The Simon Center for the Professional Military Ethic

    Don't Kill Me Doctor: Wash Your Hands!


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    Posts : 99
    Join date : 2009-10-26
    Location : West Point, NY

    Don't Kill Me Doctor: Wash Your Hands! Empty Don't Kill Me Doctor: Wash Your Hands!

    Post by Admin on Thu Oct 29, 2009 12:21 pm

    January 21, 2009
    Don't Kill Me Doctor: Wash Your Hands!
    by Sharon McEachern

    "Wash your hands or else!"

    It's not a threat from Mom. It's a warning by hospitals to doctors. The "or else" means you could get sacked if you don't clean up your act.

    It's hard to believe. The chances are only 50-50 that the doctor treating you in the hospital, even when performing your surgery, has washed his hands. The odds are the same as flipping a coin. Actually it's worse than that. According to the National Quality Forum, hand-washing compliance rates at hospitals are generally less than 50 percent.

    Methicillin-resistant staph aureus, or MRSA, is the strain of a once-innocuous staph infection that has become invulnerable to first-line antibiotics and kills more people every year in the U.S. than the AIDS virus and in the majority of cases is contracted in hospitals, reports the Sacramento (CA) Bee.

    Knowing this fact, you may be more willing to challenge your doctor and ask her if she has washed her hands before she touches you. That's exactly what some hospitals are asking patients to do.


    And that's not all that hospitals are doing in desperation. The problem is so great that hospitals are threatening to fire physicians found lax in washing their hands. Some medical centers are measuring their liquid soaps and using hidden cameras to see if physicians are really washing their hands.

    Hospitals should be safe places to go, not a place where you go in and then die from something other than what you came in with.

    Ask Tom Brady, quarterback for the three-time Super Bowl champion New England Patriots. He contracted a serious infection after undergoing knee surgery. Brady had to have a second surgery to clean out the infection.

    More than 2 million patients get infections in hospitals and 90,000 die from them each year, according to the U.S. Centers for Disease Control and Prevention. (For the CDC fact sheet on MRSA, go here. )

    In Houston, laminated handouts now come with every patient's first meal at Lyndon B. Johnson General Hospital and Ben Taub General Hospital urging patients to "gently remind your health care providers to wash their hands and wear gloves." Doctors caught treating patients without washing their hands face counseling by administrators and written reprimands in their employment files, reports the Houston Chronicle.

    Some hospitals have monitored supplies of soap and sanitizer to determine if workers are washing up as they should. At The Methodist Hospital in Houston they use undercover hand-washing spies to monitor how often health care professionals follow hand-washing guidelines.


    Getting doctors to wash their hands is a problem around the world.

    Doctors working in transplants and neurosciences at Addenbrooke Hospital in England are the worst staff for following hand hygiene rules aimed at cutting superbug infections, according to Cambridge (UK) News. The hospital's most recent infection control report shows that hand hygiene compliance was 64 percent among neuroscience doctors, who treat brain and nervous system conditions, and 75 per cent among transplant doctors. But nurses in the same departments scored 99 per cent and 96 percent respectively. "Other staff," including cleaners and porters, scored 97 per cent and 100 per cent in the same departments. What's wrong with the doctors?

    In Scotland, calls have been made for spy cameras to check on National Health Service hand washing, reports the Scotsman. Questioning the reliability of official monitoring of hand hygiene designed to combat hospital superbugs, a public health spokesperson called for covert camera surveillance to ensure all staff are washing their hands. This came after figures released under the Freedom of Information Act that NHS audited only eight per cent of wards -- 21 wards out of 260 -- with most surveillance periods lasting only an hour. Some administrators are concerned that staff are aware of audits, leading to temporary changes in practice. Now Scotland's Health Secretary has instituted a zero-tolerance stance to hand hygiene noncompliance -- doctors and nurses who repeatedly flout hand-washing guidelines will be sacked.

    The Australian reports that New South Wales doctors have been told to wash their hands or be fired, following mandatory hand washing protocols, including counseling as well as publishing infection control rates for each hospital ward.


    One neurologist and brain surgeon advises "an arrogant medical priesthood" to "wash your hands." Dr. Michael Egnor is also a creationist. However, even if you do not believe in evolution as does Dr. Egnor, his comments on physician hygiene are worth consideration.

    Speaking on "the failure of medical personnel to practice good hygiene such as hand washing," Dr. Egnor labels some traditional medical practitioners "what hypocrites." Saying that "arrogance of scientists and physicians is an old scrouge," he believes we are beset by a medical "priestcraft" who despite conferring enormous benefit to mankind also confer considerable harm as well.

    "In my own hospital, we have prevented several hundred deaths (based on mortality rates from past years) by such expedients as mandating and facilitating hand washing by doctors and nurses as they move between patient rooms and by a focused effort to reduce hospital acquired pneumonia and blood infections," posted on Evolution News & Views.

    I still don't get it. Why do so many doctors, who of all people know the dangers, refuse to wash their hands? Is it really arrogance -- I'm so great I do not have to follow the rules? My magnificence is so grand germs wouldn't dare use my healing hands to infect others. Surely it isn't merely a lack of caring about their patients. If that's it, why be a doctor?


    I think it's denial. They know better but don't allow themselves to really think about it consciously -- they block it out -- because if they did not, then they would have to change their behavior or feel guilty. Why do they block out the need to wash their hands frequently? That's it! It is so frequent -- all the time. Yes, they're in a hurry and they've got lots of patients to see. But Jeez! It takes about 15 seconds to do an effective job of washing your hands with soap and water.

    I friend of mine told me that doctors have to wash their hands so often that their hands become chapped, their skin splits (exposing them to infection) and their hands hurt all the time. Many physicians believe it's just not worth it.

    If there's any truth to this excuse, then the hospitals shouldn't merely put out more soaps and sanitizers while turning on their spy cameras, they should spend money on really good dermatological hand creams. It could save a lot of people's lives. They should at least know the real reasons that doctors aren't washing their hands enough. Then perhaps they can deal with the problem more effectively.

    I do like the Houston hospital's reponse, asking patients to confront their doctors by asking if they've washed their hands. But I question whether most patients will do so. The ultimate authority figure, doctors hold your life in their hands and most patients do NOT want to make them mad -- but rather, they desperately want their doctor to like them.

    But, more "please don't kill me doctor -- wash your hands" is a valid request.

    What do you think?

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