There’s a secret that doctors know but don’t always talk about—one of the most germ-laden places to visit may be a medical office.
While doctors, nurses and medical assistants have gotten more conscientious about washing their hands, millions of Americans still develop health-care related infections every year. As you’d expect, hospitals are among the most germ-laden places, but even routine doctor visits can present risks.
Troubling development: Bacteria that can lead to life-threatening Clostridium difficile infection (commonly referred to as “C. diff”), a diarrhea-related illness that once was found almost exclusively in hospitals and nursing homes, has been linked to visits to doctors’ and dentists’ offices, according to a 2015 study published in The New England Journal of Medicine.
If you know where the germs are most likely to hide out in medical offices, there are simple steps you can take—beyond handwashing—to reduce your risk of picking up microorganisms that spread colds, flu and other diseases.
IN THE WAITING ROOM
Even though it’s impossible to find a germ-free doctor’s office (or really any place that people frequent), you shouldn’t let that stop you from seeing your physician if you’re sick or need a checkup. When you go, just be sure to follow these steps to avoid germs that lurk in these common hot spots…
• Dirty pens. Patients are accustomed to the pen-and-clipboard check-in ritual, but have you ever wondered what lives on the clipboard pen? It’s been touched by hundreds of germy hands, including those of people who are seriously ill. If your check-in involves an electronic tablet, many fingers have touched that as well.
Test swabs taken from doctors’ offices show that the average writing implement harbors vast quantities of pathogens—far more than door handles, the armrests of the waiting-room chairs or the doctor’s computer keyboard. Because people grip pens with unwashed hands…put them behind their ears…or even in their mouths, pens are also germier than the clipboard you get at check-in.
My advice: Carry your own pen for filling out forms in your doctor’s office, signing receipts and to use anywhere you might need to give your signature—at the supermarket, department stores, etc.
• Germy magazines. The well-thumbed magazines on a waiting-room table can carry whatever germs were on the previous reader’s hands…or were sprayed like an aerosol from a sneeze or cough.
My advice: Bring your own reading material to the doctor’s waiting room. Our research, conducted at William Paterson University, found that germs can survive for weeks or even months on paper.
• Other patients. Pediatrician offices often have “sick” and “well” areas in the waiting rooms. This hasn’t become common practice for doctors who treat adults—perhaps because adults tend to be more careful about hygiene than young children, covering sneezes and coughs and using tissues—and few doctors have waiting rooms big enough to accommodate separate areas.
My advice: Don’t sit near patients who are coughing or sneezing, wiping their noses or are otherwise visibly ill. If possible, schedule routine visits so that you’re not in the office during flu season. And definitely keep up with vaccines, including those for flu and pneumonia.
Helpful: Consider wearing a face mask in the doctor’s office, particularly during flu season. Experts used to think that the flu virus was mainly transmitted through coughing and sneezing and by touching contaminated surfaces. But we now know that these infectious aerosols, airborne droplets produced by coughs or sneezes, can hover in the air for hours. New research shows that these aerosols are also transmitted simply during normal breathing.
You can buy surgical-style face masks in pharmacies…or ask for one at the front desk if your doctor’s office provides them for patients who could be contagious. They don’t provide a perfect barrier, but a snug-fitting mask will help protect you from other patients—and protect them from you. Even though you may feel self-conscious wearing one, the other patients will appreciate it if they think you’re the one who is sick.
• Handheld devices. Doctors routinely carry cell phones, tablets or other electronic devices when they make their rounds or see patients in the office. They use them to take notes, check your medical history and look up drug information—and unwittingly to pass germs, in some cases, from one patient to the next.
Shocking research: In a study published in Online Journal of Health and Allied Sciences, 75% of the cell phones carried by health professionals were contaminated with disease-causing germs, including methicillin-resistant Staphylococcus aureus (MRSA) and other dangerous pathogens. Equally concerning was that more than half of the health-care workers said that they never cleaned their phones…and 87% admitted that they didn’t wash their hands after using them.
Even if your doctor is conscientious about handwashing, the device will reinfect his/her fingertips every time it’s touched.
My advice: Ask your doctor to wash his hands after touching the device—and before touching you. Gloves can help, but only if they’re new. You can say to your doctor, “I see that you just touched your tablet. Would you mind putting on a new pair of gloves?”
• Contaminated stethoscopes. The stethoscope is the classic emblem of medical care. It’s also one of the most contaminated.
Scientific evidence: When researchers measured bacterial concentrations both on stethoscopes and on the hands of doctors who used them, in 71 out of 83 cases, the stethoscopes carried more germs than any part of the doctors’ hands except for the fingertips, according to a study in Mayo Clinic Proceedings.
Unless a stethoscope is wiped down with alcohol after every use, assume that you’re being exposed to bacteria or viruses from the patients who came before you.
My advice: Doctors have gotten better about cleaning their stethoscopes with alcohol wipes, but they may forget…so remind them!
• White coats. Most doctors wear a white coat and keep it on all day. It’s not as clean as it may look.
Research published in American Journal of Infection Control found that 23% of physician white coats carried disease-causing microorganisms, including, in some cases, antibiotic-resistant MRSA.
My advice: Whether or not the doctor is wearing a white coat, be aware of what the doctor touches before he touches you. He should don his gloves right before examining you. If the doctor adjusts his necktie (another germ hot spot) or gets something from a pocket, he should put on a clean pair of gloves. Politely ask your doctor to use an alcohol pad to swab skin areas that have been accidentally brushed with a necktie or jacket sleeve.
When the appointment’s over, feel free to give your doctor a fist bump instead of a handshake…or, better yet, just a friendly smile. He will respect your nod to the latest trend in hand-hygiene practices!
After your appointment: Don’t forget to wash your hands before leaving the doctor’s office—ideally, with soap and water for 20 seconds, but with an alcohol-based hand sanitizer if a sink is not readily available. Research has shown that hand jewelry—and particularly rings, which are rarely removed—is a common cause of bacterial contamination (and transmission), so scrub well, including on and around rings.
Grab a clean paper towel on your way out of the restroom and use that as a barrier when you open doors and push elevator buttons. Then throw it in the trash on your way out of the building.