Background

As a practicing physician I enjoy greeting my patients each day by bumping our elbows at the start of each clinical visit. This is a replacement for shaking hands and is accompanied by me reciting the phrase: “Do the NibTM”. This phrase is a shortened version of the longer phrase “do the non-infectious bump”.

The NIBTM is a very personal, yet fun way to inject both humor and safety into our time together.

Something very special happens during almost every elbow bump: the patients laugh or giggle, then they say in a very logical tone: “Oh I get it, you are trying to minimize contamination with me”. Indeed I am thinking exactly that. Patients are appreciative of these efforts.

If a doctor were to shake hands with a patient without washing his or her hands and without using gloves, the doctor would become a disease vector: a source of bacteria or virus spread between people which then could cause disease. Given that you go to the doctor’s office to help cure a disease, such a situation would potentially introduce a new pathogen into your present situation. Clearly this is the antithesis of your desired outcome

In the non-clinical everyday world we often shake hands with other people, rarely stopping to wash our hands or sanitize them. In fact, even though people may be concerned with the spread of pathogens through hand contact, most people will shake regardless of hygiene. For example: almost no one will stop to wash their hands before shaking hands with another person. Neither hand sanitizer nor water from a sink is readily available, especially during a chance meeting.

How then can we promote ways for all people to minimize pathogen contamination during the course of a normal day?