Should physicians ditch the white coat during the pandemic? Twitter threads sets off debate

Should physicians continue to wear white coats in the midst of the COVID-19 pandemic, or will wearing them contribute to the virus' spread? A debate on this topic has raged on Twitter among healthcare professionals over the last two days.

On March 18, Michael McClurkin, MD, a psychiatry resident at Yale School of Medicine in New Haven, Conn., tweeted: "This may hurt some feelings but ... I think the white coat should be retired. They're not hygienic. Especially in a pandemic when the virus can live on objects for days/hours? What do people think? #COVID19 #medtwitter"

This set of a firestorm of replies, with healthcare professionals debating the pros and cons of donning the iconic white coat.

Some agreed with Dr. McClurkin. One Twitter user, Alisa Niksch, MD, (@alisadoc1), a pediatric cardiologist in Massachusetts, tweeted "Never was trained to wear one! Rainbow Babies and Children's Hospital actually discouraged wearing a white coat unless wearing scrubs outside the OR. So, it just stayed in a closet for the most part. Agree-it's scary and just gets dirty too often."

Another user, Kelbie Bauer (@KelbieA), a physician assistant, tweeted "Yes! Absolutely! Just look at the cusps and bottoms of our coats. Dingy and gross."

Survey results, published in January in the American Journal of Infection Control, show many physicians wear their white coats for a week or more before washing them.

Dr. McClurkin reiterated this point in response to a Twitter user who suggested it was easy to get white coats cleaned.

"Not if you're a resident working 80 hours a week, with 1 day off a week, and no access to the in- hospital cleaning services only attendings have," Dr. McClurkin tweeted.

Some Twitter users disagreed, however.

J’Leise Sosa, MD, (@drsosaobgyn), an OB-GYN, tweeted "Disagree. In the pandemic, anything we wear poses a risk of contamination unless we can change after each pt [patient]. A white coat shields my exposed skin and portions of my scrubs so that when I take off clothes at the end of day, I hopefully have fewer bugs to take home to my family."

Many who replied on the Twitter thread said that it would be best if healthcare professionals just stuck to wearing scrubs.

"For now everyone should be wearing scrubs and removing before entering homes," tweeted Kevin S Shah, MD, (@KevinShahMD), a Utah physician.

Another Twitter user, Yamini Natarajan, MD, (@NatYamini), a gastroenterologist in Houston, agreed with Dr. McClurkin's tweet, but also pointed out that with a personal protective equipment shortage in the country, healthcare workers are being asked to reuse several items.

"I agree! But I do think this topic doesn't replace the need to address crucial #PPEshortage — facilities are asking providers to reuse masks, which poses similar risks," she tweeted.


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