26 Comments

The solution, then, is to not permit them to wear any clothes. Unless they’re ugly.

Bob

Nosocomial infections are a VERY big, but inadequately addressed problem: http://www.nypost.com/p/news/opinion/opedcolumnists/needless_deadly_peril_at_us_hospitals_zxuU5g9fxg4zHSnvo9coSK

Bacteria transmitted from hospital surfaces to physicians’ neckties and then to the patients are a small part of the problem; ties are a vector of bacteria from a more fundamental source. But legislating solutions in a piecemeal fashion will not solve anything. Rather a comprehensive infection control scheme whereby ALL surfaces in the hospitals are bleached down every day combined with mandatory hand washing, completely disinfecting patients’ rooms before a new patient arrival (not just changing the linens and washing the floor) combined with other anti-bacterial measures, and yes prohibiting neckties, WILL solve the problem.
The unwillingness of the CDC, state health departments, hospital administrations, The Joint Commission, etc. to do anything about the root cause of hospital borne infections is shocking. Rather the “solution” seems to be to simply implement reporting requirements and statistics gathering for nosocomial infections. Also Medicare announced that they will not pay a hospital for infections contracted in their facility, but hospital administrators cannot seem to connect the dots and root out the cause or why they are not getting paid.

Paying for cleaning personnel and a bucket of bleach seems to me to be a much more cost effective solution than the additional medical care, misery, death and lawsuits precipitated by otherwise preventable infections.

By the way, people tend to disregard what they cannot see, and we cannot see bacteria. I’m sure that Walter or any one of us do not have any problems with the OSHA regulation that prohibits neckties in a machine shop because it is obvious that someone can be easily maimed or killed should the tie inadvertently get snagged by the spindle of a lathe or milling machine. Tie–lathe–connect the dots–aha–dangerous! On the other hand, tie–patient dying–????????????????–duh, stupid law!

One last note. If you think that only the old, very sick and hence weakened patients get nosocomial infections, you are very wrong. Women delivering babies have been infected with MRSA, minor elective surgeries are routinely compromised by infections with hospital borne bacteria, and hospital visitors have brought home illnesses such as c. difficile among many others. The general public, even the thinking general public, knows nothing of the dangers lurking behind the hospital doors.

I read about a hospital somewhere (my memory fails me) that drastically cut back on nosocomial infection by not only banning neckties, but mandating that the medical staff be bare from the elbow down.

Sounds silly, but it’s probably the right solution. Nobody denies the ties are infectious, but cultural / habitual barriers prevent many of them from actually doing some about it. Might as well pass a law to make it happen.

In the UK (where incidentally we have a civilised state run health care service) it is now standard practice to ban ties and insist on bare arms. Even politicians visiting hospitals are required to take their ties off and roll their sleeves up.

Why not just mandate they wear haz-mat suits?

Are the people who are upset with this saying they have reviewed the infection literature and say they don’t believe not wearing a bow-tie will help save someone’s life? Or is it that even if it does save someone’s life, the doctor’s rights/civil liberties/whatever are more important than saving that life? Or is it just that it sounds dumb so it must be dumb?

I can’t figure out what the argument is. Someone explain.

Sooo…does this mean the “cough into your sleeve” mandate is now out the window? I wish doctors would make up their minds.

This has been known in the medical profession for over a decade. Like the rest of us, doctors seldom (if ever) wash their ties. In consequence, the ties are a breeding ground for infections. The law makes sense, though one would hope the medical profession could regulate this behavior without having to get the New York State Legislature involved.

I smell a market for autoclavable/irradiable ties.

It shouldn’t be the responsibility of legislatures at the State or National level to try and fix all of societies ills.

This is overreaching by the Legislature to institute a dress code for doctors.

Not their business

I work in a hospital. I’ve heard that the issued white coat that we all can be a infectious disease hazard considering it’s not washed everyday. As a result your everyday clothes are cleaner than the white coat. Obviously I don’t wash my ties after a single use.

Maybe they could ban white coats. That would deny the hospital their marketing opportunity.

Just in. In Albany, NY, the New York Medical Association overwhelmingly adopted a regulation requiring that all members of the NY General Assembly attend a Neck Tie Party.

Are the legies of New York and California having a contest to see who can come up with the dumbest laws.

News Flash!

The hair on the arms (and head and face if you have facial hair) is a primo breeding ground for bacteria, and unlike the mostly inert contents of the tie (I say mostly because men do sometimes let fall the contents of their eating utensils upon themselves which means mostly their wearing apparel since it is never wise to eat hot soup in the buff). So unless you strip ’em and shave ’em and cap ‘n gown ’em, it’s all for naught.

And if they do strip the doctor’s of their ties, no doubt the same said will unbutton their collars, exposing the infirm to an even worse carnage…chest hair. Oh the humanity.

And lastly whatever the doctors do bring in on their ties is chump change bug-wise compared to the people who see the patients for longer periods of the day, like nurses, orderlies, and the nastiest of all, friends and family.

My PCP wears a bow-tie, looks pretty snazzy in it too.

But you must haul food, medical supplies, and such, in reused reusable bags.

What is up with that?

And, btw I don’t remember the last time I saw my doctor (Carol […] wear a necktie. And most of the men wear scrubs, or laundered jackets or coats,

Sounds silly, but so is a lot of science to the naive.

Ban the neckties. It is a proven public health issue.

“is it just that it sounds dumb so it must be dumb?I can’t figure out what the argument is. ”

That kinda sums up this blog for me. I’ve been reading this blog or a while and struggle to come up with the central thesis here. It appears founded on the premise that there are too many lawyers and too many frivolous lawsuits. OK, fine. Yet most of the posts are themed on “here’s some law or government intervention that looks absurd”. Yet there is no sense of what a reasonable solution is. Civil remedies as opposed to regulation? Well, no, that leads to lawsuits. Better regulation? Well, no, governments are stupid and regulation leads to absurd outcomes — every instance of an absurdity or unintended outcome seems to be a tacit argument for abandoning the regulation entirely rather than reform or attempting to get legislators to craft regulation better. No regulation at all and limited means of civil redress? Really?

Ron, think of it more as entertainment. It’s just fun to sputter “stupid law! stupid government!” at the sharkbait that’s thrown out without having to think too hard. It’s basically the legal equivalent of failblog.

“…people tend to disregard what they cannot see, and we cannot see bacteria.”

Interesting to see this comment. Why, then do people go crazy about “deadly radiation”, which also cannot be seen or touched, or smelled, etc.?

The real solution to this problem is to prevent people with infections from coming into hospitals.

Of all the comments, mandating the development of infection standards and remedial measures makes the most sense. Hospitals are hotbeds of infection.

I’m a great fan of those hand sanitizing stations they all installed during the supposed flu pandemic. I always sanitize my hands on the way out. Perhaps I should go through the decon shower.

Sadly Mannie, the over use of hand sanitizers is part of the problem. Bacteria and viruses are everywhere, literally, the little critters that are not killed by the sanitizer will grow resistant to it and will go forth and multiply. And their children will take that resistance with them. The same goes for antibiotics. In America the so-called super bugs are resistant to almost all, if not all, known antibiotics. They get resistant faster than we can develop new drugs.

Myron, you are correct that most of us here don’t have all the answers, but I can assure you that neither do the politicians and bureaucrats either. And in most cases, we as a country and civilization would indeed be better off if they did nothing rather that stifle us and smother us with senseless and useless laws and regulations.

Norway has a plan. They don’t allow the use of the super drugs except for very special occasions. They do not have a super bug problem.

Children who are allowed to play in that great Petri dish of outdoors show fewer, if not none, of the allergies and susceptibilities of infection because their bodies created their own antibodies, as we were programed many eons ago to do. Yes what doesn’t kill you will make you stronger.

To the rest of you, I suggest you reread my initial comment, disregarding the bad attempt at humor and sarcasm. This is a “feel-good” law. It will do little if any to solve the problem, but some politician will demand re-election on the basis of saving you at the hospital.

“as a country and civilization would indeed be better off if they did nothing rather that stifle us and smother us with senseless and useless laws and regulations.”

It is this type of extreme black or white thinking that is naive to the point of being dangerous. I don’t think you have any idea of the laws that currently work well that protect you. Do they work perfectly? No. But I’d sure as shit prefer to have an FDA, for example, regulating food and drug safety, than nothing at all.

rxc said: “The real solution to this problem is to prevent people with infections from coming into hospitals.”

He is close to right. The real solution to this problem is to prevent people from coming into hospitals. Then people wouldn’t catch infections in hospitals.

BTW, let’s ban ties completely. (Where’s a smiley face when you really need one?)

“It is this type of extreme black and white thinking that is naive to the point of being dangerous.”

This is right. To the man with a hammer, everything is a nail. Let’s just say, for the sake of argument, that we have too many laws and we are overly regulated. I’m sure there is some truth to that contention. So from this, we conclude that every new law must be bad.

The only good thing about this rule is that it required no thinking. New law/regulation = bad.

But I’d sure as shit prefer to have an FDA, for example, regulating food and drug safety, than nothing at all.

Right. Because we have seen how the FDA has approved products and that approval has protected companies from lawsuits for producing a legal product.

We have seen how the FDA doesn’t protect the food supply, and often serves to protect large companies while stepping on the smaller or even medium sized producer.

The fact of the matter is that despite your and Ron’s contention, this is not a “black and white” issue. All people want is reasonable regulations that actually protect people rather than do harm.

You would rather have laws that don’t protect perfectly. I would rather address those laws and find out why they do not work. Once that is achieved, you fix the laws. Instead, the “black and white” thinkers say that “if a regulation doesn’t work, we need more regulations that don’t work!”

There is nothing wrong with questioning the effectiveness of a law or regulation before and after its implementation.

Otherwise, you are in love with regulations, and don’t care about their actual costs and effectiveness.