As the occurrence of vaccine-preventable diseases declines, the challenge of communicating the risk of not being immunized increases.Every situation is unique; parents have diverse concerns for various reasons. These can be cultural, religious or even personal. Many believe there is a link between some diseases and immunisations or believe in strange ideas perpetrated by unscrupulous online media. It’s no secret.
Blogs like this actually are in the minority. I understand my blog is in the medium sized category. I can get around 1500 to 2000 hits a day. What I get in a month Natural News often gets in a day. It racks up 8 MILLION views. If a 1000 hits equated to $1 it would be large enough to be making around 9000 dollars A MONTH and that is without sales of quackery and speaking fees and all the other things Mike Adams gets. Considering the level of research and the harm it causes it is quite shocking.
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The fact is? Anti-Vax and Quackery and the Conspiracy Theories are a great way to create click bait and drive your site up the rankings. If I had named this post Avicenna meets these Anti-Vax and you won’t believe what happens next!, we may see more hits. What we face is often a slick system of production where “experts” in vaccination turn out to be utterly ignorant but create their own effective fan base. It’s through everything. Word of Mouth, Actual advertisement and indeed a large number prey on the forums and areas dedicated to new mothers.
Often when I speak about the quackery involved in natural and home births, I am inundated with disbelief as male skeptics tend to be unaware of the problem. In addition? The rhetoric of feminism and pro-choice is used to defend the right to have a “natural and home birth” which is fine. If you are aware of the risks and the fact that natural birth is quackery and “dangerous” quackery at that and you are willing to take on an inferior modality of care then you are free to make your choice. It is then an informed choice. It is not an informed choice to say that home births are safer than hospital births.
The truth is? You can provide safety information, but the only people who takes this on board are those who hesitate about vaccines cause they aren’t aware of both sides. And part of this means also providing them with the information needed. Too often newer parents are scared away by our anger towards the anti-vax who often are dishonest in their actions. I hope more new parents on the border line read this.
The strategy of the anti-vax is to create doubts in medicine. It is why they bring their own “doctors”. The thing is? Most of their doctors aren’t doctors. Chiropractors are basically masseuses. Sure I enjoy a massage but I am not going to take financial advise from one or purchase a house on one’s advice. I am not going to take that sort of advice from most people. People are experts in certain fields. Either they are passionate about it or they have training in it. The anti-vax portray their “doctors” as the real deal. Chiropractors believe spinal adjustments improve your health. I have cut open enough dead bodies to know that spines (while flexible) don’t really move in relationship to each other and that if they do move and touch the spinal cord then what you get is pain and paralysis. Many injuries caused by Chiropractors have the same effect too. Homeopaths believe water has memories if you tap it against a leather covered wooden board and that the less of a substance there is in something the more powerful its effects which is silly. Often? The concentrations are so minute that if we were to take the entire planet’s water, we would have just one molecule of the active ingredient. Herbs aren’t as accurate as the precise drugs we make and crystals don’t heal. The stars do not mean anything. Some people think that this is sad. I think that because we don’t live in a world where things just work on magic, it means we can understand how precisely things work.
Yes? We don’t know how everything works. If we did? Science would stop. So if the science cannot be faulted what do the anti-vax do?
They fault the practitioners.
Doctors are human beings. We have faults. We make mistakes. We are not gods. A good analogy is a sport. This is a hard job, most people accept that. But anything less than 100% success is considered a failure. But we know that is impossible. The sad truth is we are all going to die. What doctors do is delay the inevitable. A doctor’s survival rate is not an indicator of quality of care. Many cancer and trauma doctors have low survival rates due to the type of cases they come in contact with while a bad dermatologist may never ever kill anyone.
Or they attack our personalities. Countless Christian Anti-Vax point out my atheism (As if that means I eat babies) as a flaw. Many utilise my pro-choice stances. A fair few who follow the blog regularly often attempt to shame me as I am sex positive. We literally are seeing defences such as “Oh yeah? Well you don’t think S&M is bad, so your stances on a scientific proven fact are invalid!”. And to an extent this is effective.
See? We forget doctors are people. We have such high expectations of our doctors that we forget things. I cannot show visible tattoos. I had to remove piercings to look respectable. We often have to give up cultural things simply to fit in. And the worst bit is how fake this is. In an attempt to fit into people’s perceptions of doctors we often punish doctors who don’t speak in a plum voice. We forget doctors have likes and dislikes. Imagine refusing to see a doctor simply because he supports West Ham? Yet we think that bringing up my enjoyment of scotch, my love of games and indeed what I choose to support as reasons to denigrate my actual proven knowledge.
Stephen Hawkings enjoying porn isn’t going to make his work invalid.
And if all that doesn’t work? Make things up!
The most common accusation that I get is that I am a big pharma shill. I hope so! Come on guys! I defend your awesome vaccines and you never throw me a bone! I keep hearing how you guys keep us in Hugo Boss, Saint Laurent and Champagne but all I have is Tesco’s Cherokee, Axe and Reverse Osmosis Water.
We should try our level best to convince parents to vaccinate. We need to start creating resources that help explain how the human immune system works and how vaccines help and why it is a civic and social and parental duty to ensure kids remain vaccinated.
If you try your level best to convince parents that they should vaccinate. If you cannot? Then as doctors we often cannot do anything else. The patient-doctor relationship is fractured and cannot be fixed. The patient’s parent clearly doesn’t want vaccines and clearly will not adhere to any treatment plan you make. They should find a new doctor.
And you as a doctor do not need the liability of an unreliable carer. Should you keep them on you will become a handy scape goat should the child fall sick and honestly? Your practice would do better without the drama of having to deal with a a decision maker who constrains your capacity to treat due to ignorance.
And always remember that patients never realise that we are human. I fear that a huge part of medicine screws us over by trying to fit doctors into a really professional and rigid cage when we should encourage doctors to learn a natural style off communication. To be able to use a realistic conversation to acquire information rather than the often condescending tone we think is “professional”. Our patients often don’t understand us and part of our culture that needs to change is how we interact with the patient. A bedside manner should be organic rather than a rigid set of rules.
And bedside manner counts a lot. I often sit on the patient’s bed. to talk to them. Many of my patients tell other doctors that I spend more time with them as a result of this. JUST sitting down while I talk to them on my rounds is enough to make them happier. A standing doctor is perceived as busy and wanting to leave. So even though me and the person standing may take the same time, my patient has higher satisfaction (And my legs don’t hurt as much by the end of the day so it is a win win!).
All these things count and we need to start using them more, not to maintain the rigid professionalism of the old but to create a new one where the patient sees us both as a doctor and as a human being and so realises we are just as flawed as they are and so we become more relatable to them and thus more trusted.
And that’s the core of the pro-vaccinatiion strategy to get parents to vaccinate. We need the knowledge and we need the delivery.