Shaking Hands

An interesting article on the internet caught my eye this morning.   It was a survey of infectious disease experts and epidemiologists who were asked if they would ever resume typical interpersonal behaviors such as hugging and shaking hands as well as attending crowded events such as concerts, religious services and traveling on airplanes.

It made me think of my regular routine which I followed for 40 years as a pediatrician.  Who knows how I would adapt to the present situation if I were still working?    Since the patients would be waiting for me in the exam rooms, I would always knock on the door, just as a polite formality in case they were still in the process of undressing.

Since the patients would be waiting for me in the exam rooms, I would always knock on the door, just as a polite formality in case they were still in the process of undressing. 

“May I come in?”

As I entered, depending on the child’s age, I would say hello to the child already sitting on the exam table and would extend my hand.  If this were the first visit, I would always introduce myself as “Dr. Kraft.” 

“I’m happy to meet you”

In an instant, I was able to assess the situation.  I could observe the comfort or discomfort of the patient from their verbal and non-verbal cues.     

Very quickly thereafter, I would address the parent or parents and ask them why they were there. To the parents, I would always say “I’m Dan Kraft.” Many parents would later tell me that they appreciated that I paid attention first to their child, and that they liked that I introduced myself using my first name. 

While this was happening, I would walk a few feet to the sink and wash my hands and dry them carefully.  I would sometimes ask the parents if they noticed that I washed my hands before examining their child.  I expected that everyone would be aware of my routine, but only about half of the parents stated that they had noticed.

I would wash my hands, and watch if the parents would notice this

Over the years, my routine would be tweaked slightly.  I would make a point of swabbing my stethoscope before using placing it on a patient’s chest.  Soon before I retired, I abandoned wearing a tie because of studies claiming that ties could spread infection from one patient to another. 

I would clean my stethoscope before each patient

Where did I learn this particular routine?   When I was growing up, my uncle was becoming a pediatrician.   Whenever I would visit him, I would enjoy following him on rounds and in his office visits.  I witnessed his friendly interaction with his patients and their families.   Early on, I knew that I wanted to become a pediatrician and follow in his footsteps.  Little did I know that I had subconsciously incorporated his rituals into my daily practice.

At one point in my career, my practice was being courted by a larger practice from Miami.  We would have been the first practice in our county to join this busy practice.  Initially I had my misgivings because I knew that they were such a high-volume, fast-paced operation.  It probably would been a drastic change for our office which was slower and where we devoted more time to each patient and his or her family. 

As part of the process, I went to Miami to observe the “style” of the practice.  I spent the whole day with one of the senior members of their practice to determine whether our practices were compatible.    In the course of a busy afternoon, I noticed that the doctor did not wash his hands even once either in front of the patients or in between each visit.  It was partly due to his seeing twice as many patients as we would be seeing during that time period. 

Rush, rush, rush……

I was so turned off by the pace of the office that I decided that our practices would not be compatible.   Despite reassurances to the contrary, we would probably have been expected to adjust to the increased volume.  When I realized that the doctor was “processing” patients so quickly that he didn’t have time to wash his hands before examining each patient, I concluded that the merger was not going to happen.

I returned to my office and informed my partners that we would stay independent and not join the larger group. I never regretted that decision.  I never wanted to compromise the style of seeing patients that I had chosen early in my career.  Our patient satisfaction scores were always high because patients could tell that we were sincerely interested in their care.  And equally important, the job satisfaction of the doctors and nurse practitioners who worked in our office was an important priority. 

I can honestly say that it rarely happened that even on a super-busy day, I wouldn’t come home and tell my wife that it had been a good day.  Looking back on those 35 years, I was happy that I had set the tone and the pace of the practice which ensured that it was a workplace that I was proud to have created.     

A happy pediatrician

One thought on “Shaking Hands

  1. And a practice and tone we are all honored to continue:-)
    Thank you for creating our medical home.


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