The New York Times recently published an article about how quintessential white coats and billowing gowns characterize doctors and patients. Not all doctors wear those coats, but physicians that do often only change their coats every few weeks, giving garments plenty of time to harbor bacteria. The bacteria then comes into contact with patients. Some hospitals have followed the example of Britain and outlawed the white coats, but others keep them on, if only for the convenience of having pockets.
Patients, on the other hand, are often put into robes that expose either their front or rear, requiring two to preserve modesty. Veteran clinicians can testify that it is far easier to push aside clothes than put a stethoscope into two johnnie gowns that have been well-secured. This is a sacrifice that is made at the altar of hospital efficiency, not one that optimizes patient experience. Doctors do not witness the irritating incovenience of shedding layers of clothing only to struggle back into them once the examination has come to an end. The author of the article comes to the conclusion that when a doctor arrives dressed in a white coat to treat a patient dressed in flapping robes, any wisdom that might be gained from the process is lost.
To remedy the problem leaders and physicians can re-examine the situation from a place of empathy, with a view to improve the process for all involved. If doctors insist on wearing coats, hospitals should institute a mandatory washing policy. If coats can be done away with in favor of more hygienic options, then all the better. Rather than feeling naked and at a disadvantage when the physicians walk in, patients should be met when they are fully clothed. Clinicians should engage with patients face-to-face for a few minutes, determining what needs to be examined based on this conversation. From there, it would be a simple matter to hold up a sheet or draw curtains around the bed, instructing the patient how far they need to undress themselves, and talking to them while this is taking place to prevent loosing time. Once they are ready, the patients can choose to use the sheet to cover themselves or remain as they are, depending on their level of comfort and the needs of the examination.
As fellow blog contributor and then-patient Anna Montgomery writes in Nurse Giggles and Doctor Warmth:
Empathy is important because it increases pro-social behavior, which in turn, leads patients to develop rapport with and trust their clinicians. Trust and rapport are the currency of communication. Communication helps clinicians better problem solve leading to better patient outcomes.