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Medicine | ESSAY

Who's in charge? Read my scrubs

August 09, 2004|Dennis Palumbo | Special to The Times

A recent report in Time magazine said there was growing confusion among hospital patients as to the identities of medical staff, because nowadays doctors, nurses and aides all wear the same pale green scrubs. One U.S. hospital came up with a unique solution: stitching "R.N." tags on the nurses' shirts , "M.D." on physicians' and so on.

I applaud this idea, given the amount of confusion patients already experience during a typical hospital stay. Between the reams of insurance forms to be deciphered, the Kafkaesque maze of identical corridors to be navigated and the disorienting array of bad wall art to be endured, it's a miracle patients remain psychologically coherent enough to make informed decisions about their healthcare.

Add to this the inability to distinguish between your surgeon, the night nurse and somebody collecting donations for the new geriatric wing and the whole enterprise becomes downright dispiriting, to say the least.

However, I wonder if using name tags to indicate job descriptions is enough. Perhaps the labels need to be more forthright. For example, "R.N. who will ignore your call button." Or "M.D. who thinks he's God's gift to women." Interns could be even more direct, with curt labels like "Almost a doctor" or "Sleep-deprived but still on my feet!" Such a policy would do more than just eliminate confusion. Perhaps for the first time in medical history, a bracing element of candor would be introduced into the institutional mix.

As I think about this, I see other possibilities. Your average hospital scrub contains a couple yards of material. Why just make use of a few paltry inches? I can imagine cheerful maxims emblazoned on that familiar green: "I'd rather be doing research." "Malpractice insurance is for wimps." "Everything I know I learned from watching 'E.R.'!" If nothing else, this could be an icebreaker in those first awkward moments prepping for surgery.

Of course, I may be thinking too small. Given the appalling financial state of many hospitals, why not take things a step further and sell advertising space on hospital garb? If race-car drivers and tennis stars can plaster brand names on their persons, why not medical personnel? I know I'd feel in pretty good hands receiving a prescription from a physician with "Pfizer" emblazoned on his chest, or wearing a "Johnson & Johnson" shoulder patch. (Plus, I'd have to assume he or she would have plenty of access to free samples.)

Then again, maybe the hospital should take a more direct approach. Imagine looking up at the smiling face of a student nurse as she adjusts the height of your bed rails ... and there, displayed in discreet lettering on her crisp blouse, are the words "Ask me about liposuction." (In the ad business, this is called point-of-purchase marketing.) A tad mercenary, perhaps, but what it lacks in decorum it might make up in revenue.

The point is that at least this is an attempt at restoring some kind of legitimate doctor-patient interaction. And it needn't be a one-way street. Just think of the unpleasant surgical mishaps to be averted if a patient wore a gown that read, for example: "I'm Your Noon Triple Bypass" or "The Clot Is in My Left Leg."

Although the last thing the world needs is more clothing with words on it, in this case the trade-off might be worth it. After all, in the daunting, impersonal matrix of modern healthcare, any contact is good contact.


Dennis Palumbo is a psychotherapist practicing in Los Angeles and the author of "Writing From the Inside Out" (John Wiley & Sons, 2000).

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