REFLECTIONS ON THE WHITE COAT AND THE CARE OF
THE PATIENT
A
s president of GLMS, there are several ceremonies in
which you participate. Recently, I had the opportunity to
speak at the University of Louisville School of Medicine
White Coat Ceremony. This event welcomes incom-
ing first-year medical students and presents them with
their first white coat (courtesy of GLMS). The second
ceremony was the “Wear the White Coat Experience” in
which community leaders from Louisville shadow GLMS physi-
cians for a day in order to experience a day-in-the-life. Although
my comments were brief at both events, the ceremonies caused me
to think seriously about the concept of the “white coat.” What does
this mantle stand for and what does it mean?
During my preparation, specifically for the medical student
White Coat Ceremony, I handed the draft of my speech over to
my trusted copy editor, content editor and anything-else editor,
my wife, Dr. Carolyn Burns. I am truly grateful for her help in
smoothing out the rough edges of the requisite articles for Lou-
isville Medicine. She handed me the rather heavily edited speech,
and I noted she had included a quote by Francis W. Peabody, MD.
The quote was from the publication “The Care of the Patient” tak-
en from a series of talks before the students of the Harvard Med-
ical School in 1927: “The treatment of a disease may be entirely
impersonal; the care of a patient must be completely personal.” (1)
This resonated with me. It compelled me to learn more about
Dr. Peabody and to consider his words more thoughtfully. The first
paragraph of this publication caught my eye: “The most common
criticisms made at present by older practitioners is that young
graduates have been taught a great deal about the mechanism of
disease, but very little about the practice of medicine, or to put it
more bluntly, they are too “scientific” and do not know how to take
care of patients.” Was what he said to the Harvard medical students
in 1927 still relevant to our current medical students? Was what
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LOUISVILLE MEDICINE
he said over 90 years ago relevant to the modern physician with
our highly technical approach to patient care? If so, what action
should be taken to ensure we teach the concepts of patient care to
medical trainees in a well-rounded and compassionate way? How
do we assure ourselves we will do the same in our own practices?
After reading Dr. Peabody’s essay, I concluded his statements
are, indeed, relevant to health care today. His discussion regarding
the impact of emotional dysfunction on the physiological being
is quite appropriate for today’s physicians given the high levels of
anxiety and depression in our society. I have personally witnessed
how we unfortunately overlook the emotional aspects of our pa-
tient care, concentrating more on laboratory results, ancillary tests
or the ever-present electronic medical record. We must remind
ourselves not to ignore the link between physical, emotional and
mental well-being. This is where the science and art of medicine
conjoin.
We should remember that we can gain significant insight from
publications written almost a century ago. Dr. Peabody’s article
is clearly a treasure to the medical community that should be re-
quired reading for all medical students and practicing physicians.
I believe the best way to close is by quoting his final sentence:
“One of the essential qualities of the clinician is interest in hu-
manity, for the secret of the care of the patient is in caring for the
patient.”
Dr. Burns is a private practice ophthalmologist. His practice, Middletown Eye Care,
is located in Middletown, KY.
1) Peabody FW. The care of the patient. JAMA 1927; 88: 877-882.
Dr. Francis Peabody was an American physician with extensive research in-
terests in typhoid and poliomyelitis. Historically, he is one of the most quoted
physicians from Harvard Medical School.