“The single most important thing a patient can do is ask everyone who is going to be treating you to clean their hands,” says Betsy McCaughey, founder of the Committee to Reduce Infection Deaths. “Ask that they do it in front of you. Don’t be misled by gloves; gloves are no assurance at all.”

Many moms and dads dread visiting a pediatric waiting room full of sneezing kids in the height of flu season and try to keep their toddlers away from much-handled community toys.

“Bring along a children’s book,” McCaughey suggests. “Bring an alcohol-based (waterless) hand cleanser, too. Don’t worry about looking obsessed — other parents will catch on.”

She advises parents to be especially careful if a child has a scraped knee or another gateway for infection. “If your kid has a wound — keep him or her on your lap and cover the wound; have them wear long pants.”

Chrissy Boylan is the Fairfax, Va., mother of a five-year-old, a three-year-old and an infant. She visits the pediatrician frequently, and says, “You do figure out that you only want to bring them in when they’re really sick.”

Her pediatrician’s office has “sick” and “well” waiting rooms, but Boylan says, “I wonder if they’re using different examining rooms, too. I feel like the [dual waiting rooms] are more to make parents feel better.”

Dual waiting rooms don’t work, says Dr. Steven Hirsch, a pediatrician in solo practice in Rockville, Md.

“Ideally, though you would want to separate out children with contagious infections such as a common cold or stomach virus from those who are not contagious, it’s too difficult to figure out,” Hirsch says. “A lot of children there for well visits actually have contagious viruses — or their siblings do.”

Sneezing and coughing aren’t the biggest problem, Hirsch says: “The flu virus is not spread by aerosolized particles floating in the air. Transmission usually occurs when you come in direct contact with a droplet.”

This can happen when a sick person touches his or her eyes, nose, or mouth then touches an inanimate object such as a doorknob or elevator button. That living germ gets transferred to the inanimate object. If you touch the same object soon afterward, then touch your child’s eyes, nose or mouth, that virus gets transmitted into her body, Hirsch says.

So instead of shared toys, Hirsch’s staff provides individual buckets of toys for each child to play with during their visit. At day’s end, staff members wipe down the toys and let them dry overnight, long enough for most germs to die.

Hirsch says that fresh, unwrinkled paper on the examining table is a tangible proof of a sanitary space: “You rip the used paper off after each patient and people see the clean, crisp paper and are reassured that the office is clean.”

But that’s not good enough, he adds. “After every patient, it only takes a short period of time with an antibacterial wipe for me, or a staff member, to clean the examining table, door knobs, chair railings and counter tops — anything that’s been touched.”

Marian Sonnenfeld, M.D., former chief of mammography at Brigham and Women’s Hospital in Boston, says a woman can ask the technologist if the equipment is wiped down between patients, for mammograms and other X-ray procedures.

Her own medical issues have forced Sonnenfeld to step back from her role as a clinician and view infection prevention from the patient’s perspective.

She recalls going to a physical therapy office where they “changed the sheet on the treatment table but not the pillowcase on the pillow. I did most definitely say something about that. They said something along the lines of changing the pillowcases every morning, which of course was totally insufficient.”

But she also describes a gastroenterology practice that supplies tissues, hand gel and masks in the waiting room, and posts signs urging people — whether vulnerable patients or visitors with contagious illnesses — to use them.

Chrissy Boylan doesn’t believe in being alarmist: “It’s hard enough dragging kids to the doctor’s office; I don’t want them to feel like they can’t touch anything.” And yes, she lets them read those shared books in the waiting room.

“My general take is that as a parent you should take precautions, but I believe in my children building up their immune systems,” by not being too fearful of germs. “I like parents that kind of chill out,” Boylan adds.

According to the Web site of the American Academy of Pediatrics, “The risk of developing infection after an outpatient clinic or office visit has been evaluated. In all instances, children who visited physicians’ offices had better outcomes than children who did not receive regular care.”

While it’s worth insisting on health care cleanliness, it can feel awkward.

“Absolutely, it is hard to assert yourself and to speak up,” acknowledges Bradford Jordan, director of development for McCaughey’s committee. “But as long as doctors, hospitals and administrators are not taking it on, it’s our only line of defense.”

Sonnenfeld says it’s possible to be respectful of the practitioner while “making sure one’s own needs are addressed and met. A patient might say, ‘I know you’ve had a lot of sick patients here today and just for my own comfort, I’d like to confirm that you’ve washed your hands between the other patients and me.’”

Source: HBNS