During a recent emergency department shift, an emergency medicine resident at Northwestern describes caring for a woman facing a suspected oncologic emergency. On entering the room, the clinician introduced themself and offered a handshake to the patient and family. That simple gesture seemed to ease tension, prompt a smile, and create a brief human connection before diagnostic results and medical decisions were discussed.
The handshake did not alter the clinical course or the patient’s test results, but it appeared to remind both parties that the interaction involved a person experiencing a frightening moment rather than only a medical problem.
The opening seconds or minutes of a patient encounter influence everything that follows. Before clinicians take a history, perform an exam, or explain plans, patients are already forming judgments about whether they trust the care team and feel comfortable sharing intimate or sensitive information. In settings such as emergency medicine, where clinicians must rapidly ask about substance use, sexual history, violence, psychiatric symptoms, housing insecurity, or severe pain, the need to build trust quickly is particularly acute.
A small gesture like a handshake can contribute to establishing the conditions for productive clinical work: it signals acknowledgment and may make patients more willing to engage with the team and comply with examinations or care recommendations.
Research suggests many patients desire the traditional handshake from their clinicians. A JAMA Internal Medicine study surveyed 415 adults about physician greetings; more than 78% indicated they wanted their physician to shake their hand. The investigators also analyzed recordings of 123 outpatient visits and concluded that physicians should be encouraged to shake hands while remaining attentive to nonverbal cues indicating a patient’s comfort or discomfort.
These data support the idea that offering a handshake can align with patient preferences, provided clinicians remain sensitive to individual responses.
Other modest adjustments also appear to influence the quality of interactions without adding time. A 2023 study found that placing a chair near the bedside increased the likelihood that clinicians would sit during patient encounters and that doing so improved patient satisfaction and communication scores without increasing the visit length. Such findings illustrate that small, deliberate choices in clinician behavior and the care environment can meaningfully affect patient experience and rapport.
A handshake alone will not produce a deep therapeutic relationship, but it can be one component of a set of practices that foster trust and better communication.
Several systemic and operational pressures have contributed to the decline of handshake use. Clinicians face demands from the electronic medical record, increasing patient volumes, frequent interruptions, and pressure to make rapid decisions. In the emergency department these pressures are especially evident: clinicians often manage multiple critically ill patients while alarms intermittently sound and teams continuously cycle through the room.
Under such circumstances, encounters can begin with eyes on a computer rather than on the person in front of the clinician. Patients may be asked to repeat their story to multiple team members without clarity about who is accountable for their care. These dynamics permit accurate diagnosis and correct treatment while still leaving patients feeling unseen and disoriented.
The Covid-19 pandemic introduced additional barriers to physical contact. Physical distancing, personal protective equipment, and concerns about transmission led to widespread reductions in handshakes in hospitals and clinics. In many places, the handshake never fully returned.
There are valid infection-control considerations: hands can transmit pathogens. The piece argues that the appropriate response is not indiscriminate elimination of human contact, but rather consistent hand hygiene and sound clinical judgment. Clinicians should sanitize their hands before and after patient contact regardless of whether that contact involves a handshake, a physical exam, or a procedure.
The article notes clear circumstances in which a handshake is inappropriate: when isolation precautions apply, when a patient is significantly immunocompromised, or when either party may have a transmissible illness.
Not every patient will want a handshake. Cultural or religious traditions, physical limitations, pain, and personal boundaries can make hand contact unwelcome. Clinicians must avoid forcing a handshake or assuming it will be accepted.
Alternatives can communicate respect and deliberate human connection: a warm verbal greeting, placing a hand over one’s own chest, or another culturally appropriate gesture may serve the same purpose. The central aim is not the handshake itself but the intentional act of human acknowledgment that supports trust and communication.
The responsibility to create a humane patient experience extends beyond physicians to all members of the care team. Every introduction by nurses, technicians, and other staff is an opportunity to make an unfamiliar environment feel less impersonal.
As medicine becomes more technologically advanced—with artificial intelligence, remote monitoring, and sophisticated diagnostics—clinicians and teams must be intentional about preserving human elements of care. Small interpersonal practices that acknowledge patients as people help maintain the therapeutic relationship even amid rapid technical change.
The author, an emergency medicine resident, uses a single clinical vignette and selected research to argue that clinicians should reconsider the handshake as one deliberate way to foster trust quickly. The recommendation is pragmatic rather than absolute: employ handshakes when appropriate, practice hand hygiene, use clinical judgment about infection risk, and respect patient preferences and cultural context.
Ultimately, the article calls for intentional acts of human connection across the care team as medicine grows more technologically complex, emphasizing that small gestures can meaningfully affect how patients experience care.