Germs In The Doctor's Office? The Low-down On Healthcare-associated Infections

January 16, 2018 4 min read
Germs In The Doctor's Office? The Low-down On Healthcare-associated Infections

Unfortunately, it is possible to get sick from going to visit a doctor. This phenomenon is typically known as a healthcare-associated infection, and it's more common than you think. Here's what you need to know, and why it's challenging to combat.

In a recent post exploring overdiagnosis and overmedication , we asked whether it is possible that the things which were designed to help us feel better are actually making us feel worse? This article will continue with this theme, but instead of examining the state of medication it will examine the state of the waiting room, and other physical healthcare environments. Many people rush to the clinic and push their doctors to prescribe them medication. They feel that if they are sick they need to go to a GP's clinic and they must take medication to get better. That simply is not the case. Unfortunately, it's possible that this manner of dogged determination, the need to be given a tangible solution, can actually lead someone to become sicker. How is this possible? Waiting rooms, and even some examination and operating rooms, in hospitals and clinics are ripe with the potential to get you more sick – and they do so at a surprisingly high rate. This is a grave issue that is indeed taken very seriously by health agencies all around the world, including the World Health Organization (WHO), because it places an immense burden on healthcare systems. Medically speaking, the technical term for this predicament is "healthcare-associated infection" (HCAI). Other names include "nosocomial" or "hospital" infections. They are infections occurring in a patient during the process of care in a hospital or other healthcare facility which was not present or incubating at the time of admission. In other words, you go in for treatment and leave with an infection that you didn't go in with.

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The prevalence of these infections is much more rampant than most people expect, especially in developed countries where we all assume that healthcare facilities are sterilized bastions of cleanliness. Hundreds of millions of patients are affected by healthcare-associated infections each year, leading to significant mortality and financial losses for health systems. Dr. Tom Frieden, Director of the United States Center for Disease Control, pronounced  “new data show that far too many patients are getting infected with dangerous, drug-resistant bacteria in healthcare settings.” In fact, according to the WHO, of every 100 hospitalized patients at any given time, 7 in developed and 10 in developing countries will acquire at least one healthcare-associated infection. Surprisingly, Singapore's rate of  healthcare-associated infections is even worse than both the developed and developing country averages published by the World Health Organization. According to a 2017 study authored by over 20 doctors and academics from almost all of Singapore's hospitals and healthcare groups, approximately 12% of patients leave acute-care facilities with healthcare-associated infections. What is the significance of these healthcare-associated infections? The possibility of these infections is problematic for a few reasons:

  • It creates additional suffering and comes at a high cost for patients and their families;
  • Infections prolong hospital stays, create long-term disability, and increase resistance to antimicrobials
  • Represent a massive additional financial burden for health systems, generate high costs for patients and their families, and cause unnecessary deaths. It has been calculated that the financial losses as a result of this in Europe amount to 16 million extra days of hospital stay each year.

While waiting on improved institutional measures, takes steps to protect yourself.Despite the fact that HCAI is the most frequent adverse event in health care, its true global burden remains unknown. It is incredibly difficult to collect reliable data: most countries lack surveillance systems for HCAI, and those that do have them struggle with the complexity and the lack of uniformity of criteria for diagnosing it. Governments and health organizations around the world are working on ways to improve this situation and reduce patient risk. Nonetheless, it is an incredibly complex issue and substantial institutional progress still seems far away. You can take measures to protect yourself.
Next time you're feeling sick with something that doesn't seem too serious, consider whether rushing to the doctor's office is the best option. Perhaps it's appropriate to take a bit of time before going to see the doctor, with the hope that you'll get better on your own. Alternatively, as a good middle ground, you could use telemedicine services to speak to a doctor online from the comfort of your own home. If you're sick you might just need an MC to take some time to rest at home. 65% of all GP visits in Singapore are for acute, likely self-limiting (i.e. can recover on its own), conditions. Examples of such conditions include upper respiratory tract infections (flu, sore throat, cough etc.), diarrhoeal diseases, and sprains. This means that roughly 32,000 Singaporeans go to a GP every day for conditions that they don't need medical treatment for.  S ometimes the best medicine is no medicine. Just because something like an antibiotic is quick and easy, doesn't mean it's best for you in the long run. Sometimes it is, but you should see a doctor and let them decide (just try not to get sick while doing it!).


We're trying to make healthcare more accessible and convenient for everyone. In some places, like Singapore, this means making your primary care experience much more convenient. In other places, such as rural India, this means helping people see doctors for the first time in their lives. We think this is important stuff. We're always looking for ideas that could help more people. If you have any cool ideas, we'd love to hear from you! And when you're sick and need a doctor, remember that RingMD is here for you, wherever you are.