To be concerned at the number of people on MN second guessing doctors?

[Wolfgirrl]

Every day I read a new thread where the poster is canvassing opinion on whether to reject medical advice.

The most common seem to be wanting to refuse a caesarean/induction and not wanting to top up fail to thrive babies with formula.

I totally agree that everyone has the right to refuse medical treatment etc, but when it relates to a baby you're not just putting yourself at risk. It just seems selfish to me? Interested to hear other's opinions.

To be fair, my cat could second guess my GP on HRT and get more things right.

@JamieLeeCurtains

Not exactly the answer I was expecting but okay

It's not totally black and white though. My GP won't up my thyroid medication even though I'm at the top end of normal blood numbers with active symptoms. I went private as even the national thyroid charity says for health you need to how numbers a lot lower than mine. I've now got a prescription for stronger drugs.
There have been lots of times with my child who has a liver transplant where I have gone against medical advice and a couple of times that has saved his life.
Doctors can get things wrong too, they are only human.

If I accepted the "advice" from the "experienced" doctors at the last GPs practice I was at, I would be dead.

If I listened to my booking midwife I would have put mine and my baby's health at risk. Her advice was so poor, the GP I saw had to double check everything. The consultant obstetrician I had was also horrified.

If I hadn't listened to my health visitor about vaccinations my baby's health would have been put at risk.

Unfortunately there are healthcare professionals who do what is easiest for them and that includes not giving patients the correct information. Some of this is due to class and race prejudice. And before you moan about this I have family and friends in healthcare who have had to deal with this crap themselves getting treatment before they pull rank.

My dad was told to gargle pepper for lung cancer by one GP.

We're not talking about ignoring all advice, but asking for a second opinion if something doesn't sound quite right is fine.

People make mistakes, OP. I went without antibiotics in pregnancy for 10 weeks because the GP who got my results from the hospital didn't realise that the guidance had changed and antibiotics needed to be prescribed ASAP. I called in when I read that the leaflet they'd given me contradicted what I'd been told by them. I got a thank you for the prompt, after an initial fobbing off with, 'I'll check and call you back but I'm absolutely certain you don't need them.'

Medical practitioners are people. Overworked, over-stressed, under-paid people. And people are fallible. YABU.

GPs see so many patients with such a wide variety of symptoms. They get about 5 minutes to see each patient. There is no time to look at a problem holistically and just tend to treat the symptoms, following the recommended 'pathway' for diagnosis and treatment.

I know my body better than anyone and I can spend hours and hours researching if I choose to. I think that puts me in a much better position to understand what is going on. A good GP will listen to what a patient is saying, but all too often we're dismissed. This seems to be particularly true for women's health.

I think in the example of inductions etc, there's a whole lot of evidence that suggests there's no reason for a perfectly healthy pregnancy to be induced at 41+ weeks as it can safely continue. The doctors will blanket suggest inductions for everyone at 41+ weeks because of the small number of cases were its risky to continue the pregnancy. Being induced can drastically effect your ideal birth scenario and carries its own risks for mum and baby, which may outweigh the risk of continuing the pregnancy.

Doctors have a much lower risk tolerance for many patients than the patients have for themselves.

Many of us would take a small (but present) risk of death or injury in order to avoid near-certain milder trauma. Not everyone will prioritize risk in the same way.

Doctors should make sure patients know the real-life odds ratios, and overall incidence rate, of problems, and make those rates clear to the patient. From there, people should be allowed to self-evaluate whether they feel comfortable with the risk.

Too often, OBs push induction or c-section for situations where there is an extremely small (less than 1%) chance of major complications, because they want to minimize complications in general. However, for some women, it would be worth it to take a 1-2% risk, or even higher, to avoid a surgically invasive procedure.

When you're diagnosed with cancer, doctors lay all this out in front of you and help you work with them to make a treatment plan that can be based on your desire for quality of life and avoiding trauma unlikely to have a major impact on the overall outcome. It's not assumed that you'll just ALWAYS want to take the route that leads to the absolute best survival outcomes, even if you were young and healthy beforehand. Everyone accepts that chemo and radiation and major surgery is very traumatic for cancer patients, and even if someone disagrees with someone's treatment choices, we usually understand why someone would choose not to go under the knife or subject themselves to treatments that would give them a worse quality of life, even if it extended the quantity.

But when it comes to obstetrics and newborns, all that autonomy goes right out the window. Doctors fearmonger by telling women there is a "higher chance" of stillbirth without telling them that their chances are still very, very low of having a stillbirth. They take the approach that what the woman goes through during the birth is absolutely meaningless.

Inductions and c-sections aren't nothing. They're certain, certain trauma, and often involve extended recovery and complications. Yup, docs, we wild women are taking our lives in our hands when we dare to VBAC after a traumatic c-section with permanent quality of life impacts. Why can't we just put our bodies through absolute hell and sometimes permanent, life-changing injuries, in order to go from a 1% chance of stillbirth back down to a .5%?

A doctor still has their individual take on things. People weigh up risk/benefit slightly differently. An example is my midwife discussed booking me in for induction at 41+5 as was routine. I was happy with that but then saw another midwife who strongly recommended I said no to the induction and waited. Presumably the first midwife was considering the fact that stillbirth increases after 42 weeks, whereas the second midwife based her view on the fact the increase is very minimal, especially under 40.

When it comes to breastfeeding, I think many doctors take a very medical approach. Topping up allows people to know how much they are feeding and is probably the quickest route to improvement. It may be equally valid to take a more holistic, long term view to focus on improving breastfeeding. I say may because it obviously depends how serious it is. Other professionals may be mire qualified in the specific area of feeding.

My parents are doctors. They are highly qualified professionals but they are just people. It’s fine to get second opinions, ask questions, ask about their reasoning and decision-making process and work out whether their recommendations do indeed seem like the right course of action for your circumstances. I’m not sure why you wouldn’t do that. Certainly when it comes to decisions relating to your baby it could be said to be foolish and irresponsible not to look into things properly, but I’m not so much of a dick as to believe that that is the case for everyone who follows medical advice without question

But sometimes you know the GP is wrong. My DD had thrush in her mouth and the GP told me she needed treatment but that I didn't (DD is breastfed). The NHS website and NICE guidelines state that if there is thrush in the baby's mouth or on the mum's nipples, both will need treating. I don't need a medical degree to be able to read. A week later, when my nipples were agonising, a different GP prescribed me treatment and was surprised I hadn't been given it the first time.

Not a hugely serious situation I know, but just an example.

Doctors are not gods, they get things wrong. Regularly.

What is really scary is the amount of people who just take their GP's word on their health issues as gospel purely because they are a 'doctor'.

Elderly people in particular place far too much trust in what their GP tells them, they are so easy to fob off and if they don't have a more savvy person to fight for them they will just vanish into dementia or other age related problems.

Womens health is also mostly ignored by most GPs so we should be second guessing and calling them out about it.

I think too many people assume a “doctor” knows everything about every ailment and condition under the sun. My mum thinks telling her cardiology consultant about her degenerative eye condition is OK because he’s still a doctor right? And since she’s got her slot with Mr A she might as well see what he thinks about the problem Mr D is looking after and save herself another visit to the hospital.

Well the negligence of the NHS killed my baby so...

Topping up is thrown about as advice ridiculously fast in the UK. It's crucial in the situation that the baby for whatever reason can't get enough milk from breastfeeding. But in most situations you can get the baby more milk by simply... breastfeeding them more. Or looking at the feeding process to see if anything can be improved (latch, milk transfer, duration, etc). Where it is advised mothers need to be closely supported because topping up is a destructive intervention to breastfeeding. This is hardly ever offered.

Most midwives have had a single session on breastfeeding, GPs and health visitors likely no training on it at all. Formula companies market heavily at all three. Unless you happen to have a midwife, GP or health visitor who has breastfed themselves and/or has a personal interest in the topic their knowledge of breastfeeding support is likely to be poor. I think this is ridiculous BTW and probably the most likely reason why the UK has such a massive drop off of breastfeeding after the first few days/weeks. You do often get better advice from an online forum than from front line health professionals which is awful!

Sometimes it follows that other health topics are the same. Gps can't be specialists in every subject.

You do know Drs are just people? Some make mistakes. Some are shit.

I'm not saying get a diagnosis off the internet but a discussion or 2and opinion is totally reasonable.

Have you had your eyes opened yet @Wolfgirrl or do you still think that every doctor is utterly fabby?

Mums a GP. I didnt listen to her about induction nor formula. She had a c section to have me, brought up children in 80s when advice was different.
She also brushed off all my niggles and made me feel like a stupid anxious new parent who's a burden to the nhs. Once ds1 was hospitalised for a week and I was told by the consultant luckily I brought him into a&e when I did. I almost didnt because she thinks everything will blow over with paracetamol.
Doctors are just people. People make mistakes. Medicine is not 100% science. They provide an opinion. Opinions require bringing in their own knowledge or experience into their judgement.

op won't like the way this has gone!

@KnickersandGnomes yes and no.

My question was really more centred around women refusing medical advice when the alternative is not another risk.

For example PP who refused induction at 41 weeks. Yes the chance of an adverse outcome is tiny but still a risk. And what are the risks of the induction? The baby is more than term so no worries there.

Doctors are not infalliable beings, they get things wrong. IME instinct counts for a lot - if I feel a doctor is wrong about me, she or he usually is.

@DahliaDay I'm fine with it, I didnt have a direction in mind. A lot of the answers dont really get to the heart of what I asked anyway.

@BertieBotts breast feeding statistics in developed countries aren't collected the same way.

So if you do any form of mixed feeding you are excluded in the UK there as in other countries you are still counted in their breast feeding statistics.

@BirdieFriendReturns - I'm sorry.

@BertieBotts there was another thread on this last week, I actually think there is too much support for breastfeeding and it has the opposite effect.