Very young moms and their “research”
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Anonymous
The Tuskegee Experiment doctors and the opioid over subscriber doctors undoubtedly sounded as insufferable as you do. |
Anonymous
this is exactly the problem - you have no clinical judgment, you just rely on guidelines and research like the rest of us. so what exactly is the point of having a doctor - unless you are a surgeon you just go online to read the same stuff we do, you showed as much yourself. and for your “evidence” perhaps you should read the paper “why most research findings are false”. at least a half research findings is not replicable. |
Anonymous
If you don't, you probably aren't practicing evidence-based medicine -- at least in pediatric care. The AAP does have recommendations for some minimal labwork in children, based on benefits/risk analysis. 1. Two newborn screens (universal): heel pricks in the newborn period, with conditions tested varying somewhat by state 2. Newborn bilirubin: recommended each newborn have one level drawn, with others in follow-up if indicated 3. Iron deficiency anemia: All children at 12 months, with levels at other times if indicated 4. Lead level if at risk (not just when they present with signs or symptoms of the condition, but based on risk): Specifically at 12 and 24 months in high-risk children, and as indicated otherwise 5.Lipid profile: all children at 9-11 years of age and a second at 17-21 years of age, as well as when indicated 6. HIV at 15-18 years of age, and when indicated Many of these are screens also indicated when there is risk identified, not just when presenting with a condition. There are other screens I did not list which are only indicated because of risk (again, not because of presenting condition). More info at --> https://www.aap.org/en-us/professional-resources/practice-transformation/managing-patients/Pages/Periodicity-Schedule.aspx |
Anonymous
DS Pediatrician drew blood for the first time when he was 6. We were in for continual stomach pain, we had been in once before and were back for a second visit. The Doctor did a full exam, checked if his organs were enlarged with a physical touch and decided to draw blood to check for other possible problems. DS handled it fine but it was his first blood draw and it happened after the Doctor could not identify the problem through other means. We thought it was more anxiety based on something happening at school but felt we should make darn sure that it wasn't medical. We tested for strep, only because it was going around (no fever, no rash, no signs in the throat) and it turned out he had strep (or might be a carrier who doesn't get sick even though he has strep). We treated the strep, winter break happened and the stomach problems went away. So yeah, Doctors will order blood draws when needed. Most 6 year olds don't need a blood draw and I am sure that the Doctor would rather avoid them because they don't want kids to be scared to go to the Doctor. And we did "knock our child out" to have four cavities filled when he was 3. Our dentist identified the cavities, we went to a pediatric dentist who confirmed the cavities. We could have gone for four fillings and hope that the gas worked for the 3 year old or we could "knock him out" and get all four filled once. We brushed his teeth twice a day, no dream feeds, lots of water, juice only at breakfast. He had been going to the dentist since he was 2. He happens to have soft teeth and was prone to cavities. It sucked but we were not going to all cavities to continue to grow and going back to the dentist four times and exposing him to the gas struck us as excessive. He also had sealant put on his teeth. But that is what the Dentist, a trained medical professional, recommended and that recommendation was confirmed by a second dentist. |
Anonymous
Still better than the woo-woo alternatives. "Best practices" often aren't best, and there is data to show this, too. The problem is that in order to do better than mainstream evidence-based practice, you have to show you can. You have to justify what you are claiming. Wanting it to be so, or thinking it ought to be so, isn't good enough. Still waiting for whatever justification you think is convincing and holds up to external scrutiny. |
Anonymous
"Not replicable" does not mean "false." It means that an experiment using the same parameters was unable to reach the same conclusion, not that the original researcher was falsifying data. "Not replicable" usually means "more research is warranted." Also, most decent physicians - not just surgeons - subscribe to multiple medical journals, do yearly retrainings, attend conferences, and the like. They're not out there Googling stuff. And national standards of care do not substitute for individual judgment calls, and national associations never claim that they do. Seriously: why do you think physicians even attend medical school, if there's nothing to learn that can't also be learned by Joe Schmoe with a wifi connection? |
Anonymous
And I think this is the crux of the problem. The number of people who pre-diagnose problems with Dr. Google and then will not believe an actual professional caregiver because they don't concur with WebMD are the real issue. Due to their age, those in the 19-25 age group who have grown up with the Internet, Google, Alexa and cell phones are much more likely to be in this category; but there are plenty of people in other age demographics who also fall into this category, but to lesser degrees. The highest percentage will be in younger age groups, so the highest percentage in the 19-29 age group, less in the 30-39 age group, less still in the 40-49 age group, etc. We are in our 50's and both are IT specialists, so we are much more savvy about the Internet and resources than many of our age peers, but the primary difference is that we read the Internet not to diagnose, but to research. When we talk with medical specialists, we then discuss what we read, not to contradict the medical practitioners, but to ask them whether what we read applies or is related to what our (or our children) are experiencing. My spouse has a genetic disorder that is very rare (about 90,000 cases world-wide). I've spent the last 20 years caring for and taking my spouse to medical specialists around the country and we've found a team that we really like. But, since we often go from specialist to specialist, we spent the first 10 years with notebooks and notes and each time we talked with a new specialist, we discussed what had been done, I kept copies of medical records, tests, etc. I was asked by several specialists if I was a medical specialist in this field, but each time I confirmed that I was not, just a specialist in exactly one patient. I find that the difference in reception is in keeping an open mind, presenting what I've learned not as fact, but as research and discussing information we have. All of our doctors take the time to present what they've found, and why they are recommending the treatment that they do. They will discuss if what I've learned is appropriate or not. However, since we had children late, we are often around peer parents who are 15-20 years younger. Discussing with them or seeing what they post on FB, I can see the phenomenon that OP cites as a problem in many of my younger peers. It is true that younger people do tend to believe what they research on the Internet and are much likely to believe that it gives them ammunition to advocate for themselves and to contradict professionals that they seek rather than present such research to discuss. But I don't think it's restricted to young parents, just that they are more likely to be that way due to the way they grew up. |
Anonymous
Sure it can. The problem / reality is many doctors fall on to “I am older, come from a better social class, and am more educated than you are, ” and never actually choose to discuss the WHY with their clients. |
Anonymous
Why do people keep saying clients? I have never heard a doctor refer to a patient as a client. |
Anonymous
And maybe that’s part of the problem with doctor responses on here. “Patient” is a term that suggests that person should defer to the doctor. Client puts them on a more equal level, which doctors like the OP don’t prefer. A client is paying you, and can question your expertise, and is involved in their choices. I know MANY doctors who don’t refer to people as “patients” any more. |
Anonymous
Glad that's working out for you. As a physician, I have no quibble with changing terminology. Discussing this relationship in business terms ("A client is paying you, and can question your expertise, and is involved in their choices") is a more explicit acknowledgement of a two way street, also. PP, do you have any objection to physicians declining to work with any patients they may choose not to, so long as it is not on the basis of a protected status? Say, just as a landscape designer might chose not to work with clients he or she feels may not be a good fit. That's totally okay, right? |
Anonymous
New poster here - we are talking about pediatricians, so the parents of the patients are not their patients. Clients is appropriate. |
Anonymous
| I will say that my one friend who is constantly posting anti-vax stuff on FB DID become a mom when she was very young (22). It is now 23 years later, though, and she is STILL on it. And she has also tried almost every (it seems like) MLM company in the book. |
Anonymous
| You know whats more obnoxious, people like you who criticize everything someone else does. So, you expect people to come in, do as you command and not question or think it through.. hmm... sounds like far worse parenting and neglectful. |
Anonymous
And, you know what's just as bad, those who shame others by posting demands to vaccinate and do things their way when it may not be best for all kids. |