Why Do People Follow Medical Authorities? - Page 4

[kathymuggle]

dbl post.

[pickle18]

I will come out of lurker status to take a crack at this...

For one thing, I think it is dead wrong to say, "because doctors often advocate circumcision/early weaning/c-sections/etc. we can't possibly listen to them about vaccines."  There are so many issues with this logic, and it could be said about anything the doctor says/does - so why go to doctors at all, ever, since they can never be trusted?  Why bother getting a second opinion or searching for a care provider, since all doctors are part of a mainstream medicine army that isn't allowed to deviate from the script or have individual opinions?  Doctors are individuals.  I think it is a dangerous oversimplification to paint with such a broad brush - if they agree with the standard vax schedule, they may have professional or personal reasons for that beyond "blind trust."

Which brings up kathymuggle's question...

I don't think trust precludes research.  I don't think all trust must be blind.  So when many say they "trust their doctor" or "trust science" I believe they have done sufficient research (sufficient *for them*) to back up their doctor's recommendations.  Or, phrased another way, doctor says, "I recommend x" - they sleep on it, think on it, do their research, don't find an unacceptable risk involved, and say, "Ok, I trust my doctor's expertise."

Ultimately, it's a question of personal assessment of risk.  If I think something my doctor is proposing is fraught with possible complications, seems unnecessary, etc. I will do that much more research.  Other times, I may do scant research and rely more on their expertise, if I perceive less of a risk.  Just as I generally rely on car mechanics to tell me what my car needs, even though I know they may recommend lots of unnecessary interventions, and I try to be cautious of that.

I see my grandparents generation "blindly" trusting their doctors - to the point of not even asking any questions.  This is not my approach at all - I often blatantly contradict my doctors advice, if I feel strongly about it (or we would not have DS).  I like information and to square things away in my heart/head.  Yet that does not mean I never rely on my doctor's advice, and that does not mean I have all day to sit around researching anything and everything my doctor proposes.  Doctors are not infallible gods, but neither does my google searching an MD make.  

[pickle18]

I feel I can trust my doctor while being appropriately skeptical of influences of pharmaceutical companies.  I feel free to deny a vaccine or a drug offered - other times, I will take them when I agree it seems like a good idea.  Alot of Western medicine is legal CYA, and you have to filter that out, too.  There's also professional bias - I know every time I have a surgical consult, the surgeon is going to recommend surgery, because that's what they do.  I've had doctors make their spiel, then tell me they are fine with my decision to disregard what they say, because they had to say it for legal reasons.

None of these things make me implicitly unable to trust the judgment of my doctors, or science.

[pek64]

One reason not to trust doctors, in general, is poor advise in the past, from multiple doctors. That can be confidence shaking.

[Bokonon]

Originally Posted by pickle18 

For one thing, I think it is dead wrong to say, "because doctors often advocate circumcision/early weaning/c-sections/etc. we can't possibly listen to them about vaccines."  

I didn't say that.  My point was that when people say "I trust my doctor's advice about vaccines" and then say "My doctor thinks my son should be circumcised - what a UAV!", it's hypocritical.

[pickle18]

Originally Posted by Bokonon 

I didn't say that.  My point was that when people say "I trust my doctor's advice about vaccines" and then say "My doctor thinks my son should be circumcised - what a UAV!", it's hypocritical.

Why is it hypocritical to agree with your doctor on some health issues and not others?  For it to be hypocritical, you would have to be saying that people should either always listen to their doctors or never listen to their doctors.  Since you don't think people should trust their doctors on vaccines, the implication is it's the latter.  

It's an oversimplification - you imply that because they are wrong on one thing, you shouldn't trust them on another.  My doctor is human - an individual with many different opinions on multiple issues, some I agree with, some I sure as h#ll don't.  I can ascertain whether my doctor seems knowledgeable about a particular issue (like breastfeeding) and base trust on that - trusting their opinion on one issue, and not so much on another.  I don't think that's hypocritical.

[Bokonon]

Originally Posted by pickle18 

Why is it hypocritical to agree with your doctor on some health issues and not others?  For it to be hypocritical, you would have to be saying that people should either always listen to their doctors or never listen to their doctors.  Since you don't think people should trust their doctors on vaccines, the implication is it's the latter.  

It's an oversimplification - you imply that because they are wrong on one thing, you shouldn't trust them on another.  My doctor is human - an individual with many different opinions on multiple issues, some I agree with, some I sure as h#ll don't.  I can ascertain whether my doctor seems knowledgeable about a particular issue (like breastfeeding) and base trust on that - trusting their opinion on one issue, and not so much on another.  I don't think that's hypocritical.

It's not about agreeing, it's about trust.

[pickle18]

Originally Posted by Bokonon 

It's not about agreeing, it's about trust.

You're saying that if you disagree with your doctor on one issue (circumcision), you can't trust them on any other (vaccines) - or else you are a hypocrite.  I think it's more complicated than that.  My doctor can be a complete idiot about one thing, and know alot about another.  I think it is up to every person to evaluate their own doctor's expertise and decide when/where to trust them, and when/where to challenge them.  

Trust and agreement (or, per your example, disagreement) are part of the same thing.  If I trust my doctor's judgment, I will more readily agree with her decisions, or to what she proposes.  If I find I often agree with my doctor, I'm more likely to trust them (this may be where your point lies) - but that isn't the only factor.

I guess what it comes down to is if we are talking about absolute blind trust - or if we are talking about the kind of trust that is circumspect and earned.  My personal opinion is that at least *some* of the people who say they trust their doctor fall into the second camp.  I've certainly had doctors that lost my trust or never earned it to begin with, but I don't extrapolate from those isolated experiences to make judgments about the whole profession.

[MeepyCat]

Originally Posted by Bokonon 

It's not about agreeing, it's about trust.

Someone asked me two questions about trust once, that I thought were very revealing:

- Do I trust my husband?

- Do I trust my husband to file our tax returns?

The answers are very different.

Do I trust my pediatrician?  Sure!  But even the most absolute trust has limits.

[chickabiddy]

I trust that my doctor knows more than I do about medicine.  I do not (automatically) trust that he has the same priorities that I do or would do the same things I would do with that knowledge.  Over the years I have come to trust that he understands and respects my priorities, but that trust was earned.  I'm also comfortable telling him on occasion that I appreciate his knowledge and opinion, but would prefer to take a different route than he recommends.  That doesn't mean that I think I know more about medicine than he does, but it does mean that I may prioritize things differently; for instance, what he describes as a small risk might indeed be small but still unacceptable to me, or what he describes as somewhat risky may be a risk I'm willing to take.

[IdentityCrisisMama]

Originally Posted by chickabiddy 

I trust that my doctor knows more than I do about medicine.  I do not (automatically) trust that he has the same priorities that I do or would do the same things I would do with that knowledge.   

I think that's a nice way to put it. I think I probably feel the same way. 

[contactmaya]

Originally Posted by WildKingdom 
 
So, what's the source of your definitive knowledge that doctors receive no training in breastfeeding?
 

While i didnt post  what you are responding to, i can answer your question.  My sons pediatrician told me, that continuing to breastfeed him past the age of 2 was 'infantilizing' him.

Either he never learned about breastfeeding in med school (including not bothering to keep updated with WHO recommendations for breastfeeding, or, he was stupid, or, he was incompetent.   I wouldnt want to accuse him of being the latter.Thats source enough for me.

[IdentityCrisisMama]

My Dr seems pretty up to speed on breastfeeding. I think she BF'd for quite a while herself and the way she phrased the questions of infant feeding was very, very much that BF was the expected norm. I appreciated that she chose to assume all her clients were BFing. At DC's 18 month visit I mentioned going to the dentist and she was nice to help prepare me for a likely anti-BF on demand lecture from the dentist (which I've already gotten).  

Did you end up fining another doctor who was more knowledgeable about breastfeeding, Contactmaya? 

[pek64]

A doctor has to listen. To your priorities, your symptoms, your needs. All the education in the world doesn't replace that!

[Turquesa]

I think that the question of whether or not I *trust* my doctor may be the wrong one to be asking.

First, trust is an emotionally loaded concept; someone you don't *trust* is usually a nefarious individual out to mislead or hoodwink you. When my doctor recommended rice cereal for my baby, I didn't opt for avocado because I don't *trust* her. She's just unaware of the conflicting medical opinions on first foods and probably didn't get the recent memo about arsenic content. None of this makes her "untrustworthy."

"Trust" can readily become a term for guilting and gaslighting patients. "How could you?? Don't you trust me, your doctor?"

Unless there's an immediate, life-or-death emergency and no time for research, I never trust any ONE authority or ONE source to give me all of the information that I need to make medical decisions. Medicine is too complex for that.

[WildKingdom]

Originally Posted by contactmaya 

While i didnt post  what you are responding to, i can answer your question.  My sons pediatrician told me, that continuing to breastfeed him past the age of 2 was 'infantilizing' him.

Either he never learned about breastfeeding in med school (including not bothering to keep updated with WHO recommendations for breastfeeding, or, he was stupid, or, he was incompetent.   I wouldnt want to accuse him of being the latter.Thats source enough for me.

So, from your sample size of 1, you can infer that all doctors receive no training in breastfeeding?

Please see my previous post describing the training my classmates and I received.

[pek64]

Originally Posted by WildKingdom 

So, from your sample size of 1, you can infer that all doctors receive no training in breastfeeding?

Please see my previous post describing the training my classmates and I received.

Maybe we can poll MDC folks and get a larger sample size.

[Adaline'sMama]

Just out of curiosity, why does one have a doctor that they don't trust? I mean, outside of living in a place where your access to doctors is extremely limited, why would someone stay with a doctor that disagrees so strongly with their pov about the health of your child?

I shopped around for my doctors, both for birthing and for my kids. I  drive 40 miles to my pediatrician because we have similar philosophies about my kid's healthcare. It's a huge priority. 

[Rrrrrachel]

Originally Posted by Adaline'sMama 

Just out of curiosity, why does one have a doctor that they don't trust? I mean, outside of living in a place where your access to doctors is extremely limited, why would someone stay with a doctor that disagrees so strongly with their pov about the health of your child?

I shopped around for my doctors, both for birthing and for my kids. I  drive 40 miles to my pediatrician because we have similar philosophies about my kid's healthcare. It's a huge priority. 

Ita. I have never understood this phenomenon.

[chickabiddy]

Originally Posted by pek64 


Maybe we can poll MDC folks and get a larger sample size.

My extremely un-crunchy family practice doctor said "well, she's got the best nutrition anyhow" when my exclusively breastfed daughter refused solids until 14 months, and had no issue with my nursing her to age 3.5 (I actually nursed even longer than that, but we moved out of state and I left that practice).  That same family practice told me when I was pregnant that they would not do circs.