Dr. Mark Lamos isn’t afraid to shake his patients’ hands. But, according to at least a few physicians, he should be.
Several California-based doctors penned an article this month in the Journal of the American Medical Association suggesting banning handshakes in health care settings. The idea had been proposed before, but the article renewed the debate within medical spheres: Is proper hand hygiene enough, or are more drastic measures necessary?
“This is a question that hasn’t been settled for many people,” said Lamos, the medical director of a physicians’ practice affiliated with the Greater Baltimore Medical Center. “But I can’t imagine people really want their physicians to be so separated from them that they refuse to touch them. There’s something to be said for wanting to prevent the spread of germs, but we have to draw the line somewhere.”
A ban on handshakes would cross that line, according to Lamos and others, who say physical contact is necessary for building trust between patients and providers, as well as connecting with people in nearly all other situations.
“Could I produce data that says getting rid of hand-shaking will reduce disease to some degree?” Lamos said. “Yeah, probably. But I’m personally not willing to give up that aspect of my humanity. That’s the bottom line.”
Other physicians, however, have gone in search of data. A study published last year in The Journal of Hospital Infection found that “fist bumps” transmit fewer bacteria than handshakes. More research is needed, but the study fueled the argument for eliminating the gesture in health care settings.
“I definitely think it’s something to discuss,” said Erica Jones, a nurse and the infection prevention coordinator at Mt. Washington Pediatric Hospital. “Anything that could eliminate infections is worth looking into.”
If handshakes have no place in hospitals, what about in other social settings? Many professionals say a ban on handshakes is out of the question.
“I will fearlessly shake hands with anybody at any time,” said Jan Houbolt, the famously sociable former executive director of The Leadership, a training program for business executives. “It’s all part of building the immune system.”
And building relationships, he said.
“I’m sure medical folks know better than I do about the spread of disease, but it’s just not high on my priority list,” Houbolt said. “I’d rather take the risks of shaking hands. Actually, I’ve been known to go around giving people hugs, sometimes inappropriately.”
Shaking hands is also critical to Del. Susan Aumann, R-Baltimore County, who says connecting with constituents and fellow lawmakers in Annapolis would be difficult without “the power of touch.”
“When you extend yourself to another person — shake their hand, look them in the eye — there’s a bond that builds,” Aumann said. “Maybe people are more comfortable talking to me because of that.”
Even in health care settings, Jones said, a no-handshake policy might make sense in theory, but perhaps not in practice.
“It’s such a longstanding part of our culture, it may be difficult for people to accept that you’re not going to shake their hand,” Jones said. “It could be hurtful if they don’t understand why, or even if they do understand the risk but still want and need that touch, because being in the hospital is often very difficult.”
At a pediatric hospital like Mt. Washington, however, eliminating handshaking might be easier than at facilities serving people of all ages.
“I think it would be fun for the kids to find new ways to greet each other, like maybe the fist-bump or the peace sign,” she said, adding that cutting out most hand-touching could “substantially reduce” the number of infections transmitted, particularly during flu season.
The authors of the recent JAMA article suggest replacing the handshake with the fist bump or some other gesture to convey a greeting and respect. But several people said the fist bump does not express the same openness as a handshake.
“While infection prevention is very important, there’s that human aspect to the [handshake] that symbolizes caring,” Jones said. “And while the fist bump may be fun, it may not symbolize that you care.”