Can’t We All Just Get Along?
Moslem and Jew. Windows and Mac. Republican and Democrat. Partisanship and sectarian strife abound but these are nothing, as tame as church picnics, compared to the seething clandestine war being waged in teaching hospitals across the country over whether the house staff should or should not be allowed to wear scrubs as normal attire. At one extreme in this battle are the dark forces of oppression who would make their residents wear a shirt and a tie under their surgical gowns if the those pesky rules about infection control didn’t make it impossibe. At the other are are the noble advocates of personal liberty who believe that attire is a personal decision that each must make according to his conscience.
I try to stay neutral but the case for scrubs is pretty convincing.
First of all, residency training is not totally hygenical and, unless you are one of those no-good lazy bastards in PM&R, you have a pretty good chance of getting something unwholesome on you. I’m not saying that the wards are obstacle courses of flying bodily fluids because they’re not. Even in the Emergency Department, with a little foresight, you can go days without getting slimed. In fact, the nefarious opponents of scrubs will often point out that your low risk for getting sprayed doesn’t justify not dressing up and they scoff at the house staff’s fear of a little accidental goopage. “What, are you a nurse?” they ask with a contemptuous snicker.
But with how much bodily fluid are you comfortable? I’m zero-tolerance myself. Call me squeamish but one drop of vaginal discharge or vomit on my shirt is enough to make me want to change it. I have no desire to either keep a stock of pants, shirts and ties at the hospital or spend the day enjoying the memories. Scrubs, as they are usually supplied by the hospital, are disposable. I once got sprayed with urine and I didn’t think twice about cutting off my scrub top (because I wasn’t going to pull that thing off over my head). I’m not exactly a metrosexual but I’ve been known to pay as much as 30 bucks for a dress shirt. Ruin one shirt a week, and by definition a shirt with any total stranger’s discharge on it can not be washed enough so I will wear it again, and we’re talking some serious money. I don’t care if it’s a drop of blood on the cuff. I’m not wearing it one minute longer that I have to.
Advantage: Scrubs.
Hospitals are not offices. We don’t work in cubicles, sitting in our ergonomic chairs all day except when we make a trip to the candy machine or to the boss’ office to swap some management jargon. Most of us spend the day walking and most academic hospitals are huge. Duke is so big, for example, that they have a train running between the main hospital and the clinics. I once tried to estimate how far I walked every day and it came out to miles.Â
Think about it. If you’re on the second floor on a remote wing and you get paged to the eighth floor on the other side of the hospital, you might have to walk a quarter of a mile, not to mention taking some stairs. I like elevators, don’t get me wrong, but they are usually full of patient’s families and you have to wait for them (patient’s families never take the stairs). Do this for a thirty-hour call day and you will cover a lot of ground.
Office attire, as it is designed for people who spend their day working on spreadsheets (or whatever they do in offices) is completely unsuited to our nomadic lifestyle. Scrubs, on the other hand, are light, airy, and they don’t chaff. And there is no way to wear a tie while wearing scrubs. I hate ties. I know the trend is to disparage them as fomites, carriers of pestilence from one patient to another, and I suppose this sounds reasonable.  But I hate ties simply because they are ridiculous and uncomfortable. Ridiculous because they serve no purpose and uncomfortable for obvious reasons. I wear a tie to church but that’s because it is uncomfortable and focuses the mind on the evil of earthly things.Â
Besides, office attire is typically worn from nine to five. Most residents work far beyond the typical work day and you start feeling clammy after wearing your church clothes for more than ten hours. It’s bad enough we have to stay up every fourth night running around the hospital without having to do it clothing we’ve been wearing since the previous morning.
Advantage:Â Again, scrubs.
Do scrubs look unprofessional? It depends who you ask. Your old-school attending regards them with the same loathing he holds for the greasy pants of a urine soaked wino. He thinks that physicians should dress to impress. But isn’t that the point? If I’m to understand him, I need to wear a tie to impress a guy who they found under a bridge, hasn’t had a bath in six months, and drinks Lysol when he can’t afford “Mad Dog.”
Seriously, a clean pair of scrubs under a clean white coat looks professional enough for everybody short of the Pope. People have been conditioned to expect their doctors to wear scrubs, even without the white coat. Just tuck in the shirt, avoid the 101 Dalmations print top and you’ll do fine.
Advantage: Still scrubs.
Â
I’ve just learned that at the hospital where the majority of my 3rd year will be, none of the doctors wear ties. It’s like a fantastic business casual paradise. It’s like walking into RadioShack. I’m happy to say the least.
I am all the way for the scrubs! I love it… In fact I take a pair home before call. This way I can get extra 10 minutes of sleep – time which otherwise would’ve been spent looking for something that is appropriate for the shift. And I’ll tell you, I cannot think of anything in my closet that is appropriate for jumping out of stinky bed in the call room at 4 am and running to the ward where my patient is bleeding per rectum! Besides I think scrubs not only professional but also hot… So OK, I am shallow… and love to sleep…
Hell, I know quite a few people that consider the ability to wear scrubs regularity a high point of the career. They’re gonna be pissed if they end up with a dress code house like what you’re saying!
There was a study (published in.. I think Obstetrics and Gynecology or else in the Amer. Journal of Obs & Gyn) that surveyed patients about how they felt about what their obstetrician cares.
Turns out, as long as you don’t show up in a ratty t-shirt, cut-off shorts and flip-flops, patients don’t care if you dress fancy (i.e. ties), business casual, or in scrubs. They just want someone to take care of them.
Amen to that. Scrubs rock.
Three cheers for scrubs! My husband’s residency sucked quite enough, thank you, so anything I didn’t have to wash, iron or pay for was a godsend. It’s not easy to maintain a professional wardrobe when you bring home $8.50 an hour; any attending who’s forgotten that needs a good swift kick.
1. I am definitely in the camp that it is hard to make an argument against the shirt and tie based on the “flying bodily fluids” model.
2. That said, I prefer scrubs for comfort and economy.
3. I also find it hard to believe that a shirt and tie are somehow more “professional.” I don’t know about you but where I work half of the residents and attendings manage to look like they just walked out of a Dilbert cartoon. My favorite so far: short sleeve white shirt with a Looney Toons tie. PGY-4 general surgery!
My mentor said that he had a friend (surgery resident) who absolutely loved scrubs. For his birthday, the PD stolea bunch of scrubs from the hospital, took it to a seamstress who made a full fledged bonafide suit w/ a tie out of scrubs. Pure heaven!
When I had my Gallbladder out, I thought the surgeon was so hot in his scrubs. Much better than the jeans and tee he showed up in to discharge me.
Love the scrubs!!
I’m in favor of scrubs for the two reasons you gave – in the hospital that is. If I were in a clinic during office hours, I’d probably prefer dress clothes. But then again, I love to shop LOL.
Also, I think you meant chafe, not chaff 🙂
For: Scrubs in the hospital, always comfy, someone else does your laundry, spillage is no biggie.
Against: Men who wear scrubs to bars or to work out. They belong in the hospital, not a method to attract women!
Slimed, goopage, damn, Panda, you had me laughing ’til I nearly pee’d myself. Mind you, I was discreet.
You ask: Do scrubs look unprofessional?
Me: Abso-freak-ly not. What it conveys to this gal on the other side of the bedpan is that a working doc is taking care of me and not a pansy-butt. Save your tie for Mother’s Day brunch.
well put.
And they make great PJs,
And can be worn to class on test days.
i think scrubs are great except when the hospital scrubs are some awful color like pink.
i advise my residents against scrubs in clinic. i prefer a shirt and tie (but don’t require). On the floors, I don’t care as long as they are clean. my rationale for the clinic shirt and tie is for behavior. i am in ortho, so i have to somehow control the adolescent humor and behavior a little bit.
scrubs give you the sense of freedom, kinda like PJ’s. shirt and tie, may be because of the noose, cause people to act more “proper.” just like a suite and tie increase the “proper” behavior. most in our department where the ortho uniform, polo department shirt with kacki pants.
My own school has rules about professional dress for all patient encounters. While we’ve done away with the tie, scrubs are not allowed except for in the OR. I did some searching and have come across several articles that time and time again say that although patients want doctors to wear dress shirts and a tie (surveys), patients find their doctors to be professional and competent no matter what the physician wears (clinical trials). I’ve sent a couple of these articles to the deans. Unfortunately, there are no plans to change the dress code.
Scrubs are comfy! I had to wear them at the vet clinic where I worked in high school, and now I use them as PJs. BTW, I think scrubs are better than a shirt and tie because in the office wear the doc looks obviously uncomfortable, whereas he/she is much more comfortable and thus better able to focus on the patient when he/she is in scrubs.
In the hospital, I’m definitely all for scrubs. For an office visit though, I think it would be a bit weird if my doc was wearing scrubs. But I don’t think I’d think any less of him/her.
And don’t knock the pink scrubs Someonetc! At the hospital attached affiliated with my school, pink scrubs mean only one thing: Shock Trauma Team. Even the guys wear the pinks scrubs with pride given how kick ass that particular department/area is here.
I love the scrubs. At my med school, we are required to wear a shirt and tie for all clinical encounters except OR, delivery room, ER (depending on the hospital) and call after 5 p.m. They always go to the surveys claiming that patients respect doctors most who wear a tie and white coat. Extremely frustrating.
Fortunately, the children’s hospital attendings generally frown on white coats because they scare the kids, and I’m doing as many rotations as possible over there. They’ll even grant some leeway on ties. Definitely a more relaxed and fun work environment.
Someonetc, your rationale for not wearing scrubs is just crazy.
I usually respect what you have to say but can you see how you’re being a little condescending here?
?condescending,
it’s my clinic. i ask that they don’t were scrubs if they are not in the OR. it actually is a deparmental policy. when i was a fellow all residents and fellows had to wear shirt, tie, and coat when they were out of the OR. i wear scrubs all the time and i hate the white coat and badge, so i get in trouble all the time by security. from experience (anecdotal i know), the more towards professional atire you get, the more “professional” you act. some people can wear scrubs and be professional, others can not. trust me, with most of the fraternity behavior in ortho there needs to be someone who settles them down otherwise they will be farting in the conference room and giving each other titty twisters.
i really only ask for a couple of things when folks come to clinic, i want them to look like the care about their appearance a little. in the ER adn on the floors, i don’t care.
i am not sure how i was condescending just a statement. i am actually in scrubs know 🙂
Of course it’s your clinic. And you can run it however you want. But your rationale, to control the adolescent behavior, is what some might consider to be condescending.
most don’t wear ties actually, they wear the polo shirt and kakis or button down. that comes down from the chief.
trust me, i am adolescent enough, i use to wear a suit ’cause it made me feel more formal (the whole patient doctor thing). that’s what a lot of our private guys do. it did make a little more proper, not slouching in the chair, i didn’t pick my nose and i would act more “professor” like. i got over myself ’cause it made me feel like an ass. so i am down to shirt and tie. kind of status quo for most of the attending physicians in our hospital.
i ask residents to dress appropriate. my opinion is that they do act more controled when the “dress up”. if most people evaluate their behavior in casual clothes, business casual clothes, suit, and tux, the will find they do behave differently.
Panda this is off topic for this particular post, but thought you would get a kick out of it; from a current cnn.com article about space flight to Mars…
“The document does spell out some health policies in detail, such as… the number of hours crew members should work each week (No more than 48 hours).”
Ok, so yeah, they’d be flying a space shuttle and whatnot, but why is it that NASA doesn’t think its a good idea to force highly trained people in stressful circumstances to work ungodly hours but the powers that be in the medical world think it is safe for surgeons and the like to do so?
Or rather “‘surgical residents’ and the like” (is what I ought to have written).
I like scrubs on doctors because if the particular doctor has some nice chest hair, it usually pokes out at the “v” at the top.
(Yes, I ogle the chest hair poking out of doctors’ scrub tops. And yes, I lust after it—I am not a saint.)
(Had to laugh at you cutting off a scrub top and being squeamish about getting stuff on you. You’d make a crappy nurse—we LIVE in dirty scrubs all day long and it doesn’t phase us in the least, heh!)
Good Lord. I wear a t-shirt under my scrubs because I have a lot of chest hair. In fact, I have been somewhat uncharitably called “sasquatch” by my neighbours because in the summer I run without a shirt.
By the way, nobody looks good in scrubs. I’ll give their critics that. Everybody gains a couple of points wearing a shirt and a tie (unless it’s a geeky sirt and a clip-on of course) but if you’re not a good-looking person to begin with, scrubs are only going to detract from your appearance.
Just my 2 cents here.
I love scrubs. Wish I could wear them every day!
But, I do clinic every week for a neurosurgeon and honestly, I dress up for those patients (tie and iron) and don’t think twice about doing it.
Seriously, my heart goes out to those folks that I see; and I think it’s appropriate that I dress my best for them. So, I do and I don’t think twice about it; e.g., it’s seems natural and appropriate.
Again, just my 2 cents. Wish I could be more comfortable and wearing scrubs all day…
I dunno, PB. I remember a poll on the studentdoctor forums as to which color scrubs showed off your arms the best, which I can’t seem to find now. I believe black was the color of choice for the gun show.
I agree, scrubs rock! What other kind of clothes can you wear that allow you to look professional, but also work well as pajamas. And they’re comfortable as hell too!
“I wear a tie to church but that’s because it is uncomfortable and focuses the mind on the evil of earthly things.”
It’s fascinating how many veils original sin wears in the religious mind.
You wouldn’t put a basketball player on the court in a suit because it would impede his work. Similarly those in the medical profession, only in their case it would be irresponsible to let fashion undermine their work.
Of course I would take that even further, to the nurses with 3 inch nails and 15 rings.
It doesn’t matter what you wear as long as it is not covered by a lab coat that is grungy and looks like it hasn’t been washed in years.
Ramses, don’t be condescending. I am a religious guy, a good son of the Greek Orthodox Church, but I was just pulling your leg about wearing a tie to church for mortification. I wear it to show my respect in the Lord’s house.
Ahh, alas, it was meant to convey humor rather than contempt. ‘Veils -> ties’ and so on. My apologies. I don’t hold religion in contempt, IMHO it’s the little white lie that does more good than any other. I still attend family funerals and such at church, and I dress respectfully as well.
My apologies. Your humor mojo is superior to mine and looking back, I feel like a wanker for missing it.
I hearby grant you one “free pass” to post on any topic you care to without threat of deletion.
A shit and tie requires dress shoes. This doesn’t seem so bad at 6 am but after about 14 hours and 5 miles …. And no, sneakers with dress clothes — like ponytails on men — do not make you look hip.
On the other hand, dress shoes or heels with scrubs are dorky, but scrubs look fine with comfortable shoes like running shoes or canvas casuals. Plus I can run faster and jump higher.
Advantage yet again — scrubs.
And while we’re on the topic of footwear, clogs look stupid no matter what else you’re wearing.
Fashion tip #2: regardless of how you feel about scrubs vs. dress clothes, it’s one or the other. Khakis with scrub tops do look as bad as it sounds.
oops, that should be a “shirt’ and tie
sorry
bill, the whole point of scrubs is obliterated if your footware isn’t comfortable. and i’m not a doc (i’m a flight attendant), but i’m on my feet for hours and hours and hours, going up and down the aisles and up and down in the sky. feet can swell. and there has never been any shoe that aleviated foot pain as well as the Dansko Professional Clog. they come in a wide variety of styles and colors. i’m sure that a number of them wouldn’t detract from the appearance of a scrub-wearing person. they’re just fine with slacks too. and some of my colleagues wear them with the skirt…but i admit that it’s an acquired look.
i still marvel that i’m not allowed to be scheduled to hand out peanuts for more 14 hours in a day (that’s *scheduled* time…my company doesn’t have any duty days longer than 11:50 hours…but sometimes delays happen and we end up working till whenever. it’s pretty rare though.) but you can visit a doc who’se been at it for 24+ hours. insane. crazy. ridiculous. unsafe. unkind. unfeeling. must change!
As a nurse, the comment “What, are you a nurse?â€, (they ask with a contemptuous snicker) is probably typical of the way some “Professionals” feel about us. But we are your eyes, ears, nose, voice, and hands when you have left the bedside; our role in infection control is vital to your patient’s recovery.
OK, not to dwell. I’d like to respond to the article re’ scrubs. As a nurse, I believe the shirt and tie should only be in the office. The hospital is a warehouse; a vast of potential of contamination with each step in the miles we do. Of course, plain (light) coloured scrubs make sense! Every hospital, clinic, etc. should offer free laundry for all uniforms. We should not leave and enter our communities with the dust of all our miles! How often do you see someone in scrubs, or whites in the grocery store or bank? Believe me, on payday you will!
I have an issue with the cartooning of a professional’s uniform. The multi-coloured tops could hide multiple bodily fl. spots. I still wear all white. Partly, I earned this uniform, but with experience, I realize, almost anything is visible on white!
I hope today’s mistakes regarding what has been allowed with hospital attire, doesn’t contribute to yet more antibiotic resistant bacteria.
You, as doctors, need to be allowed closeness with your patients. This may or may not result in the exchange of body fluids, but if it did, scrubs and lab coats seem the simplest way to ensure no further exchange of these “accidents” with others. It should be up to you as to how you want your pts to see you in your own offices, but at the hospital, wear what can be easily traded in for a new set, and cleaned to standards that protect the user and the patient! Also, docs, wash those hands; use the hand cleansers, before entering and exiting the rooms!! (Pls., someone assure me the hand cleansers won’t contribute to new resistances!) (I refuse to use abx. soaps in my home for that reason, am I being paranoid?)
ps: tried to go to your home page, but unable. Take care!
As a nurse, the comment “What, are you a nurse?â€, (they ask with a contemptuous snicker) is probably typical of the way some “Professionals” feel about us. But we are your eyes, ears, nose, voice, and hands when you have left the bedside; our role in infection control is vital to your patient’s recovery.
OK, not to dwell. I’d like to respond to the article re’ scrubs. As a nurse, I believe the shirt and tie should only be in the office. The hospital is a warehouse; a vast of potential of contamination with each step in the miles we do. Of course, plain (light) coloured scrubs make sense! Every hospital, clinic, etc. should offer free laundry for all uniforms. We should not leave and enter our communities with the dust of all our miles! How often do you see someone in scrubs, or whites in the grocery store or bank? Believe me, on payday you will!
I have an issue with the cartooning of a professional’s uniform. The multi-coloured tops could hide multiple bodily fl. spots. I still wear all white. Partly, I earned this uniform, but with experience, I realize, almost anything is visible on white!
I hope today’s mistakes regarding what has been allowed with hospital attire, doesn’t contribute to yet more antibiotic resistant bacteria.
You, as doctors, need to be allowed closeness with your patients. This may or may not result in the exchange of body fluids, but if it did, scrubs and lab coats seem the simplest way to ensure no further exchange of these “accidents” with others. It should be up to you as to how you want your pts to see you in your own offices, but at the hospital, wear what can be easily traded in for a new set, and cleaned to standards that protect the user and the patient! Also, docs, wash those hands; use the hand cleansers, before entering and exiting the rooms!! (Pls., someone assure me the hand cleansers won’t contribute to new resistances!) (I refuse to use abx. soaps in my home for that reason, am I being paranoid?)
ps: tried to go to your home page, but unable. Take care!
I remember one time I was working a hospital display, (pharmaceutical sales) a physician came up to me and said I should not dress better than the doctors that I called on. My response to him was “it is kind of hard to dress worse.”