Physicians Attire Can Contribute to the Unintentional Spread of Bacteria

by Joseph Esherick, M.D., FAAFP, FHM

Physicians and healthcare workers have long known that certain articles of clothing can act as fomites with the potential of spreading infection.  The best studied articles of clothing and equipment that can contribute to this spread include neckties, scarfs, stethoscopes, white coats, bracelets, watches, necklaces, lanyards, and now electronic devices like mobile phones. 

To minimize the spread of infection there are some over-riding principles that we can follow:

1.  Good handwashing between patients

2.  Disinfect your stethoscope between patients using alcohol

3.  Minimize wearing neckties, scarfs, and lanyards or at least tuck these into your clothes when examining a patient.

4.  Frequent washing of white coats in hot water and dry heat

5.  Disinfect your mobile phones frequently

6.  "Bare below the elbows" strategy encouraging short sleave shirts and no watches or bracelets on rounds

These are the best ways to avoid colonization of these items on your person; however, clinicians are often torn by the desire to dress professionally since many patient surveys have concluded that patients tend to respect and trust the advice of physicians who look more "professional" compared to those who do not wear as formal attire. 

Regardless, please try and follow as many of the principles above and be aware of the items that you wear which can carry pathogens between patients.

Doctor stethoscopes and white coats can transmit infection