Blog Global Health Center

A personal case study on white coat syndrome

Written by Caitlin Shin, MA, BS, MD candidate at the California University of Science and Medicine; Summer Pediatric Research in Global Health Translation (SPRIGHT) Scholar at the 2023 Institute for Public Health Summer Research Program

Blog post author, Shin, and her sister at Shin’s white coat ceremony

During my time in the Institute for Public Health Summer Research Program – Public and Global Health track, I had the privilege to attend a presentation by Lisa de las Fuentes, MD, MS, co-director of the Cardiovascular Imaging and Clinical Research Core Laboratory, on Identifying and Modifying Disease Exposure. As I listened to her speak on identifying elevated blood pressures in the U.S. population, I recalled the day when I was 18 years old, that my primary care provider expressed concern about my blood pressure.

“Hmmm, your blood pressure seems quite elevated for someone your age. Are you nervous right now?”

With a confused look plastered on my face, I shook my head, but in truth, I was quite anxious. I knew I was due for a flu shot and blood draw that visit.

Ever since I was a toddler, the sight of a stethoscope around a person’s neck brought tears and worry. Syringes symbolized discomfort and pain while stickers and lollipops could only console me so much. To this day, even as a medical student, health care providers giving me injections still make me nervous. (Thankfully, the stethoscope around my own neck does not bring me the same anxiety.)

My primary care provider’s concern did not last too long when I later came back with a paper filled with normal blood pressure readings, which had been taken in the comfort of my own home, twice a day. My physician saw that I had a case of white coat syndrome, which is defined as elevated blood pressures due to anxiety within a health care setting.

De las Fuentes’ lecture not only reminded me of my own experiences with navigating my elevated blood pressure, but it also provided me with more context on how white coat syndrome could manifest in my future medical career. When I start my clinical rotations next year and see an elevated blood pressure reading on a patient’s chart, I need to make sure to ask proper follow-up questions to truly see if their reading was elevated due to a cardiovascular problem or anxiety. If I decide to pursue research in internal medicine or cardiology, white coat syndrome could potentially skew readings taken in the clinic and ultimately alter the precision of my data.

As both a future physician and a patient who still feels bouts of anxiety at medical check-ups, I am determined to approach each patient encounter with compassion, understanding, and a genuine desire to alleviate their anxieties.

Overall, from this lecture, I can not only incorporate the knowledge that de las Fuentes provided into my medical education, but I can also bring my personal experiences of anxiety during my medical visits to the clinic. As I continue my medical journey, this personal case study will remain etched in my memory, reminding me of the importance of empathetic care, thorough investigation, and the power of addressing anxieties at the sight of a white coat.