Docs Wash Hands Like Guys In Gas Station Bathroom

Thursday was Global Handwashing Day

OK, a new study by the London School of Hygiene & Tropical Medicine did not directly compare how often someone washes their hands after using a gas station bathroom and how often your doctor washes his hands before examining you. But, being careful not to touch anything, we can do the math.

The School of Hygiene study just published in the American Journal of Public Health, placed electronic sensors in service station bathrooms along highways in Britain to see the way men and women responded to electronic reminders to wash their hands with soap and water.  After monitoring some quarter of a million people, they found that 32 percent of men and 64 percent of women washed their hands.

Most of the electronic messages caused some improvement in hand-washing, but the one that worked best was, “Is the person next to you washing with soap?” As one researcher told the BBC, “What other people think – what is deemed to be acceptable behavior – is probably a key determinant….It was interesting to see that, for men, the more people there were in the toilet, the more likely they were to wash their hands with soap.”

Which makes the average British male very much like U.S. doctors. As an article by Didet et al. in the Annals of Internal Medicine (and concluded, doctor hand-washing “was associated with the awareness of being observed, the belief of being a role model for other colleagues, a positive attitude toward hand hygiene after patient contact, and easy access to hand-rub solution.”

But at least British motorists aren’t stepping out of the gas station into a surgical gown. A multicenter study in the United States, published earlier this year by McGuckin and colleagues in the American Journal of Medical Quality, found that baseline compliance for following hand hygiene rules was just 26 percent in intensive care units and 36 percent in non-ICUs. After a 12-month “feedback intervention,” compliance increased to just 37 percent for ICUs – about the level of the average guy using a bathroom in a British gas station – and 51 percent for non-ICUs – still below the average female British bathroom user. (No word on whether female doctors washed their hands more than their male counterparts.)

The School of Hygiene study said that men responded best to messages of disgust, such as, “Soap it off or eat it later.” Meanwhile, the World Health Organization estimates that health care-associated infections affect as many as 1.7 million patients in the United States each year, cost $6.5 billion and contribute to more than 90,000 deaths annually.

Perhaps sinks in U.S. hospitals should consider electronic messages of their own, such as, “Soap me before I kill again.”

Michael L. Millenson is the president of Health Quality Advisors LLC and holds an adjunct appointment at Northwestern University’s Kellogg School of Management. He is the author of Demanding Medical Excellence: Doctors and Accountability in the Information Age and, earlier in his career, was a Pulitzer Prize-nominated reporter for the Chicago Tribune.

Livongo’s Post Ad Banner 728*90

Categories: Physicians

Tagged as:

Leave a Reply

5 Comment threads
0 Thread replies
Most reacted comment
Hottest comment thread
4 Comment authors
Gas StationLynn MrbartwaRDr. Rick Lipin Recent comment authors
newest oldest most voted
Gas Station

A gas station, fueling station, filling station, service station, petrol station, garage, gasbar, petrol pump or petrol bunk (India) is a facility which sells fuel and lubricants for motor vehicles. The most common fuels sold are petrol (gasoline in U.S. and Canada) or diesel fuel. Fuel dispensers are used to pump petrol (gasoline in U.S. and Canada), diesel, CNG, CGH2, HCNG, LPG, LH2, ethanol fuel, biofuels like biodiesel, kerosene, or other types of fuel into vehicles. Fuel dispensers are also known as bowsers (in Australia), petrol pumps (in Commonwealth countries), or gas pumps (in North America). In recent times, filling… Read more »

Lynn M

I’ve seen in many locations the signs that say you have the right to ask those in healthcare jobs if they’ve washed their hands….but even with that sign, are you really going to ask that question? Half the people are afraid to say anything even slightly negative to nurses and doctors (which is a shame that this relationship exists), no less nearly accuse them of not washing their hands. Seems like you just have to hope for the best.


If we really have to discuss bathroom hand hygiene here, let me add that the urine of a healthy person is sterile. But that has little to do with hospital handwashing and desinfectant use, which is a real problem. I think that this will only get better with a combination of repetitive education, incentives and peer pressure, over years, similar to what happened with smoking (and should happen with the sedentary lifestyle and overeating).


I’m sure all of these doctors are naturally very clean and the real problem is patients and administrators introducing bacteria etc. into their environment. Where is the discussion about patients and administrators washing their hands! Why put this all on the doctors?

RDr. Rick Lipin

This sounds more like a Seinfeld episoide than good science?
This obession with handwashing is beyong the pale anyway.
Because no matter how hard we wash, like Shakespeare’s Lady Macbeth, the stains of the sins of what we have done to US Health care will not go away.
Dr. Rick Lippin