Changes to clinician attire have done more harm than good

The introduction of 'bare below the elbows' policies to facilitate handwashing led to the disappearance of the white coat from medical and surgical wards. While rates of key healthcare acquired infections in hospitals, e.g. Clostridium difficile and methicillin-resistant Staphylococcus aureus bacteraemia, have fallen, argument continues around the contribution of hand hygiene and dress codes to these changes. Conversely, the number of complaints against clinicians continues to rise, and respect for medical staff is falling. Are these phenomena linked to the disappearance of the white coat? Here, we debate the effects of these changes to clinician attire and ask whether the putative benefits in terms of infection control are outweighed by the possible harms to the doctor-patient relationship alleged to be caused by the loss of the white coat.