Wednesday, June 20, 2012

Shake on it

When I was doing Sports clinic during residency, I always entered the room the same way:

First, I knocked. Then without waiting for a response, I opened the door.

Me: "Are you Mr. Jones?"

Patient: "Yes."

Me: "Hi, I'm Dr. Fizzy, I work with Dr. Attending." [holds out hand] "Nice to meet you."

Golly, I was polite.

Anyway, I got in this habit of shaking everyone's hands. However, when I was doing my rehab clinic, I never shook hands. Mostly because a lot of patients had strokes, brain injuries, or spinal cord injuries, and had limited hand use. Have you ever tried to offer a handshake to a high quadriplegic? It's a little awkward, to say the least. Also, a lot of patients brought in several family members and I didn't want to be shaking hands all day.

However, I remember one day in rehab clinic, I saw a patient in the afternoon who was in the room all by herself, albeit sitting in a wheelchair. So without thinking about it, I reached out to shake her hand as I introduced myself.

And she just stared at my hand.

My first instinct was to be totally embarrassed because maybe she couldn't shake my hand. But then she said, "I don't do the hand shaking thing. You've probably shaken a lot of hands today and I don't want your cold and flu germs."

Well, I never! (I did spritz myself with alcohol before entering the room.)

If you want an inkling as to whether or not your patient is crazy, the fact that she won't shake your hand is a pretty good indication. Even if she was right, it's still not a normal thing to do. She also wouldn't let me examine her, because she'd "been examined enough." Fine with me.

When I told my attending she wouldn't shake my hand, he asked me if it was because she thought I had cooties. I had to admit that it was. And she was probably right. *Achoo!*


  1. It sounds like she may have been depressed. I work in MH, and many of the patients I see have become overwhelmed by the endless stream of medical Providers. They know they need help, but they grow tired of it. Kind of sad....

  2. I did a heme onc elective, and when I'd go in to see a patient with the attending I would introduce myself and shake their hand. I thought this would be better than standing mute in the corner and pretending I wasn't there. Apparently the attending didn't agree, because at the end of the elective (after I'd asked for feedback mid-month and he'd given me nothing to improve upon) he told me that it was "weird" to shake my patient's hands. And he gave me a shitty grade. It annoys me to this day.

  3. I quit hand shaking after a year or so in practice. Occasionally, patient will lean forward and expect it. But it does not improve the visit that much plus you get the scaredy patients who will give you germ lecture. And when these patients are nice they say they will not shake your hand because THEY have cold.

    OMDG - I remember those types of attendings that would give most everybody bad grade. And you know what, they were the ones who could not really teach well, and were very insecure.

  4. If only "cooties" could keep all the crazies away.
    P.s. Love the blog!

  5. Unless my "client" is a little old lady in church, I don't shake hands at work. And cooties are the least of my worries. I don't know what would happen if asked to examine somebody, though.

  6. I always shake hands with patients unless they are intubated. Even then I'll go up and introduce myself and put my hand on their shoulder or something. I was raised in a very handshaking part of the country I guess. It just seems weird to meet someone new without shaking their hand.

  7. I am currently an ID fellow and I have a background in microbiology. I tried the whole hand shaking thing at first but I have some weird hand phobia after starting ID. I'm not sure when it happened but I try to avoid shaking anyone's hand if at all possible. Oh, and I have been told its weird that if I use anyone else's phone I hold it about two inches away from my ear because I get grossed out. But they do say that ID doctors are weird.

  8. I stopped after working with homeless youth's who all had scabies. Thankfully I never got it, but I always itched after that rotation

  9. i greet the patient, wash my hands, and shake their hand. family too. it is a great start to the consult.