Beginning next year, British hospitals will not allow their doctors to wear neckties when seeing patients. It's not clear whether this ban applies to bow ties as well as four-in-hand ties.
The new rule also aims for a "bare below the elbow" dress code, so that jewelry, watches, the traditional white coat, and artificial nails will also be forbidden for all doctors and other hospital staff who attend to patients.
The new regulations aren't part of a campaign to make doctors drop some of their legendary British formality, though. It's part of an effort to counteract hospital-acquired infections, especially with methicillin-resistant Staphylococcus aureus (MRSA), the deadly, so-called "superbug" that cannot be killed by most antibiotics.
Doctors wear neckties to look professional, but they rarely have their ties laundered. A 2004 study in a New York hospital detected at least one species of infectious bacteria on the neckties of at least half of its doctors.
I can remember spirited criticism of our medical students when they dared to appear without a tie for grand rounds — those times when they gathered in a lecture hall to hear a patient's case presented. As a spokesperson for the British Department of Health pointed out, however, ties perform no useful function and their colonies of dangerous bacteria may spread infections within a hospital.
One major infection-preventive measure in American hospitals is the admonition for frequent hand washing by doctors and staff. I doubt, however, that hospitals in this country will soon follow the British ban on neckties and items worn below the elbow.
No necktie lover myself, I would be delighted if told that I could not wear one in the clinic or on hospital rounds, particularly on hot summer days. Patients would surely learn to accept doctors without ties.
Avoiding artificial nails and below-the-elbow jewelry would also create no problems for me.
I must admit, however, that I would miss the trusty white coat — not only for its ability to cover up any soup stains on my shirt, but also for its capacity to project what we doctors like to think of as a professional air.
But I must say, it's not clear to me how one would determine a patient's pulse rate without a watch.
