Why Do People Follow Medical Authorities? - Page 2 - Mothering Forums
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#31 of 198 Old 11-26-2012, 01:35 PM
 
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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. 


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#32 of 198 Old 11-26-2012, 01:39 PM
 
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"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). 


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#33 of 198 Old 11-26-2012, 01:49 PM
 
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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?


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#34 of 198 Old 11-26-2012, 01:54 PM
 
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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.


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#35 of 198 Old 11-26-2012, 01:54 PM
 
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"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!


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#36 of 198 Old 11-26-2012, 02:02 PM
 
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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?

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#37 of 198 Old 11-26-2012, 02:03 PM
 
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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? 


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#38 of 198 Old 11-26-2012, 02:08 PM
 
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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?  


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#39 of 198 Old 11-26-2012, 02:12 PM
 
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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.


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#40 of 198 Old 11-26-2012, 02:17 PM
 
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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. 


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#41 of 198 Old 11-26-2012, 02:50 PM
 
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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. 

Bolding mine.  I don't think you have to go that far.

 

I remember hearing a talk by Andrew Weil once, where he said there are things western medicine does really well (trauma is one) whereas with other things ( some chronic conditions were his example) western medicine does not do so well.  I tend to agree with him.  Healthcare is huge -  western medicine is great in some areas, and not so great in others.


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#42 of 198 Old 11-26-2012, 02:57 PM
 
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Bolding mine.  I don't think you have to go that far.

 

I remember hearing a talk by Andrew Weil once, where he said there are things western medicine does really well (trauma is one) whereas with other things ( some chronic conditions were his example) western medicine does not do so well.  I tend to agree with him.  Healthcare is huge -  western medicine is great in some areas, and not so great in others.

Yes, agreed! The article didn't seem to be written with that in mind, which is part of why that was my focus, yk? 


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#43 of 198 Old 11-26-2012, 03:05 PM
 
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I don't think anyone is claiming any doctor is infallible or that all doctors are equally worthy of trust and respect. Part of why I can have a trusting and respectful relationship with my care provider is because I shopped around until I found one who was worthy of that trust an respect. I think that was my obligation as a patient and a parent.
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#44 of 198 Old 11-26-2012, 07:36 PM
 
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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.
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Please explain this HUGE difference.

Still waiting for the explanation from Rrrrachel...

 

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#45 of 198 Old 11-26-2012, 07:59 PM
 
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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.

Still waiting for the explanation from Rrrrachel...

 

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Maybe I can explain the difference. I do trust my children's doctor's expertise. I think she has a good practice and cares about her community. I think she knows a lot of stuff that I don't know. She knows how to listen to my children's heartbeat. To move their joints, to look into their eyes and at their fingernails. I take my kids there (not for every recommended visit but from time to time) to have her look them over and give me her training. I know there are some folks who don't trust or see any value in well-checks or Western medicine at all but I do take some comfort in knowing that my kid has been checked out.  So I trust her to do that but I don't always take her advice. I think if I had asked her advice about vaccines she would have recommended I follow the schedule. There have also probably have been other things that I didn't see eye to eye on. 

 

But I don't see a big conflict between trusting someone's expertise and not taking their advice. I suppose if you said you "never took their advice" that would be a bit hard to swallo.


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#46 of 198 Old 11-26-2012, 08:10 PM
 
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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?

 



I feel like you're missing several kinds of middle ground here -

- Yes, it is possible for doctors, as a group, to be wrong on one subject, but right on others.

- It is also possible for an individual doctor to be wrong on one subject, but right on others.

- Since doctors disagree with each other all the time, it is impossible for them all to be infallibly correct. 

- Actually, it's impossible for ANYONE to be infallibly correct.

- It's also possible for an individual who is not a doctor to be wrong on one subject, but right on others.  The odds of being right increase with training and experience, but are never 100%.

- In particular cases, recommendations I disagree with may, for reasons not explained to me, or that I do not understand, nonetheless be good recommendations.

- We get more then one chance to choose.  We can make a choice, observe the outcome, and then decide whether to make the same choice again. 

 

I love my pediatrician, from whom I have gotten nothing but good advice (some of the advice clearly wouldn't pass muster with you, but it worked out well for us).  But my primary care physician turns out to suck - I don't trust her at all anymore and I'm trying to replace her.  Clearly, I am not an infallible judge of doctors.  For me, the moment to stop trusting a doctor is the moment that I feel like I *need* to do a ton of research before making a decision.  That doesn't even necessarily mean that the doctor is wrong, it might just mean that the issue at hand is unusually complicated. 

 

Your kids' pediatrician prefers not to vax his patients?  Good to know.  He would be a terrible pediatrician for my family, and I think he's dead wrong.  You, however, seem tolerably contented with him.  I think I probably covered that case somewhere up in those bullet points.

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#47 of 198 Old 11-26-2012, 08:17 PM
 
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It can be difficult to find a doctor to trust, too. I found a terrific OB/GYN, who was part of a practice, the other two were only tolerable. Of course, when I gave birth my terrific doctor was off! Similar thing happened with my son's ped practice. I could never get an appointment with the great doc, because he was always booked. Frustrating!
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#48 of 198 Old 11-26-2012, 08:25 PM
 
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I feel like you're missing several kinds of middle ground here -

- Yes, it is possible for doctors, as a group, to be wrong on one subject, but right on others.

- It is also possible for an individual doctor to be wrong on one subject, but right on others.

- Since doctors disagree with each other all the time, it is impossible for them all to be infallibly correct. 

- Actually, it's impossible for ANYONE to be infallibly correct.

- It's also possible for an individual who is not a doctor to be wrong on one subject, but right on others.  The odds of being right increase with training and experience, but are never 100%.

- In particular cases, recommendations I disagree with may, for reasons not explained to me, or that I do not understand, nonetheless be good recommendations.

- We get more then one chance to choose.  We can make a choice, observe the outcome, and then decide whether to make the same choice again. 

 

I love my pediatrician, from whom I have gotten nothing but good advice (some of the advice clearly wouldn't pass muster with you, but it worked out well for us).  But my primary care physician turns out to suck - I don't trust her at all anymore and I'm trying to replace her.  Clearly, I am not an infallible judge of doctors.  For me, the moment to stop trusting a doctor is the moment that I feel like I *need* to do a ton of research before making a decision.  That doesn't even necessarily mean that the doctor is wrong, it might just mean that the issue at hand is unusually complicated. 

 

Your kids' pediatrician prefers not to vax his patients?  Good to know.  He would be a terrible pediatrician for my family, and I think he's dead wrong.  You, however, seem tolerably contented with him.  I think I probably covered that case somewhere up in those bullet points.

 

Obviously I understand all of this, or at least I thought it was obvious.  My point is that the years of medical training and expertise is not enough - for you, me, or anyone.

 

When you feel like you need to do a ton of research before making a decision is when you (the royal you) have decided that your doctor's expertise is insufficient.

 

"Tolerably contented"?  The snark is unnecessary.  I am delighted that my children's doctor has reviewed the available information and has reached a different conclusion than the party line.  I think it shows a lot of courage and a critical eye above and beyond the AAP recommendations.  Even if I was a full vaccinating parent, I appreciate that he clearly has reasons to dislike vaccination.  


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#49 of 198 Old 11-27-2012, 03:59 AM
 
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Obviously I understand all of this, or at least I thought it was obvious.  My point is that the years of medical training and expertise is not enough - for you, me, or anyone.

 

When you feel like you need to do a ton of research before making a decision is when you (the royal you) have decided that your doctor's expertise is insufficient.

Is this comment about some previous topics on MDC or about discussions or feelings you have from friends and family where folks are telling you that their doctor's opinion about vaccines is enough for them?   

 

Although not me (though many here would probably consider my research insufficient), I can relate to that. There's lots my doctor does that I don't research all that much. I don't know a whole lot about the growth stuff and how that is an indicator of good health, for instance. I know a lot of parents that really second guess their doctor all the time about stuff that may not second guess the vaccine issue. I have a friend right now that is getting a second opinion on her child's lead level. Can you relate to this? Is there any service your doctor provides that you have chosen not to research?  

 

I wonder if most people have things that provoke them to do more research. I know someone who obsessively researched her knee surgery. I wish someone close to me had researched their back surgery options. Maybe it's difficult for us to relate, sometimes, to why a person would choose to want more information about one thing and seemingly "blindly trust" their doctors on other things? 

 

To understand that, maybe it helps to dig deep to see if there are some things that don't trigger you or me but that someone else would be very nervous about. 


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#50 of 198 Old 11-27-2012, 05:49 AM
 
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I understand there are people out there who do not trust doctors in general.  Some who do not like vaccines fall into this category, but many do not.

 

Trust:  Firm belief in the reliability, truth, ability, or strength of someone or something. (dictionary)

 

Do I trust my doctor?  Yes.

 

I think she is reliable, has ability and strength.  I believe she is truthful - in that she does not lie, however, I do not agree with her "truths" around vaccines.

 

I can trust a person without necessarily agreeing with everything they say. Perhaps there is a tipping point on this, but one issue (for me ) is not it.  The fact that she has handled my vaccine refusal with somewhat good grace increases her reliability in my eyes.  If I did not want to go to the doctor because of her behaviour around vaccine issues, she would not be accessible to me, which cuts into reliable and strength ( a strong person can accept the word "no" from another without getting bent out of shape)

 

 

A discussion of trust is somewhat pointless, though, without a discussion of what the real world implications are.  

 

On almost a daily basis, someone on this forum writes "I trust my doctor. I vaccinate."  Another version of this is the whole "I trust science" thing.

 

To me, when someone says this, it seems like they are implying:

 

1.  if you trust your doctor you should do as he/she says

2.  those who do not follow their doctors advice do not trust their doctor.

 

Otherwise - why say it?  What is the point behind such oft repeated statements?


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#51 of 198 Old 11-27-2012, 06:04 AM
 
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On almost a daily basis, someone on this forum writes "I trust my doctor. I vaccinate."  Another version of this is the whole "I trust science" thing.

 

To me, when someone says this, it seems like they are implying:

 

1.  if you trust your doctor you should do as he/she says

2.  those who do not follow their doctors advice do not trust their doctor.

 

Otherwise - why say it?  What is the point behind such oft repeated statements?

Ok, I think I get where you and Bokonon are coming from - this is not so much in reference to the article from the OP but a response to a comment used frequently on MDC. I don't know how on topic this is but I can see how the conversation would go in that direction. 

 

I can see how a comment like that has a meaning that implies other things. I know discussions in vax are sometimes not all that productive but I wonder how it would go if someone who made a comment like that would be willing to explain it and folks asking were open to trying to understand.  

 

Seems like it could be a good spin-off topic for sure. 


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#52 of 198 Old 11-27-2012, 06:06 AM
 
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I must be missing where people say this all the time.
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#53 of 198 Old 11-27-2012, 06:11 AM
 
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I must be missing where people say this all the time.

Want some recent links?


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#54 of 198 Old 11-27-2012, 06:15 AM
 
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I must be missing where people say this all the time.

Maybe it isn't said on a daily basis (an expression) but something that feels to her is said often.  Rrrachael, is there some light you can shed on a comment like the example given that could maybe help others understand what it means and if it implies something about people who do not follow their doctors advice on the vaccine issue? 

 

KM, have you asked what the member meant by a comment like that? 


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#55 of 198 Old 11-27-2012, 06:16 AM
 
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No ill take your word for it smile.gif

Speaking for myself, I don't vaccinate BECAUSE I trust my doctor, but it plays a part. They probably influence me more strongly on timing and a few specifics.
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#56 of 198 Old 11-27-2012, 06:46 AM
 
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KM, have you asked what the member meant by a comment like that? 

No, I have not (and yes, I probably should have, but the timing never felt right).

 

I can ask now, though, what does someone mean exactly when they say they trust their doctor or science - and what implication does that have for vaxxing? 


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

Book and herb loving mama to 1 preteen and 2 teens (when did that happen?).  We travel, go to school, homeschool, live rurally, eat our veggies, spend too much time...

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#57 of 198 Old 11-27-2012, 06:52 AM
 
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No, I have not (and yes, I probably should have, but the timing never felt right). 

I get how sometimes the timing isn't right -- it can sometimes feel like more of an attack or argument when asked in certain situations. I respect you making that call and didn't mean to say you can't be wondering now if you chose to not ask then!  I was just curious. love.gif

 

Posted by kathymuggle View Post

I can ask now, though, what does someone mean exactly when they say they trust their doctor or science - and what implication does that have for vaxxing? 

 

 

A good follow up would be how do people who say something like, "I trust my doctor so I vaccinate," think that may feel to someone who uses a pediatrician but chooses to not vaccinate (or selective or delayed)?  Can you imagine how that may feel like you are saying that folks who don't vax must not trust their chosen pediatrician? Or that one must follow all advice from a trusted physician? 

 

I can see Kathy's point on this...


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#58 of 198 Old 11-27-2012, 06:53 AM
 
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I trust my doctor to offer me advice based on his education and experience.

 

I also realize that that education and experience does not extend to understanding the ethical violations and conflicts of interest surrounding much of what he has been taught.

 

The recent events in British Columbia are a perfect example, where the Chief Medical Officer claimed that the Cochrane review found that vaccinating health care workers protects patients.  One of the authors of the Cochrane review not only corrected him, saying that the review found no such thing, and, in fact, that all the studies were of low quality!  In a 2010 Time magazine interview: "In a separate study we looked at the science that policymakers use, and it's disturbing how large the gap is between policy and evidence. We looked at the World Health Organization, CDC and U.K., Australian and German authorities — they have what it is called a "citation bias." They cite some studies that support vaccines, but other studies that find no effect are left out."

 

But my doctor, and several friends of mine who are doctors, have never looked at the studies themselves. They take the word of whichever pharm rep is "educating" them.

 

They have no idea that there is a citation bias.

 

They believe what they are led to believe.  One of my friends says that she saw a reduction of flu visits to her office after she started giving flu shots, and that this is therefore proof that they work.  And I'm sure she did see such a reduction. But it was at the same time that the grocery store started offering antibacterial wipes for their carts, and schools, stores, and offices everywhere started making hand sanitizer available, and schools started having kids wash their hands before eating lunch.

 

And there's also the placebo effect: 

Person A:  "I got a flu shot, so my respiratory symptoms and fever are probably nothing. I think I'll go to work."

 

Of course, Person A goes to work, where he spreads his virus to person B.

 

Person B:  "OMG, I didn't get a flu shot, and I have a fever and a sniffle--I HAVE THE FLU! I MUST GO TO THE DOCTOR! FLU IS DANGEROUS! H1! N1!  OMG OMG OMG!"

 

Person B goes to the doctor, infecting everyone in the office; the doctor tells Person B he should have had a flu shot, and gives him a prescription or tells him to take Tylenol and Sudafed. Person B goes to Walgreen's and infects everyone there, too.

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#59 of 198 Old 11-27-2012, 07:07 AM
 
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Too OT - will make separate post

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There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

Book and herb loving mama to 1 preteen and 2 teens (when did that happen?).  We travel, go to school, homeschool, live rurally, eat our veggies, spend too much time...

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#60 of 198 Old 11-27-2012, 07:12 AM
 
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Edited: Kathy, I think that is too off topic on this thread. Taxi's comments went to her lack of trust, which is reasonably on topic. I think your link takes the thread completely off topic and it's an interesting link that will wither derail the thread or be lost here. It would be a great link to post even as an original topic, though. Would you, please edit? 


Mama to DD September 2001 and DD April 2011 *Winner for most typos* eat.gif
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