Patient Contact: Shake Hands, Hug, Fist Bump, or Just Smile?

Shelly Reese


May 20, 2014

In This Article

Is a Handshake Becoming Passé?

You walk into the exam room. You smile at your patient and then...

Hopefully, you extend your hand. While the patient greeting may seem like a relatively insignificant part of the jam-packed office visit, experts say it's a vital determinant of patient satisfaction. What's more, despite cultural differences and concerns about germs and infection, most patients say they want and expect their physician to shake their hand.

A Lesson in Etiquette

Greeting a patient -- either someone new to the practice or a long-time visitor -- shouldn't be complicated, but the fact is, sometimes it can seem that way. Harried schedules and electronic medical records can make interpersonal communication less than personal.

But studies show that patients expect their physicians to rise above such distractions and extend their hands. Gregory Makoul, PhD, Professor of Communications at the University of Connecticut School of Medicine, has interviewed hundreds of patients about their expectations. "We'd done loads of focus groups with patients to discuss what professionalism looks like to them, and as part of that, the topic of greetings comes up over and over," he says. "Even though it's a very mundane part of the encounter, you can't trivialize it."

In 2007, Makoul published a study in the Archives of Internal Medicine based on more than 400 patient interviews.[1] The vast majority of patients (78%) said they wanted the doctor to shake their hand when greeting them. While the handshake isn't a universal greeting and individuals from certain cultures may prefer not to shake hands, it's overwhelmingly preferred by patients in the United States.

Other studies involving diverse groups of patients, including a 2013 study in Military Medicine[2] of current and former military personnel and a 2009 study published in Clinical Pediatrics[3] (in which most of the respondents were African American mothers), echo Makoul's findings: Most patients want their doctors to shake their hands.

For the most part, Makoul says, physicians are pretty good about observing the practice, but harried schedules, distractions, and concerns about germ transmission can get in the way of good manners.


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