Can "listen to the science" be misinterpreted as the doctor is always right?

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Science it right, scientists can be wrong. Is there a risk for a patient to always with question trust every thing from their doctor? At the same time is there a risk for a patient to always be skeptical of everything from their doctor to the point that they jeopardize their health.

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Yes.

 

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Specializes in retired LTC.

Hey! When a PMP is competing with Dr Google, any bets??? 

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If you work with doctors for long enough, you'll realize plenty say things that are flat out wrong or skewed in some way.  Doctors are human.  Some are humans with a strong ego who would rather guess at an answer than say "I don't know."  Most experienced nurses know of at least a few doctors we wouldn't personally entrust with our healthcare. Follow the science doesn't mean blindly follow a healthcare worker.  

In general, I think physicians are very knowledgeable and a great source of information. I also think human instincts are amazing. If something a doctor says about a given situation feels off, it's smart to question what you're being told.  Ask the doctor what led them to a conclusion, what evidence and guidelines they based something on, etc. Asking questions is OK. If something still isn't sitting right, it'd be wise to get a second opinion.

Follow the science means trusting that current, well-studied, peer-reviewed information published in legitimate academic sources is accurate. Following science requires healthcare workers to use evidence-based practice. 

Following science means that if published, research-based health guidelines say to do XYZ, and my doctor says "I don't recommend XYZ to my patients because I personally feel ___," it's worth questioning that doctor. 

Maybe the doctor in the example above has a legit reason for doing things differently. Maybe newer trials are showing a high risk to low benefit ratio for those who try XYZ, but ABC practice is getting better results. Alternatively, maybe the doctor has no good reason and just ignores/dismisses published research and best practices on a whim. Very different situations! 

I would never advise patients to blindly trust physicians. I *would* advise patients to trust their physicians over .com websites listing 502 conditions they might have based on their headache or internet forums where laypeople throw in their two cents on healthcare.

 

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Specializes in CVICU, MICU, Burn ICU.

It can be a challenge for laypersons to vet the extent to which their providers deliver care based on the best evidence.  And this is why watchdog organizations such as Joint Commission and other accrediting agencies are important to public safety.  For the healthcare consumer, at some point you need to be able to put your trust and confidence in something/someone.  That said, in the day of information-at-your-fingertips via anyone with internet access, many choose to put their trust in foolish anecdote because it is easy to find support for any number of personal beliefs that way.  I am convinced there is nothing, on a global level, to be done about this as it reflects 'the other side of the coin' consequences of personal freedom and choice. 

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Specializes in orthopedic/trauma, Informatics, diabetes.

I find that doctors may have too narrow of vision. I work on an orthopedic unit and many of our >65 pt have medicine primary teams or consults. Ortho surgeons aren't great at assessing the implications of comorbid conditions, they tend to look at the injury only. Also, just this week, I had a medicine physician who did not understand the pathology of a particular surgical repair of a fracture. He also had difficulty explaining to the pt what an A-V fistula was and why it couldn't be "removed" when it had failed. 

I think it is all perspective. Even though it may be out of my scope, I try to educate the best I can. I think nurses are better at seeing the bigger picture. 

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Specializes in CRNA, Finally retired.
On 10/30/2020 at 2:18 PM, DesiDani said:

Science it right, scientists can be wrong. Is there a risk for a patient to always with question trust every thing from their doctor? At the same time is there a risk for a patient to always be skeptical of everything from their doctor to the point that they jeopardize their health.

Scott. Atlas.

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Specializes in orthopedic/trauma, Informatics, diabetes.

He is choosing to be obtuse. Same as Oz, the other official WH physician. They choose $$ and fame/power of common freakin sense AND their Hippocratic Oath.

 

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22 hours ago, mmc51264 said:

I find that doctors may have too narrow of vision. I work on an orthopedic unit and many of our >65 pt have medicine primary teams or consults. Ortho surgeons aren't great at assessing the implications of comorbid conditions, they tend to look at the injury only. Also, just this week, I had a medicine physician who did not understand the pathology of a particular surgical repair of a fracture. He also had difficulty explaining to the pt what an A-V fistula was and why it couldn't be "removed" when it had failed. 

I think it is all perspective. Even though it may be out of my scope, I try to educate the best I can. I think nurses are better at seeing the bigger picture. 

As a patient, I have been told by many specialists, this is what I specialize in I have treated you for that condition.  I am done.  You need to return to your family physician for care and if you need me again he/she will send you back.  I only look at you from my perspective...such as I am not a trauma doctor or I specialize in ortho not general care.

Many times, I have watched the facial expression or eyes of the attending nurse and realized that I needed to ask more questions or just say no to the attending physician.  Or had a nurse when alone with me say if you don't want to do this you don't have to.  Then I know that it is time to say what a minute or to just ask why.  I have also been talked into expensive testing that if I had listened to the attending nurse or my inner warning system would not have been necessary.   

I have also had physician order medicine that is in the same family as something that I am very allergic to and it was my pharmacist that caught it and refused to fill the script.

As far as Dr. Google goes, yes it is a form of information but....and this is big but....you do not base your medical care on Dr. Google.  I have found information that explained my condition more than the doctor or nurse did and found suggestions that helped in the long run.  But you do not base your medical care on searching the internet...And, I will say that in finding this information, I was able to discuss the findings with my primary physician and get the care that I needed rather than continue with more testing that was getting me no where.

At some point, you have to trust your doctor, but you also need to watch, listen, and observe.  

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Specializes in retired LTC.

to trytounderstand - I like Dr Google too. For some real easy-to-understand detailed  explanations. I've also had docs mis-prescribe or decline. Or over-recommend tests. I can understand their logic and will respect it. But like you said, watch, listen & observe. Then make YOUR decision!

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Specializes in Med Surg, Tele, PH, CM.

You have to separate the science from the doc sometimes. Science is designed to be objective, although it does wander occasionally. But docs sometimes lean more toward the subjective side. Can be due to their own personal beliefs, the policy of the health system that employs them, or government restrictions or mandates. If you feel that you need to make an informed decision against their advice, be honest, ask questions, make your arguments. Then decide for yourself. The days of "the doctor is always right" are long gone. 

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