More than Just a White Coat
By: MALIK ASIF NOOR
Recently, the Health Department of the Union Territory of Jammu & Kashmir issued a circular mandating all doctors and paramedical staff including those under NHM and AYUSH to wear white aprons and legible nameplates during duty hours across government healthcare institutions.
While the intent behind the directive -to promote identification, reinforcing professional discipline and accountability for patients- may appear well intentioned, it misses the mark by focusing on optics over outcomes.
The order issued-makes it even more surprising, if not disappointing as it fails to recognize the deeper systemic issues plaguing public healthcare and the everyday realities faced by frontline medical personnel and patients.
One would expect a medical administrator, shaped by their own clinical experiences, to understand the real challenges healthcare workers face on the ground.
I personally feel that the order reflects a focus on superficial standards of orderliness without addressing rather overlooking the more pressing issues of resource shortages and burnout, and I trust many others, especially the concerned professionals will agree with me on this.
I believe and argue that attention should be directed towards addressing and improving critical issues like understaffing and burnout as such a shift trivialises their daily challenges and demonstrates a disconnect from the same.
Many in the medical community are calling for more meaningful reforms that prioritize their well-being and the quality of patient care. The white coat should be a source of pride—not another weight to carry. Directives like this—issued without consultation, flexibility, and an understanding of ground realities—run the risk of deepening discontent and demoralization-in an already strained workforce.
The Problem of Priorities
Before issuing directives for uniform compliance, a more serious and pressing issue of ‘Burnout’ needs to be addressed and acknowledged by the authorities. Burnout in our health care system is the real emergency and not mandating aprons and name tags.
Doctors and paramedics across government hospitals and health centres in J&K are dealing with overwhelming caseloads, emotional trauma, understaffing, inadequate infrastructure, administrative overload and outstretched work shifts beyond reasonable hours—often without rest, recognition, or support.
In rural and peripheral areas, a single doctor may be covering an OPD, an emergency, and a ward—all at once. Here, I emphasize that burnout should not be mistaken for mere fatigue. Burnout is recognised and classified by the WHO as a rampant occupational chronic stress that leads to emotional exhaustion, detachment, and eventually, an eroding sense of purpose.
When these issues go unacknowledged, and the system starts regulating what we should wear instead of how we should cope, it feels deeply disconnected. These are not isolated sentiments—they define the reality of thousands of government healthcare workers today.
In such a scenario, directive about the dress codes should not gain precedence over the ever-growing mental health crisis in our health system with the underlying fatigue, mental health issues, and operational deficits. The move can direct a wrong message: that appearances matter more than well-being.
Here, I re-emphasize that when overworked doctors are forced to prioritize cosmetic compliance over workplace well-being and patient care, it adds to their frustration and demoralization.
White Aprons: Symbols of Service or Vectors of Infection?
The white coat has historically been a symbol of professionalism, selfless service, hygiene and trust but when it’s enforced as a symbol of governments order rather than care it can generate resentment rather than improvisation. However, recent infection control research highlights that white aprons and lab coats, can become vectors for nosocomial infections.
Pathogens, disease causing agent, like: Clostridium difficile, Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), to name a few, have been found to survive on textile surfaces for prolonged periods, posing risks to both, patients and healthcare workers.
In settings with inconsistent access to medical laundry services or where aprons are reused across shifts and wards, this mandate may compromise infection control protocols rather than support them.
Furthermore, forcing its daily use in all settings without flexibility may lead to practical issues. Moreover, dictating uniformity without improving working conditions can erode the morale and dignity of staff, reinforcing a top-down control that overlooks the context in which healthcare is actually delivered.
Here the authorities could have followed the protocols implemented globally for healthcare workers. The way it was used during covid-19 pandemic displays how healthcare workers adapted to the emerging trend.
Navigating to the directive of compulsory display of name plate, in my opinion, while staff identification is essential, but assuming that nameplates alone will improve patient interaction doesn’t hit the target.
Theoretically, it promotes transparency and accountability, however, in reality, making full names and designations publicly visible at all times exposes healthcare workers—especially women vulnerable to safety risks, including harassment, stalking, and targeted aggression.
This is an area that needs a rethink as women healthcare workers also need to be taken into consideration.
In emotionally charged settings, when outcomes do not go the way families hope, the name on that badge can become a target. Identification must be implemented safely and sensitively, balancing transparency with workplace protection. In the absence of strong workplace safety policies, the mandatory display of full names without context may actually endanger vulnerable staff and cause more harm than good.
Moreover, name plates do not solve the core issue of poor patient-doctor communication, which stems from time constraints, lack of privacy, and overcrowded facilities, not anonymity.
Effective dispensing of care and productivity and satisfaction requires time, empathy, and continuity of care, none of which can be resolved by a nameplate.
The Real Issues?
Rather than prescribing dress codes, policymakers should turn their attention to pressing systemic concerns. The non-exhaustive list includes; staff shortages, leading to overburdened doctors and long waiting times; Poor infrastructure, including lack of ventilation, cleanliness, and basic facilities in many government healthcare facilities; mental health challenges, with no formal peer support or debriefing mechanisms for frontline staff; Violence against doctors, a growing concern that remains under-addressed. In such a context, enforcing dress code rule can have a demoralizing effect.
Conclusively, healthcare workers do not need regulation to serve with integrity—they need well equipped infrastructure with increased staffing, healthier working schedules and imperatively- safety at workplaces.
Also, respect cannot be earned through dress codes, rather it is cultivated through mutual trust, empathy, and meaningful reform. For our healthcare institutions to become more productive, patient-friendly and professional, let us start by improving what is broken—not by enforcing what looks good.
A directive that focuses on external appearances and administrative intent, without addressing internal dysfunctions and ground level understanding, may win administrative points but lose the trust of the very people who hold the healthcare system afloat—its doctors and healthcare staff. Let us not make aprons, which stand for honour, symbolise forced compliance or substitute for meaningful change.
Additionally, let us not confuse symbolism with substance. Wearing an apron does not inherently improve clinical care, just as not wearing one does not imply carelessness. The respect accorded to doctors should come from their work—not their wardrobe.
(The author is a social activist)