Posted on | July 3, 2014 | 5 Comments
Where do I begin? When I read the JAMA title last week, “Banning the handshake from the health care setting”, my immediate reaction was, “Seriously, have we gone this far?”
Then I read the dispassionate opening, “The handshake represents a deeply established social custom. In recent years, however, there has been increasing recognition of the importance of hands as vectors for infection, leading to formal recommendations and policies regarding hand hygiene in hospitals and other health care facilities. Such programs have been limited by variable compliance and efficacy. In an attempt to avoid contracting or spreading infection, many individuals have made their own efforts to avoid shaking hands in various settings but, in doing so, may face social, political, and even financial risks.”
And my second reaction was, “Is this really about patient welfare or about institutionally based doctors and their reticence to take the risk to touch a patient”.
Then I read, “Particularly in the current era of health care reform, innovative, practical, and fiscally prudent approaches toward the prevention of disease will assume increasingly important roles.” And my third reaction was, “Do they really want to go there, to justify contact-less caring as cost-effective?”
And in the arena of rare and strange analogies, the authors proclaim, “Although the mortality associated with smoking has been found to be substantially greater than that associated with hospital-acquired infections, some parallels may be drawn between the proposal to remove the handshake from the health care setting and previous efforts to ban smoking from public places.” To which my inner doctor shrank as humanistic care went up in smoke.
Finally I read the very last sentence, and it said, “Given the tremendous social and economic burden of hospital-acquired infections and antimicrobial resistance, and the variable success of current approaches to hand hygiene in the health care environment, it would be a mistake to dismiss, out of hand, such a promising, intuitive, and affordable ban.” And I concluded, “Just one more reason why Americans need to avoid going to the hospital.”
For Health Commentary, I’m Mike Magee