East vs. West: Hospital Fashion.

You’ve decided to dine at an upscale restaurant in New York City. You and your date walk through the entrance and the maitre’d looks up from his podium. He’s wearing a dark suit, a white shirt, and a conservative necktie.

The corners of his mouth turn up slightly as he greets you. “Good evening. Welcome to The Hoity Toity. Would you like to check your coats?”

A young lady with a dark dress wrapped around her slender figure appears. She helps you both out of your coats and, after draping them over her arm, she gives you a small ticket with a large number printed on it.

As your evening progresses, you notice the cavalcade of people providing the dinner service:

Black Shirts. These men wear black dress shirts, black slacks, and black shoes. They ensure that your glasses of water—”tap, filtered, or bottled?”—are never empty. They also clear away your plates between courses.

Striped Neckties. These men wear blue shirts, no jackets, and identical neckties with bold, diagonal stripes. They take your order and replace your silverware after each course. (After the third set of clean silverware is placed on your table, you begin to wonder just how many pieces of silverware the restaurant owns and if a human or a machine is washing them.)

Gold Vests. These men wear white dress shirts, black pants, and muted gold vests. They place baskets of bread on the table and bring out the dishes from the kitchen. When they place the plates in front of you, your Striped Necktie appears and identifies the items on your plate.

Black Shirts, Striped Neckties, and Gold Vests swirl around you throughout dinner. The maitre’d periodically walks around the restaurant, scanning the tables and customers, but says nothing. Coat Check Girl perches on a small stool by the door, smiling at entering and exiting patrons.

You’ve worked in several medical centers on the West Coast and now work in a few hospitals in New York City. While visiting patients in different wards, you notice the cavalcade of people providing medical services:

Tan Scrubs. These are the patient care technicians, the people who are rarely thanked for changing bed linens, assisting patients to the bathroom, and wiping vomit off of beds.

Pink Scrubs. These are specialty technicians, the people who record electrocardiograms, shoot X-rays, etc.

White Scrubs. These are the nurses, the people who often know more about patients—their health concerns, their personal histories—than the treating physicians.

Blue Scrubs. The doctors and doctors in training.

In all the medical centers I trained in while on the West Coast (Sacramento—how about that Delta Breeze?—and Seattle), all hospital staff wore the same colored scrubs. It mattered not what your title or position was. This uniformity fostered equality: Since everyone looked the same, everyone greeted each other with respect. (Add a white coat and things change.)

Perhaps the system of color-coded scrubs in certain hospitals in New York is a “patient centered” strategy. Patients can quickly recognize who is best suited to help them at any moment.

However, this color-coding system, at its worst, could lead to disrespectful behaviors and stereotypes that appear in social hierarchies. Those wearing tan scrubs can disappear; no one acknowledges them or their work. People may feel awe for those wearing blue scrubs, even though their behavior may not warrant reverence.

Apparel communicates information about social status, wealth, and culture. That fashion—colored scrubs—is incorporated into hospital policy is one way medicine in New York is more formal. However, I do not believe that this is a foible of medicine in New York. The hospital fashion, rather, reflects the fashion (and implicit messages about social status) of the city. And that is the subject of a whole other post.