• Open Access

Impact of Swine Flu education on coughing in the doctor's face during examination


Correspondence to: Dr Tim Metcalf, Tennant Creek Hospital, Schmidt Street, Tennant Creek, NT 0860; e-mail: Timothy.Metcalf@nt.gov.au

In 2009–10, I was collecting simple data to test a personal prejudice I had developed: that the younger generation is ruder than the older. I was unsure whether I was simply a grumpy old man. As I was doing this, the swine flu epidemic occurred and was accompanied by extensive public information, so that my data inadvertently allowed me to investigate the impact of this education on a rural workforce in the food industry.

I believed that over the past four years I had seen a deterioration in basic respect towards myself and in basic politeness and hygiene when examining new workers for inguinal hernia. It seemed that rather than covering their mouths or turning their heads away, more and more were coughing in my face when I asked them to cough during the medical examination.

The findings may have implications for the management of interpersonal respect, infectious disease epidemiology and occupational safety.

The data concerns 147 medicals on basically healthy Australians. Calculation of the overall statistical significance1 of the findings indicated no change in behaviour across the whole group before or after the flu pandemic. However, workers under 30 showed a definite improvement in hygiene behaviour. Though this was not evident in the older age groups, there were not really enough people to collect sufficient data to withstand analysis.

Overall, well over half the workers coughed without concern in the doctor's facial direction during this part of the medical. The younger group were indeed the worst offenders initially, but also showed the best response presumably to the public health campaign.

The study has led to me changing my method of performing medicals, and has happily improved my attitude to the younger generation.