The handshake represents a deeply established social custom. In recent years, however, there has been increasing recognition of the importance of hands as vectors for infection, leading to formal recommendations and policies regarding hand hygiene in hospitals and other health care facilities.¹ Such programs have been limited by variable compliance and efficacy.^1,2 In an attempt to avoid contracting or spreading infection, many individuals have made their own efforts to avoid shaking hands in various settings but, in doing so, may face social, political, and even financial risks.

Particularly in the current era of health care reform, innovative, practical, and fiscally prudent approaches toward the prevention of disease will assume increasingly important roles. Regulations to restrict the handshake from the health care setting, in conjunction with more robust hand hygiene programs, may help limit the spread of disease and thus could potentially decrease the clinical and economic burden associated with hospital-acquired infections and antimicrobial resistance. Effective development and implementation of such a handshake ban will likely require further study to confirm and describe the link between handshakes and the transmission of pathogens and disease; the promotion of an alternative, health-conscious gesture to substitute for the handshake; and widespread media and educational programs.