Who Do You Trust?

Sometimes when seeing a patient in the Emergency Department, I discover the kid isn't vaccinated.  The parents often say "I researched it" when explaining why they don't vaccinate.  When I hear the word "research," I picture protocols, test subjects, and data assessment.  Which makes me want to say something snarky to the parents, like "Oh, by 'research' you mean you pulled the original data, did your own statistical analysis, and found their study design wanting?  Or you just read some crank on the internet?"  But of course I don't. Where can you go these days for good medical advice?  The internet, when it came out, was meant to be an "information highway," where everyone could get knowledge fast.  However, it's now sometimes the "misinformation highway," where non-facts spread quickly.  Like when "anti-vaccers" use wrong material to scare people from vaccinating their kids. People used to get their medical information from TV, magazines, newspapers, and books.  However, who buys books and magazines anymore, or watches TV news?  Newspaper circulation is way down too, and papers are getting thinner and go less in-depth with their articles.  People often go to friends for advice, but like the internet, friends' information is only as good as their own sources.  Some people listen to celebrities for advice.  We always hear from celebrities, either on old platforms (TV and magazines), or new ones (Twitter, Facebook, TMZ).  Since interviewers cling to celebrities' every word, sometimes those celebrities use their media soapboxes to expound on subjects where they have no expertise. There's also a trend where institutions like medicine, news media, or government aren't as trusted as they used to be.  In the twentieth century, when medicine was making great strides with inventions like antibiotics, vaccines, and cancer treatments, lives were obviously being saved, and people listened.  Government was also showing its competence, winning World Wars, putting men on the moon, and establishing social safety nets for the poor and elderly.  Now the pace of medical breakthroughs has decelerated, and we find it harder to trust medical science, especially when one month the news reports that coffee, eggs, or butter are bad for you; then the next month they're healthy again.  And since the Vietnam war and Watergate, government has become suspect as well. Back to our non-vaccinating parents from above.  Instead of saying what I really want ("So when you did your 'research' on vaccine safety, that means you read some yahoos on the internet?"), I go more constructive.  I ask about their specific fears- what exactly worries you about vaccines?  Then I address those worries with facts, and stories from my own practice.  People appreciate education when it's presented in a positive, non-judgemental manner. Data on patient-doctor encounters shows that people still generally trust their own doctor, more than the medical establishment as a whole.  As we discussed above, public confidence in medicine, government, and the press has declined over past decades.  So like your local doctor, trust me when I say that these institutions are trust-worthy themselves.  I worked at a pillar of medicine- Johns Hopkins Hospital- and knew medical researchers, there and at the CDC and NIH.  These are earnest guys whose ambition is to serve people and do good science.  There's no conspiracy between these doctors, government, or drug companies to line pockets and hide good data from the public. I also have friends in media, from  local TV stations and newspapers, to the New York Times.  Again, they're hard-working professionals who get facts straight and provide good information.  Allegations that they make "fake news" is the fake news itself.  Bottom line: you can trust institutions as sources for good information. So where can you go for clearly written, fact-based medical information for your decision making?  First, if you're reading this column on-line, you're already there!  Go to the tabs at the right of this paragraph to read more on each subject.  If you're reading this in the newspaper, go to parentsdontfret.net for the blog version.  Other good websites are at major university-based children's hospitals, the NIH, or the CDC.  Also, there's good ol' books.  Barton Schmitt is a pediatrician who's written some of the best books on caring for sick children.  The "What To Expect" series is also very good. If it's vaccines, rashes, emergencies, or what-the-heck-is-my-baby-doing-now-is-this normal, go to these places for help.  They're tried, true, and fake news free.