About 100,000 people die each year in US hospitals from infections that they get while they are in the hospital. Less than half that many die on US highways. The hospital deaths are due to poor housekeeping and poor hygiene. Floors, walls, and doors are not cleaned regularly or thoroughly. Room dividers are almost never cleaned. The carts that carry food trays, and the trays themselves, are usually contaminated from handling and coughing. Cooks and other food handlers can easily infect the food by not washing properly after using the bathroom.

Doctors and nurses are just as guilty as other staff. Doctors rarely clean their stethoscopes after each patient. Nurses apply blood pressure cuffs to patient after patient without cleaning the cuffs. Doctors often put on gloves without washing their hands first. As a result, the germs on their hands are transferred to the outside of the gloves.

Consumer groups warn patients that they must demand cleanliness. If they see or suspect unsanitary conditions, they must tell someone immediately. It could be a matter of life or death. But, as one patient said, "No way! You don't tell your boss that he has bad breath, and you don't tell your doctor that he needs to wash his hands."