more reassuringly, only one personal telephone was isolated in this study.

Comment

This small pilot study has convincingly confirmed the conception that the weight of doctors' white coats decreases with increasing seniority. Further work is required to establish the point at which stethoscopes and other contents of white coats become ejected from the pockets.

Our grateful thanks go to all doctors who so willingly agreed to take off their coats in the canteen.

Funding: None.

Conflict of interest: None.

1. Syme D. What patients think of the way their doctor dresses. Br J Gen Pract 1991;41:436.
2. Dover S, Glasgow patients' attitude to doctors' dress and appearance. Health Bull 1991;49:293-6.