One thing I see a fair amount of on SDN is people misunderstanding others' use & intentions behind subjects where prestige, titles, etc come up. Often what I read as someone wanting recognition for their (superior) level of education is taken by other posters to be equivalent to that person maintaining that they are 'better' than others without the MD/PhD degree. People inevitibly get rather righteous about this, probably because they (correctly) believe that no-one is "better" than anyone else, so the arrogant attitude must be corrupt and unjustified. As I read over this thread, it occurred to me that people seem to be intuiting 2 different meanings of the term "better than" when it comes to comparing the relative merits or worth of 2 individuals.
At this time I would like to draw your attention to the following distinction:
1) There is a sense of 'better' that is used on this thread that is tied up with the idea that no person is better than or worth more than another person. This is usually used to drive home the point that the people who want docs to wear longer coats than non-docs must be @ssholes.
2) There is a sense of 'better' that does not include an evaluation of someones worth as a human being. It is commonly (though not universally) thought that humans have equivalent worth, qua human. There is a sense in which I am not better or worth more than a murderer on death row. There is also a sense in which I am better than other people. I have far more education than most people. My education is broader than most people. I learn faster than most people. I am healthier than many people. I am better looking than many people. I have more money than many people, etc... (I am using these expressions as examples, not making actual claims about my appearance or financial status). There is a sense in which I am better than a janitor (we come from different social classes) and there is a sense that I am the janitor's peer, as a fellow human.
The fact of the matter is that no matter what you do, SOME patients will still be confused about who is doing what at the hospital. Since nothing we can do will eliminate all the confusion, what can we do to ameliorate some of the confusion? Badges help. Standardized Uniforms help, and introducing yourself properly helps.
I want to wear a long coat. If I had my way, non-docs wouldn't wear the coat. Part of the reason for this is that I feel that I have worked harder to achieve a higher status than other people working at the hospital. The coat can be a symbol of my merits from the second sense of 'better' mentioned above, and I like that. Is an olympic athelete an @sshole for wearing her gold medal? Is she an @sshole if she gets angry at the thought of all those she competed with (who didn't win) getting to wear gold medals too? The truth is that long coats have been a historical symbol of status, rank, and education level, and those that value the work put into those ends may feel frustrated or angry when a symbol that they value is de-valued. Some religious people feel upset when their religious symbols are put on t-shirts & race-cars, etc, or are worn as accessories by people who do not share their beliefs. I think those feelings are valid too.
Someone who wants a long coat because they feel it makes them better as a human than others is an @dingus, and probably isn't where they need to be as a person, to minister to others as a physician. However, someone who wants a long coat because they feel it is a symbol of their hard work is not wrong for wanting to wear the coat. Also, because they value the symbolic meaning of the coat, they are entitled to feel frustrated when others who have not achieved the same status adopt what is a historical symbol of status in that work environment. Nurses, PAs, etc. have worked to get where they are, and they play critical roles in providing care to our patients, but but they are not the educational or social-status equivalents of physicians or research professors. Wanting to wear a lab coat is not about denying the valuable work that Nurses, PAs, etc do. It is about affirming the status & authority of the one in the lab coat. A nurse's uniform & her school pin distinguish her from a janitor in stained coveralls. Is a nurse wrong for not wanting to be mistaken for a homeless person, a janitor, or a nurse's assistant? Hell no.
Formalizing rules for uniforms at hospitals (including the no MD/PhD, no long coat rule) WOULD decrease confusion among patients. But this is not necessarily a sufficient reason for doing so. I think it is acceptable to want to maintain the historic meaning of the lab coat, and it is acceptable to want to deny the long coat to people who haven't achieved the status associated with the coat.
So according to the logic many of you are using the only ones who should be allowed the white coat should be research docs and PhDs.
