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from the and-the-oscar-for-vaccine-education-goes-to... dept.
Catherine Saint Louis reports at the NYT that according to a survey of 534 primary care physicians, a wide majority of pediatricians and family physicians acquiesce to parents who wish to delay vaccinating their children, even though the doctors feel these decisions put children at risk for measles, whooping cough and other ailments. One-third of doctors said they acquiesced “often” or “always”; another third gave in only “sometimes.” According to Dr. Paul A. Offit, such deference is in keeping with today’s doctoring style, which values patients as partners. “At some level, you’re ceding your expertise, and you want the patient to participate and make the decision,” says Offit, a pediatrician specializing in infectious diseases. “It is sad that we are willing to let children walk out of our offices vulnerable to potentially fatal infections. There’s a fatigue here, and there’s a kind of learned helplessness.”
Part of the problem is the lack of a proven strategy to guide physicians in counselling parents. “Unfortunately, we don’t have a solid evidence base in terms of how to communicate to patients about vaccines,” says Saad Omer adding that although he does not sanction the use of alternative vaccine schedules, he understands why primary care physicians keep treating these patients — just as doctors do not kick smokers out of their practices when they fail to quit. Dr. Allison Kempe, the study’s lead author and a pediatrician at Children’s Hospital Colorado, thinks the time has come to acknowledge that the idea that “vaccine education can be handled in a brief wellness visit is untenable” and says that we may need pro-vaccine parents and perhaps even celebrities to star in marketing campaigns to help “reinforce vaccination as a social norm.” "Whether the topic is autism or presidential politics," says Frank Bruni, "celebrity trumps authority and obviates erudition."
(Score: 2) by Grishnakh on Thursday March 05 2015, @07:37PM
Doctors are not enforcers, they're supposed to be consultants and expert service providers. They're a lot like mechanics for cars and aircraft.
However, the thing is, you're supposed to go to a doctor because they're the expert in whatever it is you need help with. Just like with mechanics, where you go in because the car is making a funny noise, and you want to get it fixed. You don't go to a mechanic and tell him how to do his job. You don't go to a mechanic, have him tell you the alternator is bad and needs to be replaced, and then tell him he's wrong, doesn't know what he's talking about, and that he needs to replace the starter instead. If you do think your mechanic is incompetent, you don't go there!
So why are people going to doctors if they don't believe anything the doctors are telling them? These people should simply stop going to doctors altogether, since they obviously think they know better.
(Score: 1) by Fauxlosopher on Sunday March 08 2015, @12:31PM
Even in my own limited experience I have had occasion to disagree with doctors whose skill and experience I continue to hold in high regard. There can be different priorities held by a doctor and the patient, and not necessarily in the way one would expect.
One trusted doctor repeatedly suggested a specific solution that was mechanically inferior to another (a fact the doctor agreed with during discussions), ultimately due to cost differences. Considering I was a paying customer and had determined that the higher priced and mechanically superior solution's cost was already acceptable to me, I repeatedly expressed my desire to take the route I preferred over the one recommended by the doctor. The doctor acquiesced to my desired preferences and made money by willingly performing skilled work, while I had a problem fixed in a manner which I continue to be satisfied with. I still seek the same doctor's advice and services.
Skilled troubleshooters such as doctors, mechanics, and computer techs often have access to more than one way to solve a given problem. On a maddingly-regular basis in the computer world, the best solution often conflicts with the customer's preferences, which requires finding a solution that both fixes the problem and accomodates the preferences of the customer. In like manner, taking a slower approach to vaccination schedules to reduce or eliminate guesswork in regards to bodily reactions seems absolutely sane and preferable to simultaneous injections to someone in a troubleshooting profession. The vitriolic responses in the vein of your "stop going to doctors" puzzle me since the only variable considered by the article is timetable and not a complete or partial elimination of recommended treatment.
(Score: 2) by Grishnakh on Sunday March 08 2015, @10:02PM
Even in my own limited experience I have had occasion to disagree with doctors whose skill and experience I continue to hold in high regard. There can be different priorities held by a doctor and the patient, and not necessarily in the way one would expect.
Yes, but with anti-vax, this isn't a question of different priorities, but rather complete disagreement about basic science.
Now, I will grant that the slower vaccine schedules, while more costly and time-consuming (though I do think a decent doctor's office should be able to get people in and out more quickly for subsequent shots if they would organize it properly), can be considered an OK compromise in the interest of avoiding bodily reactions, since after all, different people's bodies are different and react differently to things.
My "stop going to doctors" bit was in response to actual anti-vaxxers (I do not consider people who want a little bit of time between injections to be "anti-vaxxers"). These people aren't worried about bodily reactions to too many vaccines at once (in their view), anti-vaxxers actually don't believe vaccinations are necessary or should be done. The altered-schedule people simply disagree about about the schedule and worry about having a reaction from so many vaccines at once; the anti-vax people disagree with all the basic science about vaccines and their efficacy and herd immunity. To me, that's a big, big difference. If they completely disagree with medical science that dates back almost a century now, then why are they bothering going to doctors at all? (The altered-schedule people are only disagreeing with medical science that's maybe a decade old or so; they didn't give so many vaccines when I was a kid.) So, I can understand someone being skeptical about pumping their kid with so many vaccines at once, when it wasn't normal a few decades ago. But you have to be a complete moron to think that risking your kid catching polio, tetanus, etc. is a good idea. Any elderly person can tell you the horrors of those diseases.
(Score: 1) by Fauxlosopher on Sunday March 08 2015, @10:27PM
We agree, and the only caveat from me is that, in a nation of free humans, each individual nonetheless has the right to be a complete moron. Such humans own their bodies, and while free human children are a wonderfully snarled practical pickle, until there is at least an actual case of one individual harming another, there is no crime. (And what should most people care about that moron anway - they got vaccinated, right?) Our moronic politicians aren't helping matters, either, with criminal behavior like pushing mandatory HPV vaccines on kids, or making money off the health of soldiers with the completely ineffective against aerosolized anthrax vaccine. When liars lie about some vaccines, a not completely unexpected consequence is that the liars are distrusted even when presenting truth.
Known-good vaccines are like seatbelt laws: a good idea, stupid to disregard, but utterly void of principle (and for free people, legality) should a law tried to be made to mandate their use. I await fresh-underwear and brushed-teeth laws with bated breath.