Medical provider used same tool in my ears and nostrils

November 21, 2014 3:15 AM

I had a physical exam yesterday during which an assistant (not the doctor, but I'm unsure of this person's credentials) stuck a tool inside my ears to look around (the tool very solidly contacted my ear canal), and then immediately after without sanitizing it or using a different tip, placed the tool in each of my nostrils (and again, the tool touched the inside of my nostrils).

Is this in fact an accepted practice? Is this something worth complaining about? I feel grossed out and disrespected. It seems to me as though this is a clear vector for cross-contamination if in fact someone has some sort of infection in their ears (not that I believe I have that).

posted by mysterious_stranger to Health & Fitness (14 answers total)

Your inner ear and nasal cavity are directly connected, so maybe cross-contamination isn't an issue.
posted by stinkfoot at 3:39 AM on November 21, 2014 [15 favorites]

This is how it goes every time I've gone to the doctor's for a physical. Never occurred to me that there would be a problem - if you have an infection in your ear, then you have an infection, period. You can't re-get the same infection.
posted by chainsofreedom at 3:44 AM on November 21, 2014 [7 favorites]

What they said. Not really gross, and certainly not disrespectful.
posted by schroedingersgirl at 3:50 AM on November 21, 2014 [4 favorites]

There's a reason there are ear-nose-throat doctors; they're all part of the same system. I would expect that they always go ear then nose, because your nose is more likely to be infected than your ears, but this is standard operating procedure.
posted by sonic meat machine at 4:31 AM on November 21, 2014

I'm willing to bet that there is an endless number of everyday activities that are less hygienic than this. For example: you go to the toilet, do your thing, wipe it, and: do you wash your hands before flushing? No, you don't. So what's your toilet's flush button like? Or your belt buckle, button, or zipper for that matter. When was the last time you cleaned the keys on your keyboard?

Purity and dirtiness are not based on objective calculations of actual chances of contamination for most people, its basically random hunches. Your doctor is probably justified in not caring about cross-contamination.
posted by Pyrogenesis at 4:31 AM on November 21, 2014 [7 favorites]

Your inner ear and nasal cavity are directly connected

Not sure whether there's an issue with the practice described in the question (I'm also leaning towards no), but this isn't entirely accurate. The Eustachian tube connects the back of the nose and the middle ear, which is separated from both the outer ear (into which the tool was inserted first) and the inner ear by membranes.
posted by wachhundfisch at 4:37 AM on November 21, 2014 [3 favorites]

Just confirming that this seems totally standard to me, too.
posted by mercredi at 4:56 AM on November 21, 2014

I suppose this question is less about actual cleanliness (see above, toilet flush button) and more about the appropriateness of given actions in a professional medical setting. As such, I would perhaps be curious about what kind of thinking and routine planning is behind the action of using the same tool for examining two distinct body openings. So, I'd ask. If said action for any reason grosses me out, I'd also inform the doctor, or assistant, that this is in fact happening. Informing them might make a difference for future patients who share your feelings.

But no, it is not worth complaining about!
posted by Namlit at 5:01 AM on November 21, 2014

I guess that if I had a question about it, I wouldn't hesitate to ask the person who was doing this. What prevented you from asking, "Whoa! I'm uncomfortable with that instrument going between two orafices. Please change the tip."

At that point the practitioner can say, "This is accepted medical practice, but if you're not comfortable, I'll be happy to make that change for you."

Never be afraid to speak up, ask questions or to question your medical providers. It might save your life.
posted by Ruthless Bunny at 5:10 AM on November 21, 2014 [3 favorites]

Funny timing: I'm a medical student in the US and we just covered ear and nose exams this past Wednesday, and this very topic came up. My preceptor (an MD) said that this is standard practice and does not constitute a cross-contamination risk.
posted by lizzicide at 5:20 AM on November 21, 2014 [39 favorites]

Yep, this is how it's typically done. Saves the smallest bit of plastic...
posted by gemutlichkeit at 6:52 AM on November 21, 2014

For what it's worth (and I'm aware of how nonsensical it is), I'm fine with my finger moving ear to nose, but going nose to ear would seem dirty.

I've also had the same thing happen at the doctor's office and didn't think anything of it.
posted by Dip Flash at 7:05 AM on November 21, 2014

Response by poster: I've never once had this happen in a medical exam before, so I am shocked to hear it's standard practice.

There was no time to stop it from happening at the time, before I realize what she was doing it was too late.

I continue to think this is disturbing, but I see that it's common/accepted. Thanks.
posted by mysterious_stranger at 11:08 AM on November 21, 2014

Yes, I'm a doctor, I do it every day. I only change out the speculum if it actually gets something on it visibly, like wax. I believe I learned here on AskMe about people's preference for going ear to nose rather than the other way around, so I try to remember to do it that way. I had never thought twice about it before - since people are constantly touching every part of their face with their fingers without washing their hands, and that's where infections generally come from (the bacteria and germs they've picked up from touching other people's hands and things that other people have touched) - the specula are clean and disposed of after using with a single patient. What you should really worry about is giving yourself an infection by touching other stuff in the doctor's waiting room and exam room that has been touched by other sick people, or whether your doctor has washed their hands/used sanitizer on entering the room.
posted by treehorn+bunny at 1:14 PM on November 21, 2014 [5 favorites]