Got Germs? Do Doctors Really Need to Wear White Coats/Stethoscopes in Public ?

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Mangalore: For nearly 200 years stethoscopes have been one of the most important diagnostic tools in the medical profession. The medical stethoscope has become so common a symbol of the medical profession that nothing else identifies a health- care professional more than a medical stethoscope draped around the neck. Medical stethoscopes are used to examine sounds generated from the interior of the body. They are used to listen to normal and abnormal respiratory, cardiac, pleural, arterial, venous, uterine, fetal, and intestinal sounds. With the assistance of a sphygmomanometer, they?re also used to monitor blood pressure. The qualities of the sounds produced can signify abnormalities of these organs.




Many diseases of the heart, lungs, stomach, and blood vessels can be recognized with the trained use of medical stethoscopes. Infection can spread from patient to patient, not only on hands, but also via fomites such as ventilators, computer keyboards, pagers, and stethoscopes. Antimicrobial stethoscope covers, including those impregnated with silver ions, do not decrease bacterial colonization; evidence suggests that their use may actually increase it. Studies indicate that rubbing alcohol pads on stethoscope diaphragms can reduce bacterial colonization, and it has been suggested that cleansing of stethoscopes daily may be as effective as more frequent cleaning. Unfortunately, many clinicians do not clean their stethoscopes on a regular basis. In addition, alcohol pads are not always available, and using them requires an extra step and produces waste.


But through this article I want to ask one question is that, “Is it really necessary for doctors to wear stethoscopes when they move around in the public?”. Some may say that through stethoscope public could identify that person as a doctor, so in case of someone needs medical attention, they can approach them. But if that’s the case, I have witnessed two incidents right here in the city, where these persons wearing stethoscopes had simply ignored victims who needed medical care.





Instance number one-few weeks ago near School Book Company, Car Street- a elderly lady fainted and needed some care immediately. I happened to be around that area-I saw two men draped with stethoscopes around their necks walking from School Book Company after their purchases, but even though the fallen lady was right in front of their eyes, they simply ignored her and didn’t even bothered to assist her. Instead the medic duo got on their motorbikes and drove away. It was the good Samaritans, “the public” who came to the rescue of this lady, and brought her back to consciousness.
 
At another instance-which happened right in front of the Wenlock Hospital gate – a man was knocked down by a moving auto-rickshaw and was suffering in pain. Crowd had gathered and were trying to help the fallen victim. At that moment I saw three doctors (I guess they were doctors, because two of them were wearing stethoscopes?) coming out from Taj Mahal restaurant  after their coffee break-but although they passed by this accident victim, none of these three doctors cared to enquire or offered any help medical care. But thanks to a good citizen who had called for a ambulance from a private hospital, which reached the spot and transported the accident  victim. So my question is, “Why wear a stethoscope, if you are not ready to help someone although being a medical professional?”.





I am not trying to be prejudice towards doctors, but I am talking sense. I am not blaming every doctors either – there are many doctors who don’t walk around in the public with their stethoscopes in their hands or draped around their necks- but still you will see quite a few in that habit, especially the young medics. To be frank, being in USA for the last 23 years I have never seen a medical professional in the public in their white coats or wearing a stethoscope – The only persons you see in white coats walking around in the malls or shopping areas are the employees who work in the cosmetic departments of mega stores like Carsons-Perie Scott, Lord and Taylor, Marshall’s Fields,etc etc. But look around in the city here-medical professionals, lab technicians, medical students and other hospital staff, simply walk to the fast food shacks/restaurants, go for a smoke and so on, and then they return back to their medical care duties or practical – just look at the germs that they carry back into the medical facilities through their white clothing or stethoscopes. Medical laws clearly states that uniforms, stethoscopes and other medical equipment should be kept inside the hospital room and never taken out or worn outside.
 
Admitted in the hospital for any health reason? Be cautious of not acquiring another health problem while trying to get rid of the one already suffering! With a number of patients, with different health problems, getting admitted for treatment in the hospitals and a number of health professionals using the same apparatus to check all the patients, hospitals are not totally a safe place.When a doctor places the stethoscope on your chest and at the same time carries a cell phone, chances of infectious microorganisms infecting the patient increases.




For those who are admitted in the hospital for over 48 hours, there is a risk of such hospital acquired infection ( HAI), which can be transmitted from mobiles or the stethoscope of health professionals, in particular. This was found out in a recent study published in the Indian journal of medical microbiology conducted at the Government Medical College and Hospital (GMCH) . It was found that mobiles and stethoscopes used by the health professionals had been the agents of transmitting resistant bacteria that cannot be treated by antibiotics.


These equipments at patients’ point of care have been found to be responsible for cross transmission. The study enrolled 80 health workers with stethoscopes and mobiles. 21 stethoscopes and 19 mobiles were found to be colonized ? a bacteria starting to reproduce, grows to form colonies. The mobiles were 9-25% contaminated with bacteria staphylococcus aureus. Though the stethoscopes had been known to transmit microorganism long ago, the mobiles have added to these infections, according to the study.




The microbiologists, who conducted the study, swabbed the surface of the diaphragm of the stethoscope and the mobiles with sterile cotton-tipped swab sticks. All the 40 stethoscopes and mobiles had the staphylococcus aureus bacteria and 50% of these were resistant strains. The study documented that these bacteria entered the mobiles and the stethoscopes through the hands of the health workers (physicians and nurses).  The authors of the study concluded that regular cleaning of the mobiles and stethoscopes is vital to prevent the transmission. Out of the 80 health care workers, 11 never cleaned the mobiles and stethoscopes.
 
Having learned through these vital sources, I myself have noticed quite a many times professionals in medical, PG medical students and others clad in their white coats or draped with stethoscopes around their necks or in their hands come to restaurants -sometimes they even place their coats or stethoscopes on the dining table or seats-and later they go back to their duties, could it be a testing room or surgery room or clinical, they carry germs/bacteria from outside. I think that’s not hygiene and safe for patients.
 
We have heard doctors preaching us to be clean, advise us to wash our hands always, to be hygiene etc etc, but it seems like what they preach, they themselves don’t practice. That’s sad! In conclusion, all I have to say is that doctors or any medical staff when they leave their hospital or clinic premises, they should leave their doctor’s coat/white coat/stethoscope back at their respective offices/clinic/examination or surgery rooms. Period. Sorry, if I have hurt any one’s feelings, but I couldn’t resist in writing this article in favor of all those who go for medical treatment or check-up.

Author: Alfie DSouza- Illinois


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