Thursday, May 26, 2011

New York's Dress Code Proposal for Doctors Doesn't Go Far Enough

From AMA Medical News:
New York physicians may have to take off their neckties, jewelry, wristwatches and long-sleeved white coats when caring for patients if a bill under consideration in the state legislature becomes law.

The bill, proposed in April in the state Senate, calls for a "hygienic dress code council" within the New York Health Dept. to consider advancing a ban on neckties and requiring physicians and other health professionals to adopt a "bare below the elbow" dress code in an effort to slash hospital-acquired infections.
Even though there's no data that this does anything to reduce hospital acquired infections.

But that doesn't matter.

So why stop there? I say, doctors should do the ultimate for their patients: the Full Monty.



Elaine Schattner said...

My thoughts exactly, Wes. You beat me to the post.

Tim Hulsey said...

This parallels what is already happening. There is no evidence of causality in the literature between flash sterilization and increased risk of post-operative, but hospitals are being forced by JCAHO to use flash sterilization only in an emergency. They recommend having enough instruments to replace rather than re-sterilize a contaminated instrument. Mind you, this is not cost effective, but was proposed because there were "concerns" that flash sterilization "might" lead to increased infection rates. In all the talk about decreasing the cost of medical care, we are being asked to use cost-ineffective measures based on NO DATA!! What are we going to do when the government/quasi-government tries to make us do less than what we think is necessary for patients? Oh, wait! They already do! Can you say "inaccurate Best Practices!"

Anonymous said...

I actually use my watch in patient care at times to check pulses. There is not a clock with a second hand in every room in the hospital or clinic.


DrWes said...


Wait. Wait!

You mean you do a physical examination when you see a patient?

Praise the Lord!

Tim Hulsey, MD said...

A physical examination where you actually touch a patient?!! Is that allowed? That might spread infection!

Ian said...

If you want minimize the risk of my spreading infections to hospital patients, devise a new payment system that does not require me to examine and touch every patient every day (with the same stethoscope). Under the current E&M coding, a physical exam is a necessary component of any patient encounter.

I know this strikes a nerve with many physicians, but a daily exam in the hospital does not really add anything to the care of many patients. If you're admitted for atrial fib and on telemetry, I don't need to listen to your heart to know it's irregular, etc... Just like any other diagnostic test, allow me to use my clinical discretion about when to perform an exam.

I suspect this move would cut back on hospital aquired infections far more then any dress code

Tim said...

"... allow me to use my clinical discretion about when to perform an exam."
Ian, clinical discretion is so... 70's! Is there a CPT code for using your judgment? Does JCAHO even allow that!