Chris Lancelot: Dress codes and the battle against infection

I was distinctly unimpressed with the consultants at a recent hospital meeting: they all came jacketless and in open-necked, short-sleeved shirts that wouldn't go amiss on a beach. Did they look like authoritative, highly trained doctors? Did they heck!

It's all to do with the new dress code, of course. The DoH says cuffs and ties spread diseases and that hospital clinicians should be bare below the elbow.

As the BMA has pointed out, the evidence base for this edict is suspect, to say the least. There is (unpublished) data suggesting that jacket sleeves communicate infection - which would be entirely believable. Surprisingly, there is no evidence that hospital garb presents a health risk when worn in the community, even though the public thinks otherwise.

I find this very difficult to believe. How can a cuff disseminate infection whereas a nurse's uniform doesn't? Is it really true that a doctor (who doesn't use a white coat) can walk straight from a hospital ward rife with C.diff or norovirus and not be an infection risk when wearing the same clothes in the supermarket or on public transport? If cuffs can transmit infection, then surely any part of clinicians' clothing that has been in contact with the patient, her clothing or her bedding can do exactly the same thing?

So what should the trendy physician be wearing this winter? Personally, I would go for a freshly laundered, buttoned-up white coat (thus holding in the tie), put on when arriving at the hospital and taken off before going outside or into the restaurant. Given the infection risk from cuffs, clinicians should really be using white coats with short sleeves - or alternatively, scrubs.

But what about the image? How convenient for power-hungry managers if doctors are made to dress down! A consultant in a white coat or smart suit carried a sense of knowledgeable authority: now managers are the only NHS workers allowed to wear suits inside the hospital, inevitably giving them an upper hand in the power-dressing stakes.

So perhaps we should dream up a dress code for managers, to restore the balance. Male managers should be forced to wear suits with short trousers; the women could be kitted out in fifties' skirts and bobby socks. That'll fix 'em.

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