Researchers have asked doctors to give up shaking patient's hands, saying the practice may be dangerous and akin to smoking in public.
Regulations to restrict handshakes in the health care setting, along with more robust hand hygiene programmes, may help limit the spread of disease, researchers said.
Mark Sklansky from the University of California in Los Angeles, and colleagues acknowledge that the handshake has a profound cultural role and holds interpersonal significance, as well as commercial importance.
While providers' handshakes with patients can be perceived as signs of compassion, they can also spread germs.
"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," research authors wrote in the The Journal of the American Medical Association (JAMA).
The authors propose that lessons from smoking bans should be applied to handshakes. Given that warnings of smoking's harms and subsequent bans were able to cut a deeply entrenched habit, the same may be possible with handshakes.
"Handshake-free zones" should be established along with educational programmes and signage. A replacement gesture may need to be adopted also.
Removing the handshake from the health care setting may ultimately become recognised as an important way to protect the health of patients and caregivers, researchers said.
"Although the mortality associated with smoking has been found to be substantially greater than that associated with hospital-acquired infections, some parallels may be drawn between the proposal to remove the handshake from the health care setting and previous efforts to ban smoking from public places," the authors wrote.
The research was published in the Journal of the American Medical Association.