Should hospitals ban handshaking? And should you refuse to shake your doctor’s hand for your own health?

A handshake can be a sign of welcome, respect, thanks or civility…or it can be something unwittingly sinister because, as you know, it’s a great way to spread germs. And yet, ironically, the people who are among those most likely to spread germs via their hands are the ones tasked with fighting infections—health-care workers. This has got one doctor on a campaign to ban the handshake in certain medical settings.

KEEP YOUR HANDS TO YOURSELF

Although there certainly are policies for hospital workers about hand washing and infection control, such policies are not always followed despite numerous studies that have been published over the years about the importance of—but lapses in—hand washing in the hospital setting. According to one recent study, only 40% of health-care workers in the US regularly wash their hands before or after examining patients—that’s right, 40%.

As a way to get around this rather longstanding and stubborn problem, Mark Sklansky, MD, chief of pediatric cardiology at the David Geffen School of Medicine at UCLA, argues that it’s time to institute handshake-free zones, particularly in intensive- and critical-care units, emergency rooms and patient rooms. That is, doctors, patients and the friends and relatives of patients will all be expected to keep their hands to themselves.

So no more “Nice to meet you, doc”—at least, not with a shake.

Would patients and visitors comply with such a rule? I have my doubts, based on how automatic and reflexive it is for Americans to shake hands. Dr. Sklansky believes people would comply.

“We already have signs in hospitals telling visitors not to enter if they have coughs or rashes. Hospital workers and visitors to the hospital know that the hospital and its grounds are no-smoking zones. If these kinds of rules can be enforced, there is a very good chance that handshake-free zones will also be the norm in the future,” said Dr. Sklansky.

In his view, germy hand-to-hand contact doesn’t put only hospitalized patients with weakened immune systems at risk—it also has a much broader impact by contributing to the growth and spread of “superbugs,” bacteria that are resistant to antibiotics. In other words, the more bacteria that gets passed around, the more antibiotics get used to fight infections, which leads to the development of bacteria that can’t be treated with conventional antibiotics, Dr. Sklansky explained.

But as a physician, Dr. Sklansky told me that he understands the value of human touch and is not proposing that doctors and nurses stop touching their patients. He, however, feels strongly that limiting handshakes in certain health-care settings “makes absolute sense and most people in the medical community know it.”

But Dr. Sklansky doesn’t realistically see banning the handshake or even setting up handshake-free zones coming too soon. “The true value of banning the handshake from the health-care environment will require study,” he said. Because of the way science (and bureaucracy) works, “we may first need to find out just how many infections might be prevented by having such a rule in place.”

ALTERNATIVES TO THE HANDSHAKE

Now, nothing’s going to change the fact that humans need to acknowledge each other, and perhaps no more so than in an intimate, emotionally charged setting like a hospital. We’re not going to all walk around greeting each other like robots, no matter what rule a hospital passes, right?

So let’s look at some alternatives to the germ-passing handshake. In some places and circumstances, it’s already the case that handshakes are not permitted, of course. “There are certain cultural and religious traditions in which handshakes are forbidden between members of the opposite sex, so it is not unusual for the physician or another caregiver to give a nod of the head or place the palm of the hand over one’s own heart to acknowledge or greet the patient or his or her family,” Dr. Sklansky said.

Other forms of noncontact greeting that can be used include a hand wave with a slight bow, holding up a hand with the palm forward or placing the palms together, as if in prayer, and lightly touching them to one’s own chest. “Meaningful eye contact and a smile works well, too,” Dr. Sklansky remarked.

When you think about all those sincere, unmistakable and safe alternatives to convey greetings, and respect, it kind of makes you wonder, what’s so great about a handshake, anyway?

You might be fastidious about hand washing and use of hand sanitizers, and some health-care workers and hospitals do keep very strict hygiene practices, but how can you really know if the person or professional extending a hand to you is careful about cleanliness? Even though Dr. Sklansky thinks it may be a while before his suggestion to ban the handshake could take hold in health-care settings, you may want to protect yourself and do your part for public health even more than you already are by adopting new ways to cordially greet other people—especially doctors and other health-care workers—that skip skin-to-skin contact. I’m going to give it a try the next time I visit a hospital. And if I’m met with a quizzical look when I don’t grab an outstretched hand, I’ll just explain why—with a smile.