Why Psychiatrists do not Wear White Coats

I trained in a location where white coats were never worn by psychiatrists. I only wore mine during the professional photos on the first day of residency. From that point forward it remained in my closet. 

The choice to discard the white coat always made sense to me, because I believe one of the most healing aspects of psychiatry is the physician patient relationship. One way to enhance that relationship is to make my patients feel as comfortable as possible. There is a concept in primary care called “white coat hypertension” where some patients have increased blood pressure only when coming to see their doctor. In psychiatry you can imagine a similar scenario. Some patients experience severe anxiety prior to the initial encounter. Others have had previous bad experiences with psychiatrists making them more prone to this “white coat syndrome.”

My goal is to have a meaningful conversation with my patients, and some of the material we discuss is very sensitive. There is no reason to make that conversation any more intimidating than it already is. Everything from my style of interviewing, to dress is meant to be casual to help establish trust. Trust is an important foundation for any relationship and is critical for any physician patient relationship. 

I detached myself long ago from white coats as a symbol of knowledge or prestige. I trust in my skills as a physician and allow those skills to speak for themselves. 

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