Their ties could be your neck

Formally attired doctors at the Cleveland Clinic in 2008. Studies show that physicians' ties can be paisley highways for bacteria. Associated Press
Formally attired doctors at the Cleveland Clinic in 2008. Studies show that physicians' ties can be paisley highways for bacteria. Associated Press
Posted: October 26, 2012

By Meghan Lane-Fall

I've been lucky enough to spend most of my time caring for others instead of being on the receiving end of health care. Just before Thanksgiving in 2006, however, I found myself looking up from an operating table in the hospital where I worked as a physician, waiting for the anesthesia to kick in so I could undergo an emergency appendectomy.

In my hospital room the next morning, I was greeted cheerily by my boss, who was also the surgeon who had so thoughtfully excised my diseased appendix. He was leaning over my bed to examine me, his undoubtedly expensive necktie brushing against my sheets. I wanted to grab him by it, bring his face close to mine, and demand, "What are you doing bringing this disease-carrying thing around your neck into my room?" But I demurred.

It is time for doctors to stop wearing neckties. It's mostly male doctors, of course, but if there are any avant-garde female physicians doing the same, I urge them to stop, too.

Doctors defy all sorts of social customs. They wear odd white coats. They undress us and poke at us. They feel perfectly comfortable telling us just five minutes after we meet that we need to lose weight. So why follow this sartorial convention?

Don't get me wrong: I appreciate the effort. I would much prefer a physician who wears clean dress clothes to one sporting scrubs of dubious provenance and hygiene. And I think it's swell that doctors take their encounters with patients and others seriously enough to wear business attire.

But I don't want someone's well-meaning fashion choice to infect me with flesh-eating bacteria that might cost me another body part. Seriously, how often are those things washed?

I am not the first to notice that neckties might be disease vectors. In 2006, the year my appendix and I parted, the British Medical Association recommended that doctors do away with "functionless" attire - read neckties - because of its propensity to spread disease. In 2009, a study in Israel found that half the physicians' neckties studied were carrying disease-causing bacteria - a rate five times higher than the ties of security guards at the same hospital.

But doctors are a stubborn bunch. I should know: I'm one of them. For every study showing that ties harbor dangerous bugs, doctors have a reason their revered silk nooses can't be the problem.

Maybe the trouble is that doctors rub their dirty hands on their neckties. OK, fine, but just try to get doctors to wash their hands enough. As it is, only about 70 percent consistently do so on their way in and out of patients' rooms. And that's when we're trying really hard.

Maybe we should require that ties be washed. OK, go ahead, tell a man to wash something made of silk. Let me know how that turns out.

Some doctors complain that going without neckties would be uncivil and disrespectful of patients. As a prospective patient, however, I would feel more respected if my doctor tried his level best to prevent me from getting sick (or sicker).

It seems we keep rehashing this issue. Just this year, a simulation by the Journal of Hospital Infection showed conclusively that bacteria on neckties were transmitted to the skin of patients. So the bacteria from my surgeon's tie were surely trying to work their way into my healing incision.

If you think there are more important issues in health care, you're right. Giving everyone access to high-quality care and containing costs are imperative. But that doesn't mean we can't simultaneously pick the low-hanging fruit - the shiny, colorful, curiously-patterned, disease-bearing fruit.

If you insist on playing dress-up - and I understand that men's options for expression through wardrobe are limited in professional settings - at least wear a bow tie. I might laugh at you, but they say laughter is therapeutic.


Dr. Meghan Lane-Fall is an attending anesthesiologist and postdoctoral fellow at the University of Pennsylvania's Perelman School of Medicine. She can be reached at laneme@upenn.edu.

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