A modest proposal: Ban handshakes in healthcare

March 18th, 2015

The ancient ritual of the handshake evolved in human dynamics in part as a way to instill trust by extending the weaponless hand. Ironically, this act of goodwill could put a frail patient’s life at risk if pathogens on the hands are exchanged as well as greetings.

That has raised a question that seems intuitively valid but could be surprisingly difficult to accomplish: Is it time to ban handshakes in health care settings?

Absolutely, says one who has embarked on something of a quixotic quest to break the shake, Mark Sklansky, MD, a professor of pediatrics at UCLA Medical Center in Los Angeles.

“I really believe it is the right thing to do for our patients and there are ways of doing this that do not compromise the doctor-patient relationship,” he says. “Critics of this are concerned that it is going to further alienate patients from their doctors. If it is not replaced with any warmth and compassion in other ways, then yes, I think there is a risk of that. But there are many other ways we can express the same kind of sentiment that we do currently with a handshake.”

Sklansky concedes that a hand shake may have a calming effect on patients and family members, engendering trust and reassurance. Seen in that light, banning handshakes could raise a marginal patient safety issue in its own right, but the benefits of a ban far outweigh the risks, he notes. In any case, it makes little sense for health care workers who are constantly trying to decontaminate their hands to complicate the issue by shaking them with colleagues and visitors between patients.

“There are clear benefits to the handshake but we feel a health care setting that is a concentration of vulnerable patients and pathogenic organisms is not the right place to be continuing this gesture,” he says. “We know that it is gesture that transmits disease.”

For more on this story see the July 2014 issue of Hospital Infection Control & Prevention