The White Coat Ceremony

Almost all medical schools in the country have a traditional white coat ceremony, the first day of school when incoming students are presented their white coat, which they will wear throughout their careers. The occasion is typically marked by speeches from the dean and prominent faculty, informing those being invested with this symbol of their future profession the meaning of what it is to be a doctor along with a history of the great healers of the past and present on whose achievements and sacrifices the profession’s reputation rests. In the history of medicine, being a doctor was not looked upon as a job but as a calling, that imbued its followers with special privileges as well as distinct obligations.

As recited in the Hippocratic Oath (which has recently been modernized for our current age) we who were joining this profession (considered noble before doctors were reduced to being called “providers” and patients to “customers”) were expected to follow a strict code of ethics, to honor our teachers, and to pass on our knowledge to upcoming generations. Hippocrates admonished his followers to treat often, cure sometimes, and care always. Our coats would identify us as members of this august community, and it was a badge we were all excited to receive, even as we were told how arduous of a journey lay ahead of us. I remember the Dean telling us that we would learn a lot of what were considered “facts”, but half the “facts” taught to us would turn out to be wrong. Unfortunately he, nor anyone else at the time, could tell us which half those were; we’d have to figure it out ourselves over time.

Unlike other schools, Tulane did not give students white coats to wear, because we had yet to earn this coveted badge of our profession. Instead, they gave us long, tan colored coats with the school’s logo on the front pocket. In this way, patients could not accidentally mistake us for doctors, and easily recognize us for the students we were. However, almost all the poor patients at Charity, our primary teaching hospital, would call us “doctors” even though we always introduced ourselves as medical students, and even the wealthier, mostly white patients at the private hospitals through which we also rotated gave us the same honorific. This I thought at the time was a function of Southern politeness until I saw the same behavior in Southern California during my postgraduate training.

Despite sullying of the medical practitioners reputation in recent years (due to changes in the culture of being a doctor brought on by advanced technologies and our own bad behaviors, along with the takeover by government and large corporations of our lives) and fed by negative media depiction of physicians, most patients still hold their own doctors in high esteem. This is the reason that chiropractors, optometrists, nutritionists, as well as those who peddle cures on commercials insist on wearing a white coat. In a study done not too long ago, patients were asked to rate their interaction with a physician, one of whom wore a white coat with a shirt and tie, while the other wore street clothes with a sport shirt and open collar. The information they gave the patients were identical, but those who received the advice form the one on the white coat said they were much more likely to follow the given instruction than the patients of the one in street clothes. The coat remains a powerful symbol.

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