Why Do People Follow Medical Authorities? - Page 2

[pek64]

Originally Posted by WildKingdom 

We had classes during second year during the child development section. I remember that part of that was having a bunch of bteastfeeding moms come in to discuss their experiences with us. Dr. Lawrence did a lot of teaching on the physiology of breastfeeding. Of course, in pharmacology we had to know all about the safety pf meds for lactation. Then we had additional training while doing our peds rotation and OB/GYN rotations. We had to shadow the lactation consultants for a day. I don't remember exact hours, if that's what you're asking. It was years ago. Most of the learning is on the job during rotations and residency, so it's hard to parse it into hours.
I mean, there wasn't a course called "Breastfeeding 101". That's not how med school works. All the learning is on a continuum. It's like how people say that doctors don't learn about vaccines during school because they look at the curriculum and don't see a course about vaccines. In reality, we learn about them in microbiology, immunology, pathophysiology , pharmacology.
Sorry for typos. On phone, typing with carpal tunnel syndrome. Bad combo.

Thanks for responding. Sorry about your carpal tunnel.

It's hard to say for sure, but it seems like a lactation consultant would have more training than an OB or ped. And understandably so. But that's true, I'd rather get my breastfeeding advice from a lactation consultant than a pediatrician. But well baby checkups don't include discussing breastfeeding with a lactation consultant. They are not paid for out of all insurance (at least when my son was an infant).

Getting back on topic, my point is, how can I value medical opinions when getting those opinions from the experts I am inclined to trust are not part of the current medical establishment?

[Rrrrrachel]

Originally Posted by kathymuggle 

I am not being snarky - but I do not see the difference.

If people are advocating we should trust doctors and take their advice, that is a nice way of saying we should just do as they say.  

Wow. I'm not sure what to say to that.

[kathymuggle]

Doesn't take their advice=do as they say? 

If not, we may disagree on what is meant by "take their advice."  

[Rrrrrachel]

If you give someone advice, is that the same as giving them a command?

[chickabiddy]

Take their advice = weighing the opinions of someone who has been through medical school, clinical practice, and continuing education more heavily those of someone on the Internets with no formal training and perhaps no background to understand statistical studies.

[WildKingdom]

Originally Posted by pek64 

Thanks for responding. Sorry about your carpal tunnel.
It's hard to say for sure, but it seems like a lactation consultant would have more training than an OB or ped. And understandably so. But that's true, I'd rather get my breastfeeding advice from a lactation consultant than a pediatrician. But well baby checkups don't include discussing breastfeeding with a lactation consultant. They are not paid for out of all insurance (at least when my son was an infant).
Getting back on topic, my point is, how can I value medical opinions when getting those opinions from the experts I am inclined to trust are not part of the current medical establishment?

Absolutely. Lactation consultant probably has 10x the training and expertise that I do. I never claimed otherwise. All I'm saying is that it's incorrect to say that doctors don't get any training in BF.

I also think its stupid that insurance companies don't pay for an LC, but I think that pretty much all things that insurance companies do are stupid.

[pek64]

Originally Posted by chickabiddy 

Take their advice = weighing the opinions of someone who has been through medical school, clinical practice, and continuing education more heavily those of someone on the Internets with no formal training and perhaps no background to understand statistical studies.

And then do as I'm told? Or am I allowed to disagree, get a second opinion, or rely on my own instincts?

I followed a doctor's advise over my instincts once, with disastrous results. Never again!

[chickabiddy]

Of course you're allowed to disagree with your doctor.  Who claimed otherwise?

And you can get as many opinions as you want, from whatever health care providers you want.  If your insurance doesn't cover it, that's between you and them.

[Taximom5]

Originally Posted by Rrrrrachel 

Also, I think there is a HUGE difference between saying "I trust the expertise of my doctor and I take their advice" vs some kind of blind trust or blind faith.

Please explain this HUGE difference.

[pek64]

"Taking advice", for me means "do what I'm told". No amount of arguing is going to change that. That was beaten into me as a child. Therefore, I refuse to "take advice". I do consider what others say, compare that to my experience and my instincts and decide for myself.

There are some, like my mother, who may feel more comfortable doing what they're told. My mother once told me it's better to follow someone else's advice, because then you have someone to blame when it goes wrong! So there's one reason why some follow doctor's advice!

[IdentityCrisisMama]

I read that article and didn't find its assertions very convincing (I wonder if the Dr. who wrote the article thinks his clients should trust him?). But, I suppose I could answer the more general question based on myself. I actually really like my children's pediatrician. I think I do trust her about a great many things. I trust that she is able to look at my kids after an exam and tell me that they are reasonably healthy or at the very least that they don't have some horrible medical problem that is easily treated with early detection. You know?  I assume this is more about the vaccine issue though. My kids' doctor has never once mentioned vaccines to me without me asking. When I have a question she gives me the most direct, simple answer that she can. She knows that we are a delayed, selective vax family and she literally NEVER gives me any advice without me specifically asking. So, for me, we just do not share some of the experiences from that article or that some of you have had with friends and family in the medical profession. 

All of that said, I do my own research about most medical interventions (birth, vaccines, tests, dentistry and etc.). On at least 3 occasions that I can think of I refused standard care (or whatever that lingo is) with other medical professionals. I wouldn't hesitate doing so with my current pediatrician if I felt it necessary. I guess like so many other things I do value the expertise of doctors and don't have trouble fitting that in with doing what I think is best. If that makes sense. 

I've never been in a true medical emergency but I did take my 7 month old for stitches. I think I had become blind to trusting this doctor because I wanted her to get stitches and this was the doctor on duty. I wonder how I would have evaluated him if the situation weren't a (mild) emergency. I'm not sure how on topic this is but I think my level of "needing" to trust a doctor may vary depending on the situation. We are lucky that we have never found ourselves in that place. 

[IdentityCrisisMama]

Originally Posted by pek64 

"Taking advice", for me means "do what I'm told". No amount of arguing is going to change that. That was beaten into me as a child. Therefore, I refuse to "take advice". I do consider what others say, compare that to my experience and my instincts and decide for myself. 

So interesting, Pek! I was raised by hippies so "taking advice" just means hearing the person's opinion/expertise. Maybe you're thinking there is a big difference between "getting advice" and "taking advice". I can see where you are coming from with that. Still, I think it's kind of a semantic argument (not from you...in general). 

[Bokonon]

Originally Posted by chickabiddy 

Take their advice = weighing the opinions of someone who has been through medical school, clinical practice, and continuing education more heavily those of someone on the Internets with no formal training and perhaps no background to understand statistical studies.

And yet many pediatricians still recommend routine infant circumcision and many OBs agree to early elective c-sections.

There are threads on MDC every single day about how docs are steering moms wrong about circ, birth, and breastfeeding, but when it comes to vaccinating, the mainstream recommendations are fine?  

You just can't have it both ways.  Either a doctor's opinions and advice are infallible or they aren't.  It can't be dependent on subject.

FWIW, my kids' pediatrician prefers to not vax his patients.  What does that say?

[chickabiddy]

I don't want it both ways.  I never claimed doctors were infallible.  I claimed, and still do, that they know more about medical issues and how to interpret medical reports/studies than most of the rest of us.  That doesn't mean we have to do whatever they say, although I don't understand why anyone would continue going to a doctor that she didn't trust.

[kathymuggle]

Originally Posted by pek64 

"Taking advice", for me means "do what I'm told". No amount of arguing is going to change that. That was beaten into me as a child. Therefore, I refuse to "take advice". I do consider what others say, compare that to my experience and my instincts and decide for myself.
There are some, like my mother, who may feel more comfortable doing what they're told. My mother once told me it's better to follow someone else's advice, because then you have someone to blame when it goes wrong! So there's one reason why some follow doctor's advice!

I agree with you.

I have always associated "taking advice" with complying with what the advisor said.

John told me to sell the house.  I took his advice and sold it.  I did not take his advice and did not sell it.

I would considered "listened to the doctors advice" or "took it under advisement" to mean just that - you listened, and may or may not have acted on it. I only hear people say "I took so and so's advice" when they actually did what the advisor was saying.

ah, well, wording!

[Bokonon]

Originally Posted by chickabiddy 

I don't want it both ways.  I never claimed doctors were infallible.  I claimed, and still do, that they know more about medical issues and how to interpret medical reports/studies than most of the rest of us.  That doesn't mean we have to do whatever they say, although I don't understand why anyone would continue going to a doctor that she didn't trust.

If a medical professional has more experience and expertise than a parent, why would they feel they couldn't trust that doctor?  I trust my doctor, but know many mothers who stopped breastfeeding because their pediatrician said that their breastmilk wasn't caloric enough, or had a c-section because the doc said their baby was "too big".  If the doctor knows more about medical issues and their education is trustworthy, why would anyone need to doubt that advice and do extra research or get a second opinion?

When a doctor says "Your baby is going to die if you don't do xyz", do you think most people take it with a grain of salt?  After all, I'm not going to get that doctor's years of experience by checking the internet, right?

[IdentityCrisisMama]

Originally Posted by kathymuggle 

John told me to sell the house.  I took his advice and sold it.  I did not take his advice and did not sell it.

You both are probably right about that...I'm not sure why I even bothered to weigh in. I suppose I was thinking that we were talking about how anyone could generally respect the advice of their doctor and not take it. 

What was the original comment that sparked this aside? 

[IdentityCrisisMama]

Originally Posted by Bokonon 

If a medical professional has more experience and expertise than a parent, why would they feel they couldn't trust that doctor?  I trust my doctor, but know many mothers who stopped breastfeeding because their pediatrician said that their breastmilk wasn't caloric enough, or had a c-section because the doc said their baby was "too big".  If the doctor knows more about medical issues and their education is trustworthy, why would anyone need to doubt that advice and do extra research or get a second opinion?

When a doctor says "Your baby is going to die if you don't do xyz", do you think most people take it with a grain of salt?  After all, I'm not going to get that doctor's years of experience by checking the internet, right?

Are you saying that you think that some doctors are more trustworthy than others and are wondering why someone would choose to see a doctor who wasn't trustworthy?  So bringing the topic back on track? So the question is not so much, why do (general) people trust (general) doctors but, maybe more a question of why some people trust doctors who give bad, dated, or corrupted advice?  

[kathymuggle]

Originally Posted by IdentityCrisisMama 

I've never been in a true medical emergency but I did take my 7 month old for stitches. I think I had become blind to trusting this doctor because I wanted her to get stitches and this was the doctor on duty. I wonder how I would have evaluated him if the situation weren't a (mild) emergency. I'm not sure how on topic this is but I think my level of "needing" to trust a doctor may vary depending on the situation. We are lucky that we have never found ourselves in that place. 

I think it very much does.

Vaccines are a luxury, in some ways, in that most of us can take months and even years to make up our minds.

An emergency is a different kettle of fish.  You may very well have to trust the doctor on call, as you cannot run off to see what studies say on x versus y.  

Even conditions where people are ill or in pain are different.  You may be more inclined to give a procedure a go if it has a chance of helping you feel better.

[IdentityCrisisMama]

Originally Posted by kathymuggle 

I think it very much does.

Vaccines are a luxury, in some ways, in that most of us can take months and even years to make up our minds.

An emergency is a different kettle of fish.  You may very well have to trust the doctor on call, as you cannot run off to see what studies say on x versus y.  

Even conditions where people are ill or in pain are different.  You may be more inclined to give a procedure a go if it has a chance of helping you feel better.

Yes, I agree. I suppose if I really thought long and hard about it I think I probably take more comfort in the expertise of doctors than I think. In non-emergency situations I tend towards the cautious side of things. Worry that a doctor may be looking out for the community over an individual, worry about them acting out of fear of malpractice and things like that. But, I suppose every time I get in my car and as my loved ones get older, I think I am grateful. I never thought of it that way. But, yea, also grateful for alternatives and second opinions...and for the internet! 

ETA: For me to write doctors off as untrustworthy, corrupted crooks would feel like tempting fate. I know in my heart that there will come a day that I am eternally grateful for some pretty hard-core western medicine.