[hndudette2]

> After asking five different doctors about it, one finally agreed to prescribe it.

Were the other four too lazy/orthodox to read the papers you're referencing? Or they read the papers and still thought it wasn't a good idea? I'm going to presume that the former is the case, unfortunately.

[wincy]

They had “read” them. The first time she mentioned the drug to a doctor he just snippily corrected her on the pronunciation but nothing else. My wife carefully documented everything the paper said in a “Cliff’s Notes” sort of version with links. The next meeting we had with them they were much less hostile, it was like night and day. I guess they were impressed by her careful note taking. Even so the doctor who did prescribe it sort of acted like it was his idea, my wife kind of rolled her eyes and just let him keep thinking that.

The way we think about it is a doctor has what, 15 minutes (if that) to spare thinking about our daughter languishing in the NICU. My wife spent literally all day, all night, ruminating and worrying about her. I had just started a new job, (I was unemployed when she was born!) and honestly poured myself into that position, maybe as a way to avoid living at the hospital (I’m not proud of it but that’s what happened). But it is weird we had to get the pulmonologist to prescribe a medication that’s something the neurologist should probably be prescribing.

[blix]

Doctor's dislike when patients come in having tried to figure out something about their condition or treatment on their own. It seems to knock them out of their routine.

I have personal experience with this as a patient and a family member of physicians. I wish I didn't know what docs say and think about their patients. It's a really unfortunate characteristic of the US medical system.

[jacquesm]

It goes further than that, it challenges their ego and the feeling that they know everything better than the patient does. This is not unique to the medical profession, but there the damage is immediate and sometimes fatal.

[thatguy0900]

Is lazy really the right word? I would assume doctors have an incredible amount of stuff to continually read up on and a large amount of patients that would all individually benifit greatly if the doctor read alot of papers about their particular ailment. On top of working large hours. I would assume only specialists would be able to really try to read everything for a patient like that without "skimming"

[arp242]

Or didn't want to take the risk of using a somewhat experimental medicine (perhaps justifiably so, I don't know the details), or maybe the evidence is still promising but otherwise still very thin. Or they just didn't have the time to really research it as they also had dozens of other patients.

There could be any number of reasons; without more details, I think it's quite a leap to immediately assume they're "lazy/orthodox to read the papers".

[jjoonathan]

It's quite a leap unless you have worked extensively with doctors before and seen the behavior first hand too many times to count.

I get why it happens: they have to deal directly with patients who 99% of the time are not research capable and if they claim to be research capable what they really mean is that they've been sharing conspiracy theories on facebook. Doctors build defense mechanisms against the nonsense (authoritative tone, dismissive attitude) that grate on academic sensibilities. They can be slow to come around but eventually they usually do.

[wincy]

And you’re right, that’s exactly what happened. My wife wrote up a set of concise notes with citations and asked if the social worker could forward it to the doctors. We met with the doctors a few days later and they thanked my wife over and over again for the document, and the conversation totally changed from one that felt adversarial to one that felt much more collaborative and productive.

As the doctors cycled out though it sort of reverted to the mean, back to the authoritarian stance you expect from doctors, since NICU doctors were constantly rotating out.

[wincy]

The evidence is thin because there’s very few children with the condition. A good number of them die by holding their breath. Very scary. It’s a complication of an already rare disorder. The medication has been around since 1966 though, it’s clonidine/catapres. The first doctor she mentioned it to just rudely corrected her on the pronunciation rather than give any actual feedback on whether or not it could help.

I think you’re absolutely correct about having dozens of other patients. My wife wrote a long email, that was forwarded to the doctors, citing various articles with links to the medical journals and the doctors couldn’t thank her enough for it. It wasn’t until that happened that someone prescribed the medication for her.

[hndudette2]

I'm going off my experience with doctors that I know personally. There's definitely a personality type or an attitude there that shuts them off to things that a layperson will bring to them even if it's based on good science (only they haven't studied it before).

[fakedang]

Past experience is to blame for that. A lot of doctors blame patients for bringing utter bullshit that they scraped from Facebook or YouTube as the next Gen therapy.

For instance, I have a background in biochemical engineering, my fiancée is a cancer surgeon, 4 cousins are doctors, and another 3 cousins married doctors. Yet the entire family collectively believes in homeopathy, unani medicine (Greek medicine) and other hogwash like cupping therapy, save for a select few. The last time I visited one of my relatives, they were ingesting some ayurvedic (Indian medicine) concoction that was later found to contain arsenic. One of my friends is daughter to two doctors, yet her Dad (a former Indian Army doctor, so not the run-of-the-mill kind) still spouted nonsense on Facebook like "burning Turmeric powder and inhaling it would prevent COVID".

It's easy to understand, after all this, why doctors tend to be generally skeptical of laymen bringing them some new "breakthrough". Not much to do with personality than with what they see as a daily occurrence. Of course, one way to sift the chaff away from the grain would be to demand that patients bring in scientifically published papers, at which point most patients would scoff at you for not supporting their viewpoint.

[higerordermap]

> "burning Turmeric powder and inhaling it would prevent COVID"

This kind of bullshit is too prevalent around here, sadly. And telling that ayurveda is pseudoscience instantly makes you "anti-national" and what not.