circumventions replied to your post: Bad and Worse: Don't Give Me a Hand
why would a doctor ever shake a patient’s hand unless he knows him personally?
Depends on the culture of the area where you practice. Where I work and live, people are very friendly and hand-shaking during the doctor-patient introduction is common-place. I walk in, I say, "Hi, my name is Dr. Cranquis", I shake their hand, and then I immediately use hand sanitizer as we start to talk. I've done some doctor-shadowing in the Southern US, where pretty much any female patient older than 65 would insist on hugging the doctor at the end of a visit (nasty white-coat-germs and all).
That being said, with a patient whose Chief Complaint is "Rash" or "Fever" or "Personal" (or with ANY patient during flu season) I don't offer my hand. This patient snuck in under my radar by coming in with a CC of "Not sleeping well" -- he wasn't sleeping well BECAUSE HIS GROIN ITCHED. *shudder*
(I'd love to convince the world to drop the hand-shaking convention, actually, and switch to something less contagion-friendly -- like, say, the toe touch. Hmm, or maybe we need a universal gang-sign that means "Nice to meet you"...?)