Fist bumps safer than handshakes

By Juan Perez Jr.

Chicago Tribune (MCT)

Researchers with Aberystwyth University in the United Kingdom won a share of Monday’s news cycle with a hip way to start your next doctor’s visit.

Instead of shaking hands with your caregiver, try a fist bump. Not because it looks cool, researchers said, but for the sake of improving public health.

A brief paper titled “The fist bump: A more hygienic alternative to the handshake”, set to be published in the American Journal of Infection Control, concludes the streetwise exchange transmits far less bacteria than a handshake. So, fist bumps could lessen the risk of spreading disease.

The study’s conclusions may feel odd, but they’re actually part of a long-held discussion in the realm of healthcare.

“It’s tongue-in-cheek, but it’s important,” said Dr Rahul Khare, a professor at Northwestern University’s Feinberg School of Medicine, from his seat in the hospital’s emergency department.

Why? Because despite the millions of dollars that can be spent to implement and supervise complex infection-control protocols, containing infections in healthcare facilities [quite literally] lies first in workers’ hands.

“Healthcare workers’ hands become contaminated with pathogens from their patients, and, despite efforts to limit the spread of disease, cross-contamination of healthcare workers’ hands commonly occurs through routine patient and environmental contact,” a recent op-ed in the Journal of the American Medical Association said.

Khare and his colleagues — along with nurses and technicians — do shake patients’ hands. But they’re expected to rub globs of sanitizing liquid on their hands before they walk into an exam room, and again when they leave.

But eliminating handshakes from hospitals won’t be easy.

Consider, researchers wrote, the fact that health professionals “have been specifically encouraged to offer handshakes to meet patients’ expectations and to develop a rapport with them”.

Other alternative greetings seem less likely to catch on in today’s patient exam rooms. That includes high-fives, which researchers conclude also transmitted fewer bacteria than a handshake. The traditional “hongi” greeting, used by New Zealand natives and which researchers said “involves pressing noses and foreheads together”, might also look out of place in a hospital.

Even Khare rarely deploys the fist bump with patients.

“I do it when I see teenagers, that’s just their culture,” Khare said. “But an 80-year-old gentleman? I’m not going to fist bump him, I’m going to shake his hand.

“He might think I’m a bit of a strange doctor if I fist bumped him.”

On the other hand, Khare said a handshake’s grip on the patient-caregiver relationship can change. Especially if broader, rigorous studies can show a link between reduced hospital-based infection transmission rates and handshake elimination.

“If you can cut that by even 10 per cent by not shaking a person’s hand,” Khare said, “the amount of pain, suffering and financial cost that would save would be immense.”