Assalaamu 'alaikum,
As does msaqibj, i too agree with brother abrar from personal experience. It is far better to let them know (in advance if possible) that due to religious principals it is not permissible for men and women (non-Mehram) to shake hands.
My job also often requires meeting clients, but Alhamdulilllaah, most of them are not female, although occasionally they have been. So i've either tried to inform them in advance of my religious principals, or at the meeting. The problem is, that if there are other colleagues or clients in the meeting, they may feel a little embarrassed, so you have to be as sincere and humble as possible while explaining to them. If you don't have much time, as is normally the case, it can just take a sentence, something like, "Forgive me, but i'm afraid i cannot shake a man's hand due to religious reasons." And they will appreciate your religious beliefs, as well as your honesty and openess Insha'allaah.
Also, when i started work with the company i'm currently employed with, i set out my religious morals, and to allow some of them to understand more clearly, i briefly explained to some of the guys here why i did not for example, shake hands with females, go to pubs/bars, needed to pray etc. Once i told them, they had a lot more respect for Islaam. I find it a lot more comforting now to see the women not thrusting their hands at me when introduced.
Kashmirigirl,
In your case i would say try and avoid male patients as much as you can. I do not mean ignore them, but if you have male colleagues, try and pass them over to your colleagues and take some of their female patients off of their hands. If you explain the situation, they will understand Insha'allaah.
You are absolutely right, intentions are a major factor. However, there are also other supporting characteristics that need to be backed up by intention. If time allows, I'll try and respond to your other thread on 'niath', Insha'Allaah.
kindest regards,
W'salaam
[This message has been edited by Hasnain (edited June 15, 1999).]