— NARRATIVE ESSAYS —

I Guess the MD on My White Coat Is Invisible Today

Veneshia McKinney-Whitson, MD

Fam Med. 2019;51(1):57-57.

DOI: 10.22454/FamMed.2019.231908

It’s my first day as an attending and I’m filled with excitement.

Last night, I organized my work bag with pens, highlighters, my Washington Manual, MPR, Pocket Medicine, and Drugs for Bugs book. I ironed my clothes and pressed my white coat to perfection.

Before walking to morning report, I stop by the restroom to put on my white coat. The newly pristine white polyester and cotton is a stark contrast to my pale chestnut skin, but wow, it looks great on me! As I gaze into the mirror, the memories of the tearful and blissful moments of my medical professional journey come flooding back to me.

As I’m happily contemplating my appearance, I hear a hospital visitor spit in my direction, “That stall needs more toilet paper!” Is she talking to me?

I guess the MD on my white coat is invisible today.

I leave the bathroom to meet the inpatient service team. We discuss our patients and plan of care around a large table. Now I’m off to round on my own. As I walk into the first patient’s room, she is engrossed in her phone conversation until she sees my face. She quickly tells the other person on the phone, “I have to talk to you later, the lady is here to take my order.” With my poised blouse, A-line skirt, black pumps, and the lack of a hairnet, I thought, “Do I really look like a cafeteria lady?”

I guess the MD on my white coat is invisible today.

On to the next patient. I walk into a room filled with visitors, yet there is not a patient in the bed. A family member yells to the bathroom, “Mom, the nurse is here to see you!” When did nurses start wearing long white coats?

I guess the MD on my white coat is invisible today.

The next patient’s door is closed. Before knocking and entering, I pull back my black curls and snug them between a rubber band, just to make sure my curls are not covering the MD on my white coat. I open the door to see our pale-skinned medical student talking to the patient. I notice his blonde ringlets on top of his head bouncing. Just before I can introduce myself as Dr McKinney, the patient clutches my hand and exclaims, “You are so lucky to have this young man teaching you!” How did his short white coat trump my long white coat with an embroidered MD?

I guess the MD on my white coat is invisible today.

Or maybe it’s that my prominent and discernible African American features overshadow any embroidered white coat in which I clothe this chestnut skin I live in.

Because of having had these same experiences in medical school and residency, I enter each room as professionally as possible. I always dress the part and try to embody the true definition of what my patients imagine a physician to be. I naively thought that things would change once I was an attending. In retrospect, I thought that things would change when I became a resident. Wow, I was definitely wrong. Over time, these situations can dismantle your confidence, and it becomes hard not to internalize these racist assumptions. It is not that I believe that I am superior to the janitor, more important than the cafeteria lady, more vital than the nurse, or more elite than the medical student, but it is gut-wrenching that because of the color of my skin, I could not possibly be the doctor.

Lead Author

Veneshia McKinney-Whitson, MD

Affiliations: Medical College of Wisconsin Department of Family Medicine, Milwaukee, WI

Corresponding Author

Veneshia McKinney-Whitson, MD

Correspondence: Medical College of Wisconsin, Department of Family Medicine, 2400 W Villard Ave, Milwaukee, WI 53209. 414-527-8191.

Email: vmckinney@mcw.edu

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By Gail Shaw Wright MD  /  Posted 2/6/2019

I agree, the lack of recognition that you are a physician probably has more to do with being a woman. I have always dressed professionally, and wear my long white coat (with my embroidered name and MD on it) mostly for the pockets, and even today 30 years after finishing my fellowship am still mistaken for the nurse, dietician, social worker, etc. I just introduce myself as the doctor and move on with the visit.

By May Hong  /  Posted 2/1/2019

Although I am not African American, and don't have the same experiences as physicians of color, sometimes in certain places my patients couldn't bring themselves to call me "Dr. Hong." They called me "Ms. Hong." My nurses would get upset, and I would hear them going in afterward and ask them, "Why are you calling her 'Ms.'? She's a Doctor!" I loved my nurses for fighting on my behalf.

By Nancy Fru MD  /  Posted 1/22/2019

This is very well written. Many physicians of color and women experience this, myself included. That does not mean we should normalize or hide this aspect of our society. Imagine receiving this reaction or surprise from other healthcare providers when you're trying to run a code, care for an unstable patient, or secure an airway. I applaud this physician for pointing out this bias present in hospitals, even from minority patients. Thank you for sharing your experience.

By Michael Braggs  /  Posted 1/8/2019

As an African-American male, I've been mistaken as a nurse or a janitor. The patients have said "Hold on. They're here to clean my room" while I'm wearing a white coat. Then I introduce myself as the doctor and they might feel a little silly. If you're easily offended by your patients, then you're probably in the wrong field. There will also be these kinds of patients and you just need to grow a thick skin. Instead of caring more about looking like the doctor, just be the doctor.

By Ann Dimapilis  /  Posted 1/7/2019

While I think the color of your skin may be a factor, I believe it is because you are a female that you couldn't possibly be a doctor. As a FMR faculty for over 25 years, I've had discussions with women of all races. Even with the bright green tags with a font of 96 that says DOCTOR, a patient will still ask if I am a nurse, dietician, social work, case manager. I have gotten to the point of NOT wearing the long white coat. Then the patient and visitors have to look at my name tag.

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