As I sit in the conference room awaiting one of my first interviews for residency, the angst among all the applicants was palpable. We all make awkward eye contact and conversation with each other as our interviewers pull us out of the room one by one to speak with us. Amongst the awkwardness and anxiety, my attention was directed at the applicant next to me when I heard the dreaded inhale preceding a sneeze. I leaned in the other direction in hopes of not catching the plague, but what I saw next mortified me most. He instinctively took both hands to cup his nose and mouth, sneezing directly into his palms instead of his upper sleeve. Like a bad comedy, his interviewer called on him next as they shook hands and exchanged microbes.
It’s circumstances like these that prove handshakes are an unnecessary vector for the spread of germs across the globe. The tradition of handshaking was born centuries ago as a gesture that each person was unarmed and not carrying any weapons in their right hand. As society has continued to modernize and adapt to the changing times, this outdated tradition somehow still has a vise around acceptable societal norms. It’s time that we start moving away from handshakes and needless threats to our collective well-being.
In a time when preventative medicine is in the spotlight to lower healthcare costs, it’s prudent that we explore any avenues that reduce transmission of diseases. Unfortunately, we live in a society that isn’t very hygienic. Even physicians, the gold standard of hygiene and sterility, do a substandard job of keeping their hands clean. A 2010 study showed that only 40 percent of physicians and other healthcare professionals followed hospital hygiene protocol. This affords bacteria a home on physicians’ hands and a way to travel when they shake hands with patients.
Undoubtedly, proper hand hygiene adherence is the best way to prevent the spread of antimicrobial resistance and lower health care-associated infections. Through physical exams and countless procedures, bacteria are afforded alternative routes of transmission besides handshakes from healthcare professionals. This is why those entrusted with the care of patients must remain cognizant of proper hand hygiene during every patient encounter.
Stepping out of the hospital and into the streets shows that hand hygiene deficiency has permeated out of the healthcare setting as well. Researchers in London took swabs from the hands of 50 people on the street to analyze the bacteria on their hands. Their results showed that one out of every three hands was contaminated with bacteria normally found in feces. It’s become almost a common occurrence to see at least one person completely skip washing their hands after using a public restroom, leading to results like these.
I recognize that it’s nearly impossible to make everyone adhere to proper hand hygiene protocol which is why it’s important for society to begin to normalize not shaking hands when greeting others. Alternatives to the handshake have already proven to be more effective at reducing bacteria transmission rates between people. One recent study showed that high-fiving cut bacteria transmission in half, while fist bumping lowered it tenfold. Although these results are quite impressive, I don’t think there’s a need to have any contact between hands for a greeting to risk a transmission rate above zero.
Brandon Jacobi is a medical student.
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