Physicians’ White Coats

I read with great interest your Oct. 18 article about medical students and the “white coat” ceremony. Actually, the ceremony did not begin in 1989 at the University of Chicago Medical School. In the fall of 1973 I was a brand-new medical student at Rush Medical College and received my white coat from Dr. James A. Campbell, then president of the medical staff of Rush-Presbyterian-St. Luke Medical Center, in a “white coat” ceremony. Rush had already been conducting this induction ceremony for several years. Norma Wagoner, whom you cite in your article as having “started” the tradition, was a young faculty member at Rush during my four years there. I suspect the ceremony has been around for a good deal longer.

STEPHEN F. TARZYNSKI MD

Santa Monica

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There is a striking irony in your article: The article treats the “white coat ceremony” as an opportunity to pass along a humanistic professionalism to budding physicians. Yet nearly all medical ethicists now recognize the white coat as a trapping of power, one that serves to remind patients of their physicians’ lofty status. This enhances physicians’ paternalistic attitudes while reinforcing the patient’s subservient role.

If medical schools wish truly to inculcate humanistic values, they will teach their students that patients and physicians are equal partners in a jointly shared goal of enhancing health. Each must treat the other with dignity and respect, as whole persons of equal status and worth. Genuinely achieving this moral parity requires, however, eschewing those very symbols that only serve to maintain and promote power asymmetries, the white coat being near the top of the list.

CHRISTOPHER MEYERS PhD

Director, Kegley Institute of Ethics

Cal State Bakersfield