Doctors: Hand-washing and hand shakes better than fist-bumps

Nearly six months after research suggested fist bumps among hospital staff may reduce hospital-acquired infections, some healthcare professionals say the cost to a hospital's interpersonal interactions isn't worth it, according to Medscape.

"Holding someone's hand in a handshake is a more personal way of touching and interacting than a fist bump," Mark Schleiss, M.D., division director of pediatric infectious diseases and immunology at the University of Minnesota, told Medscape. "For me, it's absolutely inculcated in the way I interact with patients and families. Upon first meeting patients, it's a sign of respect and courtesy, and if you have a well-established relationship with a patient, it becomes almost an exchange of endearment."

There are still handshake exceptions, such as cultural differences, personal preferences, or physical or medical limitations. In those cases, "patients are pretty good at conveying their preferences," Gregory Makoul, Ph.D., professor of communications at the University of Connecticut School of Medicine, told Medscape. Physicians shouldn't assume they can predict these preferences, according to Makoul. "I'm not a big proponent of stereotyping people and saying, 'Oh, you look like you're from this culture; let me look at my pocket guide and see whether or not I should shake your hand,'" he said.

Although the fist bump may reduce the risk of germ transmission, the risk of infection via handshake should be much lower with proper hand-washing protocols, Schleiss said. "If we're going to live in a world where doctors don't wash their hands, then we should go to a head nod as a way of greeting patients," he said. "But I have yet to see a study that shows there will be influenza transmission or MRSA transmission if the physician practices good hand hygiene. Hand hygiene enables us to retain an important social and therapeutic gesture."

The lead author of the fist bump pilot, W. Thomas McClellan, M.D., agreed with Schleiss, telling Medscape that the study was meant to emphasize the importance of hand-washing, not to "supplant it with fist bumping."

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