Examining the Doctor-Patient Handshake

Re “Giving Doctors Orders,” by Maureen Dowd (column, April 13):

“Did you wash your hands?” This is not the way to start off the conversation. Doctors or staff members who respond “no” are guilty of a grave medical lapse. If they didn’t wash and then lie to you, they’re also guilty of a grave ethical lapse. Either way, the question raises their defenses and their hackles. Instead, if you didn’t witness a hand-washing ritual, then assume it didn’t happen. You’ll probably be right. Physician hand-washing compliance runs about 33 percent.

If you show them, they will wash. When they, or anyone, approach your bedside, give them notice of your intent. Hold out a bottle of sanitizer with a big smile. As you squirt them say: “I know how busy you are, and I am sure you’ve already done this a million times a day. But I’m terrified of those infections I’ve been reading about. I hope you’re O.K. with this.”

That’s it. Easy, pleasant and effective.

 STEVEN KUSSIN
New York, April 13, 2011

The writer, a gastroenterologist, is the author of the forthcoming book “Doctor, Your Patient Will See You Now.”

To the Editor:

As an intern at St. Vincent’s Hospital in Greenwich Village some 54 years ago, I also was faced with the dilemma posed in Maureen Dowd’s column: how to adhere to the dress code that required ties, and yet prevent that tie from becoming the transport vehicle of bacteria from patient to patient.

My solution was simple, sartorially elegant and bacteriologically sound: I switched to bow ties and have worn them exclusively ever since.

The bow tie should be the trademark of every physician.

 PETER CARBONARA
Englewood, N.J., April 14, 2011

To the Editor:

Re Maureen Dowd’s column: I send back food in restaurants all the time, and never let a doctor shake my hand until I see him wash his in front of me! Do I get a lot of attitude and resistance? Absolutely. That’s O.K.; then I know that this is not the doctor I want caring for me.

The bottom line is that you must be a medical advocate for your loved ones and yourself. Watch every detail of the care-giving: question and double-check every order, test and prescription, and especially make sure hands are clean, gloves new.

I may not be my doctors’ favorite or easiest patient, but they respect me and know that I’m watching them. Mistakes happen, and I could add to Maureen Dowd’s example many times over, but the patient can control and minimize mistakes and damage. Your life, and your family members’ lives, depend upon your doing so.

 THERESA MERRILL ANOVICK
Ridgewood, N.J., April 13, 2011

To the Editor:

In comparison to a doctor’s tie that conveys germs and bacteria to a patient by brushing against the patient’s gown, hand-shaking between a doctor and a patient spreads infection around a hospital much more surely and quickly.

When I was hospitalized at Stanford Hospital last week, I fist-bumped rather than shook the hands of all the doctors who came to see me. Since I seldom scratch my nose and rub my eyes with the back of my palm, the germs I potentially acquired from the doctors were relatively harmless. In addition, all my doctors thought bumping fists was cool.

 FU-TIN MAN
Cupertino, Calif., April 13, 2011