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.

I’ve found this a really interesting thread and agree with lots of the comments.

Speaking for obstetrics, doctors are definitely more risk averse than previously, and that’s because people (rightly!) no longer accept that bad outcomes are “just one of those things”. It’s no longer acceptable to have the huge rates of perinatal and maternal mortality that were seen in the past, and any instance is scrutinized and attempts made to prevent the same happening.

Infortubately, in attempting to prevent all bad outcomes, sometimes other bad outcomes are caused (eg complications of induction or c section, birth trauma both physical and mental).

There will always be a balance to be struck and a doctor cannot and should not decide for a woman. However, a good obstetrician should be able to help women understand and weigh the risks and benefits of any approach, while looking at all the individual circumstances. One woman’s risk assessment is completely different from another’s, because everyone’s priorities are different. As an individual, you can choose to accept a higher level of risk than the doctor would professionally be able to recommend.

If any woman doesn’t feel fully informed, and/or doesn’t feel that obstetric/delivery decisions are her own, then it’s definitely reasonable to seek more information. What’s not reasonable is to completely reject all medical advice on the basis of anonymous opinions from the internet - people should always be encouraged to at least go back and talk things through with the doctors again, ask more questions, clarify plans.

If I excepted GPs advice I might not be here either. My appendix had ruptured first time I was told to go home before it had ruptured, when I complained of pain and struggling to walk. Second time I went in to a&e I was told it was a urine infection despite being in agony. The nurse actually laughed when I said I think my appendix had burst and told me to calm down. An hour later they realised my appendix had burst and I needed emergency surgery. Surgeon said he was surprised I made it and I required a drain in my stomach for a week to drain out the excess crap as they said it was the worst case they’d seen. So I think yabvu to judge anyone who questions a gp regarding their own health / their children’s.

@quarantinevibes

As I said above, I am not talking about GPs.

Interesting the votes are exactly 50-50 so far! So a very polarised issue.

Most of the posts are YABU and usually have their own negative experience attached, but I would be interested to hear from anyone who defied medical advice and it didn't work out for them?

I think "tenthousandspoons* has absolutely hit the nail on the head

OP in my area both GPs and community midwives are involved in your antenatal care regardless of whether you are under an obstetrician or not.

The good thing about that is in my case as the maternity department did not have my full medical history so:
a when the booking midwife gave me dangerous information my GP checked up on everything she said and did some of their own blood tests.
b. When I had infections from an underlying medical condition my GP knew how to treat it, did the appropriate testing and alerted the obstetricians to it.

If I was at my old GP practice I shudder to think what antenatal care I would have got as the GPs enjoyed fobbing me off. One actually told me I was costing them too much and was making up my illness. (They kicked me off the books when I complained about them and signed up with my current practice at the same time.)

@beforeiputonmymakeup

Do you mind if I ask what dangerous information the midwife gave you?

There are cases where you have to put your trust in doctors. When one of our children was critically ill I gladly ceded all control to the experts who knew best. But that's quite different to your average consultation with your average gp, some of whom will be great, but others will be too busy, not up to date, crap at listening, or just plain incompetent. One GP sent my dad off with a flea in his ear despite his showing every symptom of end stage heart failure. I'm not a doctor but I have eyes and a good brain. I was right, the GP was not. I could give you a dozen more examples. If you abandon all critical judgment in order to defer to the doctor in front of you just by virtue of their title, you are taking an enormous risk.

Everyone is entitled to a second opinion on their treatment or diagnosis by another trained professional. That can be smart.

The people who come onto MN to get their second opinion are stupid.

OP what's your agenda here? I'm definitely getting a vibe of something.

The people who come onto MN to get their second opinion are stupid

It would be silly to take the word of a random MNetter as gospel, agreed. But it’s often a very good idea to canvass experience and opinion when you’re not satisfied your HCP has got to the bottom of the problem- which happens a lot. Which you then follow up with a suitably qualified professional.

In any case, not alL of medicine comes down solely to standard protocols (if it did we could just get rid of most doctors and use computers instead). It can’t be as rigid as that. Things need to be individualised and individual preferences need to be weighed up. A doctor is not in a position to weigh up whether side effects of a treatment are worth if to a patient, for example. Patient autonomy still isn’t respected across the board. People asking for experiences of others is part of the process of exercising their autonomy.

Yes, I am too Max

I've had medicines prescribed by my GP that were later stopped when I saw a specialist.

He also prescribed statins for high cholesterol without going through the options with me first even though I'd already told him I didn't want to take a statin because of my concerns about side effects - I knew several people who had bad side effects from them.

I did get the prescription made up and on reading the leaflet, which clearly stated the advice to attempt reduction of cholesterol level by diet before starting the medicine, rang him to say I was going to do that.

He was quite dismissive of the idea but I told him I would try for three months and take it from there.

Went for a test three months later and lo and behold my cholesterol reading was way down to a healthy safe level.

I took the unused medicine back to the pharmacy for disposal.

I was so ill with sudden onset adult asthma that my asthma nurse at the clinic I had to attend regularly said I should keep an emergency medication "rescue" pack in the home - steroids, antibiotics etc for future as I had deteriorated so quickly. I had cause to use the pack and when I spoke to my asthma key worker to tell him he told me to get an immediate prescription and replace it. I duly attended the GP and asked her and she literally smirked in my face and told me she'd never heard of such a thing and refused to give me the prescription. I asked her to call the asthma clinic and check and also to check my notes. I said I would wait. She did so and then with much throat clearing - no apology though - shoved a prescription for all components of the rescue pack at me. I'm very glad I second guessed her.

It was interesting actually because not that long ago someone here on MN posted about an asthma rescue pack and was ridiculed by posters on here, some claiming to be HCP who had also never heard of this preventative treatment option and were quite short with the OP.

Also when I had DS contractions stopped completely even though they kept pumping medication to induce them into me. This had been going on for hours and I was just out of hope and unable to even speak. Their plan was to continue to attempt to induce for another few hours and ex quietly asked them what they expected to change considering I had been in labour for almost 48 hours. He told them I wanted a c section, needed one and just kept on and on at them till they agreed. When they did it ds was angled to the side and his head was stuck in my pelvis. He'd never have been born naturally. When they got him out an artery ruptured and I nearly bled to death on the operating table. I'm very glad ex second guessed them.

OP you have a fairly uninformed and unimaginative view of 'medical advice'. Quite often the right answer depends on subjective assessments of risk. Consider a man who has been diagnosed with prostate cancer. He can get operated on or he can do nothing. There is no clear cut medical advice here one way or the other. On the one hand the operation is very successful in terms of removing the tumor, but caries serious side effects like sexual dysfunction. How bad is sexual dysfunction? That is a subjective question. For some men it is catastrophic, for others it is negligible. On the other hand, prostate cancer is generally a slow growing, non-invasive cancer and the man is likely to die of something else while waiting for the cancer to grow, but there is always the risk he will be in the minority of people who do die of prostate cancer.

Medical decisions are not divorced from subjective assessments of harms and benefits. Add to that risk decisions that inevitably involve uncertainty and you have a very complex choice.

Of course it has to be painful and hard work, it's childbirth?!? I know it isnt fair but it's a fact of life isnt it?

Do you have the same views about dentistry?

@MaxNormal

No agenda. I've seen a few threads on here lately that seem quite dangerous and wanted to open it up for discussion. I've linked to a few above.

@Booboostwo

I know what you're getting at, but can you explain what could be done to guarantee an entirely pain free childbirth and recovery? If so, is there a conspiracy to withhold it from us?

@Tolleshunt

Mumsnetters have to be the most paranoid people I've ever come across 😂 I've been accused of being Meghan Markle on here before, then one of her friends, now you're going to make out I'm a bad tempered medical worker or something!

Where did I ever suggest that anyone can guarantee you anything in medicine, much less a pain free experience?

Your original point is an epistemological one: MN is not a reliable source of information for making informed medical decisions. That is not the case. Not only are some MN members very well medically informed (which often happens to people who suffer from rare or chronic diseases) but can also share personal experience of what it might be like going through the consequences of certain medical choices. This doesn't replace medical opinion, but it can go along side it, especially when it comes to evaluating subjective elements of risk.

None of that means that anyone can guarantee you anything when risk is involved.

Mumsnetters have to be the most paranoid people I've ever come across

I find MN a broad church with some fringe elements. Some people are more anxious and cautious than others. I wouldn’t lump everyone together and judge them as ‘paranoid’ generally.

now you're going to make out I'm a bad tempered medical worker or something!

I’m not sure where you’ve got that idea from. It’s wide of the mark. It could even be, ahem, a little paranoid.

But seriously, I’m curious as to what’s driving you here. You presumably don’t always swallow what you’re told unquestioningly? Even if the person is, on paper, more of an expert than you? For my part, I respect medical judgments (depending on who’s giving it) and take it into account in my decision making, with appropriate weight given to it. But the ultimate decision is my own. Because it’s me and not the HCPs who will live with the consequences of it. And I know how ideology and cost cutting factors into clinical decision making too.

Medical decisions, despite all the science, often come down to opinion and a personal assessment of risk vs benefit. No doctor can know everything, even experts disagree with each other and it is perfectly possible for an expert patient to know more about their own condition than many health care professionals.
One of my children has a rare condition. I have probably read every paper ever published on the topic, in English at least. I have seen numerous experts and discussed the pros and cons of the possible treatment options at length. There isn't a "right" answer- I really wish there was - and I don't expect miracles. I greatly respect the staff who have helped us over the years. But when I get health professionals telling me do do things that I know are not within current guidelines or which we have already tried and found unhelpful, then I have absolutely no hesitation in challenging them.
I don't subscribe to the "anti expert" feeling that seems to be prevalent in this country at the moment, but nor do I blindly accept everything I am told, and I definitely don't believe that all experts are equal. Most professionals are decent people trying to do the right thing, but they are only humans and are influenced by their own experiences and beliefs as well as their training. They won't always give what is the best advice for any individual - that just isn't possible.

@tolleshunt

I have a chronic illness. I absolutely bend the rules, I know my body best and know when a doctor's advice will not work for me.

In cases like mine, and with more general health complaints (that mainly warrant a GP visit), I totally accept that you just 'know' sometimes that you've been misdiagnosed, or that doctors often only see one portion of your medical care and miss the wider picture etc.

My question was more centred around women rejecting medical advice in pregnancy and on behalf of their children as it doesn't just affect them.

And more specifically in situations where what the doctor is suggesting does not hold any seriously adverse outcomes if it doesn't work, e.g. giving a fail to thrive baby formula. Yet I see a lot of posts from women saying they 'really really' dont want to try it. Why not? What is the worst that can happen?

Yet I keep getting replies about misdiagnosed ear infections etc