Early in the pandemic I avoided seeing my patients for a while, except with virtual visits. After returning to the office I tried to maximize the distance, and minimize the duration of contact to lessen both our risks.
As the pandemic has progressed, both my patients and myself have gradually become more relaxed. I think this is from a combination of vaccinations, having effective treatments, and just habituating to the situation. Initially I had stopped shaking hands, and my patients stopped trying to shake mine. But eventually some did, with either a fist or elbow bump, or sometimes a full hand shake. Some would follow my lead but remark about how they guess we are no longer shaking hands.
A few months ago a plumber came out my house to replace a sprinkler valve system that sprung a leak after an earlier freeze. When he arrived he stuck his hand out to shake. Not wanting to be rude I shook his hand, then was careful to make sure I didn’t touch my face before washing my hands.
Not longer after, someone came out to pump our septic tank. The same thing occurred. No offense to those in the sanitation field, but if you’re a germaphobe, rationally or not, shaking hands with someone who empties tanks with human waste does not sound like a good idea! But again, I didn’t want to be rude, so I did so.
After those encounters, I pondered what I should do with my patients. Having seen plenty of guys in public bathrooms walk out without washing their hands, or with just a cursory rinse, and knowing that most people, myself included, often touch their faces unconsciously, which is how diseases often spread, I’m a little leery of shaking anyone’s hands. Pre-pandemic I overrode those concerns and did so anyway, for the social bonding benefit, but now it’s more socially acceptable to not shake hands.
In the office we wash our hands often, even pre-pandemic. We’re taught to gel in, gel out. That means you use alcohol gel to wash your hands when you walk in to see a patient, then again as you leave the room. Even with that I usually put the gel in one hand, open the door with the other (who knows who touched that door handle last), then rub my hands together as I walk into the room (which also demonstrates to the patient that I washed my hands). If I then shake their hand (and anyone else they came with), then I feel compelled to wash them again lest I touch my face during the visit, or just to avoid potentially contaminating the keyboard (though my nurse does wipe it down often). That can easily add up to washing my hands over 50 times a day. Certainly the alcohol is a lot faster than using soap and water, but is more drying on the skin.
So where does that leave things? Basically I shake hands when my patients offer it, and occasionally other times, as I continue to weigh the pros and cons. I suspect after the current wave of infections declines I’ll relax more and be able to shake off the feeling of impending doom.