Actually diagnosis comes down to distinguishing between normal and abnormal.
If you are trained in or know the full range of normal, then what's left is
abnormal. If you're trained in the abnormal, then normal becomes a diagnosis
of exclusion.

This argument echoes around many health-care arenas, not just maternal-child
health care. The individual makes the first diagnosis in most situations,
and elects to go to someone for further help.

Mothers nearly always diagnose illness in themselves or their children or
families, then hire someone to help them fix the problem. Women now can
self-diagnose a vaginal yeast infection and go to the local drug store and
buy an over-the-counter antifungal cream. Before OTC antifungal drugs were
on the market, the only alternative was to self-diagnose, then go to the
doctor and pay dozens of dollars for confirmation of the self- diagnosis,
then pay more money for prescription medicine.

The more people know about their own health, the better - IMHO, of course.
I'm glad that I can learn about health and illness from many sources
including my doctor. However, I'm also very glad that my doctor is trained
to recognize the most awful of conditions and reassure me that I don't have
one of them, OR treat me with powerful medicines and scary techniques if I
do. And I like the fact that he/she needs to have confirmation that s/he's
completed a training program - in the form of a license - to use out the
powerful stuff. At least a license establishes minimum competencies. I sure
want more than the minimum, but the minimum is WAY better than what's lower
than the minimum level of skill or knowledge.

What drives me absolutely insane is when a doctor or other supposedly
knowledgeable person doesn't know the answer, or doesn't recognize normal,
and MAKES SOMETHING UP. This I have absolutely NO patience for. If they
don't know the answer, then they should (to quote Dr. Jay Gordon), "Look it
up, doc!"

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com

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