Physician Ponders Glove-Wearing and Losing Touch With Patients

In an essay in the September/October 2010 issue of Annals of Family Medicine, Leif Hass, MD, of Alta Bates Summit Medical Center in Oakland, Calif. reflects on how his own drug-resistant staphylococcus infection affected his work in the hospital. Writing in "Losing Touch: Do Physicians Lose Connectedness with Patients When They Wear Exam Gloves? One Physician's Personal Reflection," Hass discusses how his subsequent decision to wear gloves during patient encounters created a barrier, not only to infection, but also between himself and his patients. He reflects on the value of touch as a communication tool in the doctor-patient relationship, especially as means of bridging large socioeconomic and cultural gaps. He concludes the implications of contact precautions must be considered as healthcare providers reflect on balancing patient-centered care with infection prevention and control.

Hass writes, "I understand objectively that I do not need to wear gloves with all my patients, but for a great number of patients, all clinicians must take considerable precautions to prevent the spread of infection. Guidelines support the use of alcohol-based foam products rather than gloves except when multidrug-resistant pathogens are confirmed, but given the increasing rates and virulence of these organisms, I am not convinced such measures will continue to be enough to protect our patients. I know, however, another important reason I now wear gloves is out of fear for my family and me. Yet I see touch as a communication tool. For me, touch is particularly important when trying to bridge large socioeconomic and cultural gaps. A hand on the shoulder or the knee or a thoughtful physical examination, I believe, can make a patient understand at a deep nonverbal level you are there for them. I work hard to demonstrate concern for my patients with tone of voice, facial expressions, and body language, yet I feel I am losing some connectedness without skin-to-skin contact."