As a new doctor in Mallorca, I’ve had to grapple with quite a few changes. However, one of the most visible and most symbolic differences is a certain white garment. It’s been a long time since the white coat was a common sight on doctors in the UK, with reasons given for its disappearance including ‘infection control’ and a nod to ‘flattening the hierarchy’ – the idea that breaking down barriers between doctors and patients can aid communication. In fact, despite having left medical school almost fifteen years ago, I struggle to recall a single time I’ve worn one since leaving behind the labs and anatomy rooms of my undergraduate days. Perhaps as part of a Halloween costume once, or to oblige my children’s petitions for me to dress up as a ‘real’ doctor? As a GP in Manchester, my workwear priorities always focused on practicality, namely being able to weather the (many) elements and to run comfortably (either away from or towards things, depending on the situation).
Here in Spain, readers may have noticed that it’s not just doctors who wear the white coat (the bata blanca). Everyone in the health centre, from receptionists to midwives wear at least an approximation of it. It’s seen as a symbol of professionalism and belonging, an essential part of medical care. Many Spanish doctors would feel odd attending to patients without one, as if donning the garment represents a shift in mindset. Once the white coat is on, the doctor is in the house. The same, I assume, as the transformational effect of the morning cup of tea I like to drink as I sort through results and emails before clinic.
When I had almost everything ready to start seeing patients here in Palma, the office manager pointed out graciously that all of the other doctors in the building wore white coats, and expectantly showed me where I could hang mine when I started taking bookings. The time had come.
I pottered off to the local uniform shop and allowed the shopkeeper to fuss over me, ensuring that the fit was just right despite the fact that it would take time to get used to garment which promised so much. A garment which seemed to hold all the answers, much like the generation of professors who raised doctors my age on facts and figures, when the real skill in medicine is being comfortable with uncertainties.
While the white coat may feel somewhat retro to patients from countries where it is no longer used, Spanish medicine is forward-thinking in many ways and punches well above its weight internationally. Life expectancy is above the EU average despite lower health spending per capita. There are lower numbers of deaths from preventable and treatable illnesses than in most other European countries and good levels of investment in medical facilities (including more than double the number of CT and MRI scanners per head of population when compared to the UK).
There is a valuable conclusion in all of this: a modern health service doesn’t need to do away with all of the old ways of working in order to achieve high standards. And so, now that my little practice is open and the patients have started to arrive, I will be happily donning my white coat. But only after a cup of tea.
Reference
(https://health.ec.europa.eu/system/files/2021-12/2021_chp_es_english.pdf)
https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries
Dr Wilkinson works at The Huxley Practice, Palma. For more information, see www.huxleymallorca.com
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