An ongoing dialogue on HIV/AIDS, infectious diseases,
November 1st, 2015
Should Doctors Still Be Allowed to Wear White Coats? You Decide
If you’re not immersed in the ID or the Infection Control world, you might not be aware that there’s currently quite the controversy about whether doctors should wear white coats.
I almost wrote “raging controversy” — but the adjective “raging” doesn’t really fit the sort of people who specialize in Infection Control, who are some of the most measured, data-driven, and methodical individuals in all of medicine. You know the stereotype of the brash, volatile, and cowboy surgeon, the person that everyone tiptoes around?
These Infection Control folks are the polar opposite.
Still, a white coat controversy does exist, and it goes like this:
- You can culture all kinds of scary bacteria from the sleeves of white coats.
- Doctors don’t launder their white coats very often.
- These bacteria could be transmitted to patients.
- Therefore, doctors shouldn’t wear white coats.
Not surprisingly, some have advocated a “bare-below-the-elbows” approach to doctors’ attire, and famously the British National Health Service has made it policy, banishing ties as well (and predictably not pleasing everyone). There was a tremendously entertaining debate on the topic this year year at IDWeek — such a pitched battle it almost met the “raging” criteria, but not quite (you could tell the combatants really liked each other). Right here in Boston, one of our current ID fellows feels quite passionately about the issue, and writes frequently on the topic.
The missing piece in the controversy, of course, is a definitive study showing that patient infection rates are actually reduced when a bare-below-the-elbows (often abbreviated “BBE”) strategy is adopted. Short of that, we’re all essentially hostage to whomever sets these policies wherever we work. And our hospital’s policies basically follow those of Society for Healthcare Epidemiology of America (SHEA), which “balance professional appearance, comfort, and practicality with the potential role of apparel in the cross-transmission of pathogens.”
In other words, wear white coats if you want, but keep them clean.
This data void, however, gives me permission to ruminate over some of the important and not-so-important questions that inevitably come up when contemplating white coats, and our ambivalent feelings about them.
- Why do some doctors wear them now, and some don’t? My wife the pediatrician said if she or one of her practice partners showed up in a white coat, the office staff would view it as bizarre as if they showed up dressed as a Roman centurion. She didn’t actually say that, but you get the idea — pediatricians don’t avoid white coats because of infection risk, but because they are considered potentially scary to kids. Meanwhile, the brilliant and fearsome Chief of Medicine during my residency considered us housestaff essentially naked unless we were wearing white coats, and the Chief Medical Residents kept a few extra in their offices on days he took Residents’ Report in case we showed up white coat-less — kind of like the maitre d’ at the formal restaurant keeping a few extra blazers in the coat closet in case someone arrives without a jacket.
- What do the patients want? Demonstrating that she was a far more compensated medical student than I, one of my classmates during medical school actually published a study evaluating patients’ preferences on doctor attire. Yes, patients liked white coats back then, jeans not so much. It’s one of many such studies appearing in the medical literature over the years; a systematic review of them is summarized in this paper published in the British Medical Journal. Consensus? Patients still seem to like them, but of course for every opinion about the reassuring message of professionalism conveyed by the white coat, there’s an opposite view that they reinforce outdated hierarchical structures in healthcare.
- What should doctors wear if they don’t wear a white coat? The obvious first thought is scrubs, but there are a few problems here. First, scrubs are basically utilitarian pajamas, and can get pretty nasty unless washed daily. Second, they don’t offer much in the way of insulation, a huge issue in the winter and in ubiquitous over-air conditioned interiors. Third, scrubs can be very unkind to certain body types, male and female alike. (You know what I mean.) Fourth, they have basically no storage space — cell phone, wallet, that’s it — forget the reflex hammer, ophthalmoscope (though it’s useless to me), or pocket manual, and wearing scrubs makes your stethoscope a permanent half-necklace. Finally, the public has lots of negative feelings about scrubs — especially when they see doctors wearing them outside the hospital, which means to adopt scrubs as standard gear means changing when you get to work, ugh. And if not scrubs? Men probably clean their suits less often than they wash their white coats, and my daughter told me recently that button-up short sleeved shirts on men are a huge fashion faux-pas, to be avoided as much as backpacks with wheels and belt clips for cell phones. Who knew?
- If white coats go, what happens to the “White Coat Ceremony” during medical school? Apparently, 97% of medical schools now have a White Coat Ceremony, the purpose of which is “to welcome new students into the medical profession and to set clear expectations regarding their primary role as physicians by professing an oath.” Does that oath now include a specified frequency of laundering, including minimum water temperature and the need to use bleach? By the way, you youngsters might be surprised to hear that these solemn and moving rituals are relatively new. Back when I was in medical school, they just left you in a room alone with a cadaver, turned out the lights, and timed how long you could stay there before you screamed for help.
- How would New Yorker cartoons designate doctors if white coats were abandoned? This is a very important question. Take a look — the overwhelming majority have the MD in a white coat, and those few that don’t typically involve surgeons in the OR. Here’s one of the rare exceptions to the above rule and 1) the guy is wearing long sleeves (not BBE!), and 2) it’s not that funny. I’d give it a 7 out of 10 on the funniness scale — now this one is funny. Note that this brilliant cartoonist often adds the head mirror to the white coat, just so you couldn’t possibly think that the white-coated person in his cartoon might be an insurance salesperson or an airline pilot.
Ok, so controversy not resolved. Please vote!
Another fun post; loved the “debate” on this at IDSA too. I’ll keep wearing it until it’s banned. For women physicians who are otherwise professionally dressed it provides key POCKETS which are not in most of our street clothes, especially as fashion has moved to more form fitting clothes (perhaps an unfortunate intersection with the societal weight problem). And yes, I wash it, and SCRUBS in public are not cool.
I don’t even OWN a white coat. And I have seen colleagues wearing white coats that look like they were last laundered during the Reagan administration. Yuck. I don’t wear one because of the hierarchy thing and also because I trained in a large academic hospital. One day, it occurred to me that probably every microbe known to humans comfortably resided at said hospital. I vowed to do what I could to avoid exposing my patients to more “bugs” than they would otherwise be exposed to. That’s when I started cleaning my stethoscope between patients and I vowed that I would never wear a white coat, either. (And I became somewhat paranoid about the Dynamap that got dragged from room to room to do vitals. But that’s another topic.)
There have been some studies vindicating (sort of) my decision to clean my stethoscope between patients, although the link between contaminated stethoscopes, transfer of bacteria to skin and actual healthcare associated infections hasn’t been made yet. http://www.ncbi.nlm.nih.gov/pubmed/26092471 I await a study that shows that link, as well as one showing a link between white coats and HCAI. Meanwhile, my thinking is that if I can reduce the microbial load passed on to my patients (I now work strictly outpatient, BTW), I will do what I can, and await the confirmatory studies.
I am, however, envious of all the pockets available to white coat-wearing colleagues.
What? No link to Monty Python’s Holy Grail underneath the words “Roman Centurion”? 🙂 https://www.youtube.com/watch?v=XbI-fDzUJXI
What do you wear…..street clothes……..shoes that you wear on the street……..
How do you protect your clothes……………???? How often do you clean your hands????
Did you discard your pen or clean it after you used it????
Cleaning your stethoscope after using it should be routine.
We definitely don’t wear white coats (or ties) in Santa Fe. The last time I wore one was Halloween in 2013, when I went to work dressed as an “East coast doctor.” My vote is for a locker room where you change into scrubs when you go to work, changing back when you leave. They’d be cleaned daily, and you wouldn’t have to see people wearing them at Whole Foods or In bars for use as hook-up accessories.
I agree and have seen this done in L&D units but not elsewhere.
Agreed. I suggest a nice, button-up shirt for men (possibly also button-down collar) with long sleeves (looks more formal and less geekish than short-sleeve shirts) which are rolled up. People (I’m thinking) may like the look of a guy who “rolls up his sleeves and gets down to work.”
I’m clueless as to what women should wear. Possibly some sort of fashion tool-belt? Hmmm…maybe I’ll try marketing that on Etsy.
“to be avoided as much as backpacks with wheels and belt clips for cell phones.”
You can have the belt clip for my cell phone when you pry it from my cold, dead hands. 😉
I didn’t know backpacks with wheels were uncool, either. 🙁
I’m the ID fellow Paul mentions in his terrific blog post. In my opinion, it’s “First do no harm” as you see in my article. But it goes beyond the bacteria on the surface of these coats. I think medicine needs change, and if you agree with me, the link to my petition is above. Thank you. Best regards, Phil
I did read your article and I thought it was great. But now I am hooked on The Conversation, thank you very much! LOL
Love this blog. Thanks for bringing up this issue. BTW, I am that medical school classmate who published a study in JAMA in1987 citing that %65 of patients preferred that physicians wear white coats. However, I’m wondering if they would still feel that way if they knew about all the bacterial overgrowth around the cuffs! Personally, I have a private, office based practice, and for general hygiene purposes try to launder my white coats quite regularly. I go to the hospital only to perform surgery(and wear clean scrubs) or when I make patient rounds( when I just wear my clean street clothes without a white coat). I’d like to think that my office germs may be less threatening than those in a large teaching hospital?
I always wear a white coat in the office because I need pockets! I use everything in my pockets quite frequently every day. I suppose I could try a fanny pack but that just seems wrong and pretty unattractive. Also, a white coat is a great way to hide your tennis top when you’ve been playing tennis just before getting to the office or concealing other assorted wardrobe imperfections.
As long as we are on the topic of fomites, my pet peeve as a resident was those fuzzy animals(like koalas, etc) that clipped on to everyone’s stethoscopes. I’m sure those were teeming with bacteria from all the kids who fondled them. Have those cute things been banned? My present pet peeve is those personalized cloth OR scrub hats that everyone in the OR seems to be wearing. I am pretty sure that many of the surgeons/staff do not regularly wash them and just keep re-wearing them. I think you could probably find some nasty stuff if you looked there–but you may not want to. Remember, this is the OR where sterility is a major concern. Anxious to see how this vote turns out.
We can use white coats, scrubs or any color coats, the problem is to be clean enough (I think if you are a MD you should be), wash them frequently and remember to roll the sleeves…
And thanks for this blog!
I am a hospitalist general pediatrician who wears a white coat and loves to do so. All existent data shows that children are not frightened by docs wearing a white coat. Their fear, if present, correlates much more strongly with the doc’s bedside manner. I prefer the white coat for several reasons.
1. I worked so hard for the privilege of being a doctor that I find it hard to conceive that anyone would avoid the honor of wearing the white coat which symbolizes the profession.
2. The white coat allows patients to more easily figure out who is a doctor and who is not. So many people see a patient every day, and within each profession there are handoffs every day, that I believe the white coat helps them to know when they are talking to a doctor. (As an aside, I’ve always wanted my last name and a number on the back of my white coat, but that may have something to do with the fact that I was not a football star.)
3. I believe the white coat suggests professionalism to the patient.
4. As others have noted, the multiple pockets are handy.
5. This may be my least cogent point, but I’ll go ahead and make it anyway. When we do a physical examination its important to look at the patient’s entire body, including their genitalia. Many of our patients are taught the concept of “stranger danger”, and to flee if anyone makes such a move. I think that the white coat, along with the medical setting and the presence of a parent, provides an unspoken assurance that it is safe to let this person look at my most private body area.
6. Finally, and this point has broad implications, I’m tired of making changes that are not first tested to see if they work or not. I’ve lived through a lot of them. Apnea monitors, restricted duty hours to improve patient safety, maintenance of certification, and so forth. I can support strongly change which has supportive data. I’m tired of making changes just because someone in power thinks it would be a good thing to do. The Law of Unintended Consequences has not been repealed.
Thanks for a wonderful discussion.
#6 – So right. Reminds me of when NYC required that all large gasoline storage tanks at gas stations be buried underground. So everyone did so. Then there were suddely a lot of explosions happening. So NYC required everyone to dig them up again. We can live without the stupidity.
There has been a significant decline in the most common nosocomial pathogen worldwide, MRSA. Though there is a plausible mechanism for how white coats could be contributing to the spread of MDROs, ecologic data seems to indicate other, as of yet unknown factors are much more important at least with MRSA.
I usually wear a white coat, but depending on the office microclimate and my wardrobe for the day I may go without it. A few years back a kindly nurse gifted me with a purple caddy. I put all of my accroutemant in this, including Rx pads and pharmacopeia, as well as my silenced cell phone and beeper. I hate the weight of these items in my pocket, and I swear my posture has improved since I’ve stopped carrying these items on my person. I either take the caddy into the room, or more often stash it on the computer desk just outside the room. I only carry my stethoscope.
One thing I dislike the most is to see doctors and medicine students get into the cafeteria or next to the hospital fast food wearing the coat. For them, it is showing a symbol of status. For me, it is pure grossness.
The only real problem is: would any other piece of clothing be cleaner? It wouldn’t probably be white and we’d notice later that it belongs in the washer. Plus, would you really wear your private clothes on the wards??
Anyway, the chiefs dictate what we wear
Yes: Fresh scrubs worn daily and deposited back in the hospital laundry bin at the end of the day would definitely be cleaner.
If you’re working in a setting with lots of personel and little patient familiarity such as a hospital the white coat does what any good uniform does, namely identify physicians from nurses techs and administrators but these are also the setting where germ transmission is a greater problem. I think having in house lab coats from cintas or another uniform company which also launders and repairs prn and makes swapping with fresh coats quick and convenient is the best way to go. As for the practice I work for, our patients know who we are so unless you’re insecure about yourself and feel it necessary to dress a certain way to project to your patients and colleagues your a physician you simply show up in business casual with no tie. I am interested in policies involving jewelry and electronic devices though my cell phone as probably just as filthy as the lab coat I wore ad a medical student
So glad to see the discussion this post has engendered. There is increasing discussion and I would like to see the debate move beyond the bacteria to other issues we are confronting in health care. See my petition, http://www.whitecoats.xyz for more details. Philip Lederer
The real question is….why does everyone else keep telling doctors what they can and can’t do. How about we leave doctors to make up their own minds as to how they want to practice medicine. Should doctors be allowed….? Give me a break. The public, the government, and administrators alike need to take a step back and talk about the real issues. Reasons why physician suicide is on the rise, or perhaps why physicians aren’t staying in practice as long compared 30-40 years ago, or even why there will be a physician shortage in the near future. How about this for a number one debate, why the United States spends the most on healthcare, but is at the bottom of the list in life expectancy, health outcomes, pt satisfaction. I bet your knee jerk reaction would be to point to “the doctors” right? Maybe that’s why we should be discussing theissues instead of telling us what to freaking wear!
I understand the desire to go back to the “good old days” when doctors were the kings (rarely queens) of their domain. But we know that there are some things doctors don’t do very well when left to their own devices. Handwashing and infection control practices are good examples. Rates of nosocomial infections drop dramatically when doctors are “told what to do” by infection control people and administrators. We don’t always get everything right on our own. If it’s true that white coats spread bacteria in the hospital, then that becomes an important behavior to modify…or even regulate. I have no problem with that. My job is to take care of patients. It’s someone else’s job to tell me if there are practices I could change to improve patient safety. How would I ever know that otherwise?
BALONEY! Doctors: Wash your white coats often. Bleach them and keep them clean!
As a gastroenterology resident at a rather large teaching hospital in México, I have had the chance to observe both sides of the story…
You see, doctors who wear their coats/scrubs everywhere and by that I mean the “standing in line at a food truck across the street waiting for some tasty tacos while the next procedure is prepped up”, or the “yeah why not? I’ll go fully dressed with scrubs and lab coat to the bank, supermarket, subway, etcetera” kind of situation, are sadly a common view, (although many med students do partake in this behavior, I’m referring strictly to licensed medical personnel in actual touch with patients, not the spoiled brats from 1st year of college…) in many teaching hospitals in Mexico, and if you take into account the working conditions of these facilities; less than functional ventilation, insufficient access to proper washing and handling of scrubs/coats by the hospitals, leaves the actual decision of the dress code to each attending…
And most of the residents/interns in public health hospitals have to wear a formal dress code; namely: white coat, shirt, pants and shoes, to properly identify us (as we tend to be the main work force in medical attention), and you all can imagine how hard it can get to mantain that image of pulcritude that is expected from doctors…
Anyways there’s a constant concern about nosocomial infections and the development of MDR bugs (those feared cultures on your septic patient that are resistant to..well, practically anything you can throw at em’), and at least, proper washing of hands in between each patient examination has demonstrated to reduce this events to at least some extent, in this highly toxic environment we work in…
My aproach? I try to keep my coats clean even if it’s extra work, i prefer the extra pocket spaces, which allow me to properly stow sthethoscope, note pads tablet and what not, and also I think that with proper communication, any patient can overcome that white coat anxiety and feel reassured by their physician. Aand…in the other hand. We work at the GI endoscopy unit all morning, and perform colonoscopies. Really people? You would keep your scrubs on and go home with those clothes while knowing what you were exposed to? Well…not my choice at least!!
Part of the problem is the overbearing nature of rule makers and the slovenly nature of some physicians. First of all, when the coat is ready, have it professionally laundered and pressed. What’s the point of wearing a filthy, wrinkled white coat?
Second, studies show that cuffs down by the wrist are contaminated. Does that mean we wear muscle shirts (no sleeves at all)? Based on the studies a few inches off the wrist should suffice. We don’t have to go above the elbow unless someone shows that a few inches off the wrist doesn’t cut it.
Third, this is representative of a much larger issue. Health care workers are in danger of being progressively stripped of their civil rights. We can’t unionize, we can’t decide for ourselves what immunizations we will or wont get and now we’re going to be told what to wear. This, converging with guideline based medicine being enforced by EMRs, eventually will leave us as slaves. Why has no one figured out that guidelines are values based documents (Ethics 101) and may not apply if the patients and health care staff have different values than the authors?
Forth, We’re staining out gnats while swallowing camels. Studies have repeatedly shown that people who wash their hands with antibacterial soap are more likely to carry things like MRSA than people who wash with Dawn. And the Dawn users have no increase in skin problems. Yet not a single health care institution that I know of has stopped using antibacterial soap. It seems that issues are only important if they make physicians look like they are the problem.
Fifth, your poll reflects the false dichotomies often used in politics of all kinds. It encourages shallow thinking which is the antithesis of what it means to be a physician.
As a woman who often has no real pockets in my work clothes, I find the white coat essential for that reason alone. If transmission/cleanliness are the primary concern (which is understandable), why not compromise and have facilities provide freshly laundered white coats that doctors can use on a daily basis? This is similar to the scrubs idea but avoids the hassle of changing clothes at work.
I also prefer a white coat because I hate the idea of potentially bringing hospital/clinic pathogens home to my family. That’s the reason my white coat never comes into the house unless it’s going straight to the washing machine.
I suspect expense is the reason. Hospital laundry programs are expensive.
And voluntarily taking off our white coats is free… (We are NOT suggesting a mandate). http://Www.whitecots.xyz
In the interest of cleanliness, nurses gave up caps a long while ago. Let go of those coats and wear scrubs. Unfortunately scrubs pose their own issues: 1) there’s no easy way to identify who’s who… MD, RN, garbage collector; 2) contamination. People wear their comfy PJs in the hospital, on public transportation, bring home the infected clothes, then return the next day to the hospital. People should be required to change in the hospital before seeing patients and before leaving the facility. If necessary, hospitals ought to take on the onus of the laundry. The potential money spent would probably be saved in infection control!
I reject any arguments that focus on “status” and accomplishments. Plenty of people have worked long and hard in school, and are accomplished professionals. It seems juvenile to wish to wear a garment to establish your place on a self-serving hierarchy.
I am very concerned, however, with function, cleanliness, and patient relationships. There are many ways to collect and carry the tools necessary to have at hand during the work day. The white coat is simply one option.
I was horrified to read how many doctors wear the same coat day after day. It never occurred to me that these were not washed daily! Short sleeves seem like a reasonable accommodation as you can actually see long sleeves touching patients, objects around the room, etc. And, when long sleeves are not in the way, hand washing can proceed further up the arms.
Patients are taught how to see doctors, primarily through experience. As clothing styles change, so do perceptions. However, doctors, in my opinion, should always appear better groomed, and dressed more professionally than their patients. THAT is what truly inspires immediate confidence and respect.
YES the physician should wear a white coat, especially if treating children. Of course children fear the pain of some procedures and examinations, but we are not trying to deceive them. They should know who the physician is, so they know who may examine or treat them. They are small but not stupid, they will quickly realize the truth. They will not, and should not, trust you if you deceive them.
Patients expect appropriate attire, including ties for men. Just ask them as I have when I surveyed a series of patients; they will tell you they want conservative appropriate professional grooming and attire. They don’t want casual Friday, scrubs, or jeans. Ask them. And your clean white coat will keep your tie away when you examine the patient.
There is no excuse for dirty clothes, dirty scrubs, dirty ties, or dirty hands. Save lives by staying clean and washing appropriately. We already have studies to show that washing reduces infection and death. Oliver Wendell Holmes, Joseph Lister, and Ignaz Semmelweis figured it out in the 19th century.
Coat hooks outside the rooms! Allows the best of both 🙂
Wonderful discussion, with suprisingly little data relative to other earth shaking debates.
I wonder what we would find if we routinely cultured:
1) under wedding rings
2) in the anterior nares of providers, who lean over patients
3) cell phones, which are frequently touched
4) keyboards of the omnipresent computers in patients’ rooms and nursing stations.
some of these fomites have been documented to carry more pathogens than a toilet seat.
I don’t know if the data on transmission of pathogens from these areas is any more complete, but probably there is an ID fellow out there who has more complete knowledge.
I would also offer to our colleagues in the sunny south, that , here in Minnesota, bare arms frequently lead to cold hands, which is more of a dissatisfier to patients. I see many of my colleagues putting on long-sleaved sweaters, fleece, and jackets to keep warm, likely negating the argument about spread of pathogens from long sleaves. I am questioning the British move to keep short sleeves also; when I studied in London, the wards at King’s College were rather chilly in the winter.
As a female physician, my white coat serves to offer me an easy means to carry my various pieces of equipment. It also helps in another important way: to differentiate me from the nurses and other staff. As a woman, I am asked on a daily basis if I’m the nurse/social worker/dietician etc. Now, there’s no insult in being mistaken for another member of the health care team, but I highly doubt that my male colleagues have had this issue to deal with regularly. The white coat at least helps to provide some designation of my role, and for me it’s important. That being said, as an ID doc, I wash my coat regularly (hospital laundry), but perhaps shall do it more than my current 1-2 times a week routine.
Enjoyed the thoughts, especially the issue about cartoons, which I hadn’t seen anyone else mention. Still, this is a real issue, or is a symptom of a real issue.
Some related thoughts: http://kimbellardblog.blogspot.com/2015/12/the-white-coats-are-coming-white-coats.html
There are pathogens everywhere. Indicting the white coat as more a source of infections than myriad other things makes me wonder how many MD’s slept through microbiology class?
Culture anything in a hospital outside a designated sterile area and you will find a panoply of bad bugs. Indicted white coats is myopic.
Yikes — lot of passion about fashion, and some of the smartest infection control gurus I know are fashionistas.
But wear a white coat or not, wear a tie or not, roll-up your sleeves or not — these are all fashion (or other, e.g., stick-it-to-the-man) statements, but don’t think that these are infection control measures.
Maybe plastic underwear in the OR would be infection control wear, but no data that I know for the role of these other fashion statements. And while hand hygiene rates remain in the toilet, we are unlikely to be able to prove infection control benefit of the casual look?
I’m office based (no going to the hosptial for me), and had a nephrectomy five years ago and for a time afterwards couldn’t wear some of my more form fitting clothes and found a nice line of Dansko scrubs (BTW, Dansko, please bring back the Spectrum pant), more athletic pant looking than regular hospital scrubs–I’m still wearing similar ones five years later –and my dry cleaning bills are nil. I’ve never felt that patients were at all bothered by my appearance. Now, I do NOT wear them to the supermarket or the bar. Anything is better than a frayed, stained, grey around the cuffs. white jacket.
I work in NHS – you know, the health service with death panels but respectable health outcomes for a universal service….
I was delighted to see back of white coats, hot and uncomfortable, pockets get filled with chocolate wrappers and scrunched up forms. Not one of my patients – who are mainly elderly and traditional, and glad to give an opinion – has ever bemoaned their loss, or wondered what I am. Few of my (even more) elderly colleagues miss them though.
Love this discussion,
i practice in a public hospital in China where medical attire is strictly enforced and is quite traditional. Nurses all where a traditional cap, doctors are definitely expected to where a white coat. My wife who is a pediatrician hates wearing a white coat, mainly because she feels it scares kids, but here she needs to where one. Personally I like wearing a white coat, I have all sorts of instruments to carry around and can do so with the pockets of a white coat. It certainly also helps the patients know I am a doctor and it can help to establish trust. I work mainly in an HIV hospital with inpatient and outpatient departments and want to protect my own clothes from contamination and not bring bugs home. That said, I will definitely be taking my white coat home today to wash and be more diligent about more frequent washing!
I am pro white coat because I like the functionality of it and the idea that i keep my clothes clean when needed. What I do not understand is why people consider the white coat something you do not wash daily if need. i usually wear mine up to 2 days in a row and then wash it and get a clean one. it is not that hard. end of the story.