National Clothesline

Is there a drycleaner in the house?

That cry could be rising in hospitals and medical centers around the country following a piece of recently released research.

Most doctors, it seems, prefer to wear neckties as part of presenting a professional appearance. Problem is, those ties need to be cleaned.

An Israeli medical student working in a New York hospital noticed that one difference between American doctors and their counterparts in Israel is the wearing of neckties. He also noticed that physicians’ neckties often come into contact with patients or their bedding. And he observed a curious habit of doctors — they wash their hands and then adjust their ties. Whatever might be on those ties goes right on their hands.

So what might be on those ties? Steven Nurkin, the medical student, gathered up some colleagues and swabbed 42 neckties worn by physicians who regularly saw patients and 10 neckties worn by security personnel. They then dabbed the swabs onto laboratory plates and identified the microorganisms that grew.

Twenty of the clinicians’ neckties carried pathogens. The tie of only one security guard carried a single pathogen.

Nurkin presented his findings at the 104th general meeting of the American Society for Microbiology in New Orleans.

“The necktie is important for the doctor-patient relationship,” said Nurkin. “But it’s also there on the front lines — dangling in front of patients as the doctor makes his rounds.”

Nurkin is quick to point out that his study did not prove doctors’ neckties spread infection in hospitals, only that they carry this potential.

So what’s the prescription, doc? Recommendations range from wearing bow-ties, to using tie clips and even using a disposable condom-type wrapper. Nurkin, who seems to be no fan of ties, suggested simply abandoning the necktie “We also can imitate the doctors in Israel, who rarely wear neckties,” he said.

Will doctors alter their attire? “My prediction is there will be a number of physicians who will stop wearing ties based upon this. Older physicians will still wear ties,” Lawrence Brandt, MD, chief of gastroenterology at Montefiore Medical Center in Bronx, NY, told American Medical News. “If physicians drycleaned their ties frequently, that would probably help. But most people don’t do that.”

Dr. Brandt is one physician who believes professional attire inspires trust and projects competence. He studied 31 articles on physician attire and concluded in a June 9, 2003, Archives of Internal Medicine article that patients want their doctors to dress professionally.

Other physicians said the study provides a good lesson in cleanliness for physicians and medical students.

“The first- and second-year [medical student] white coats are clean and crisp. I’m not sure how often they dryclean them after that,” said Daniel Marazon, DO, associate professor of family medicine at Ohio University College of Osteopathic Medicine.

Not often enough, apparently.