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LACTNET Home

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LACTNET  February 2001, Week 2

LACTNET February 2001, Week 2

Subject:

"stupid doctors" (long comment from a dr)

From:

Catharine Decker <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Sun, 11 Feb 2001 08:23:12 -0600

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (158 lines)

Kathleen Bruce wrote:

> One comment....please, let 's try to avoid terms like "Stupid
> doctors."  There are better and less petulant and personal ways of getting
> our point made without labelling or grouping professionals.
>
> I know that no group of professionals would appreciate being lumped into a
> grouping such as this, dumb LLL Leaders, breastfeeding-police IBCLCs, etc.
>
> Let's just drop the generalizations and get on with the great discussions.
>

Thank-you Kathleen.  As a family practice doctor and long-time lactnet
lurker, I really appreciate this sentiment.  I do not think I am a
"stupid doctor" and no matter how hard I try not to take it personally
(there certainly are *plenty* of doctors out there giving stupid advice
re: breastfeeding and I get just as outraged as you all) I cannot help
but bristle every time I read broad generalizations condemning my entire
profession.  Remember, we are all human, including doctors and as such,
we respond emotionally to such attacks.  Knee-jerk attacks beget
knee-jerk reactions and really damage current and future relations.

I shouldn't even have to say this, but...  Despite recent allegations to
the contrary, most physicians are decent people who are in medicine b/c
they care and want to help people and they work very hard and have
sacrificed much time and energy for their patients.  To slam the whole
profession is no more fair than to express any other prejudice against
any other group.  If I got on lactnet and criticized Christians or
Blacks or any other group, noone would tolerate it for a minute.  Yet,
the chorus starts to sing when someone criticizes doctors.  And when you
lash out against some members of a group, keep in mind that the
remaining members of the group are more likely to side with 'their own'
than with you.  So you wind up alienating not just the physicians who
are truly deserving of criticism, but also those who might otherwise be
on 'your side'.  Please don't do this.  Please don't drive away doctors
who might be open to joining the ranks of the pro-breastfeeding crusade.

I know you're angry that some physicians have given horrible, terrible
advice.  I'm just as outraged.  But don't tar every physician with the
same brush.  Please remember that this behavior is exactly the sort of
thing which destroys your relationship and your credibility with
physicians.  I have long been supportive of breastfeeding and wished to
encourage and help my patients with breastfeeding, even before I knew
much about it.  In medical school I received very little education about
breastfeeding and much of it was incorrect.  Thus, even though I
believed I was doing a decent job of helping my breastfeeding patients,
I was not.  I had a general awareness of some of the benefits of
breastfeeding, but a weak conviction for how vastly superior it was to
artificial feeding, also very little knowledge of how to manage
breastfeeding problems.  But I was still 'pro-breastfeeding' in the
overall sense and  had someone approached me in a positive way and led
me to better resources, I'd have welcomed it.  Instead, the negative,
anti-MD attitudes of some lactation professionals and lay supporters
actually *stood in the way* of my becoming better educated in the early
days.

As I said, I wanted to give good advice re: breastfeeding, but didn't
know a whole lot.  So I would look up information.  Fortunately, I had
picked up a copy of "Breastfeeding and Human Lactation" at a bookstore
clearance sale, so I had some good info.  But when I went searching
elsewhere for information on lactation, I was frequently slapped in the
face by this sort of vehement anti-doctor sentiment.  And let me tell
you, anywhere I would encounter it, I would turn away and look for
another resource.  In the early days, I was referred to lactnet by an LC
acquaintance, but I was so totally turned off by some egregious comments
against doctors that I assumed the people on lactnet were a bunch of
extremists and nutcases who didn't have any medical knowledge at all.
In my mind, people who were so wrong about my character were not people
with knowledge I could trust.   I would add here that the medical
profession in general tends to be pretty conservative whereas a lot of
lactnetters and other breastfeeding supporters tend to be
advocates/supporters of alternative medicine, herbals, homeopathy, etc.
Hence, at the time I further concluded that lactation professionals and
supporters were radicals who were against modern medicine and against me
personally, promoting alternative medicine instead.  So I concluded that
what they had so say was nonsense and I trusted instead the information
that came from mainstream medical sources such as my older and more
experienced MD peers, who often had old and outdated ideas about
breastfeeding.

Now, setting aside your own position for a moment, put yourself in the
position of doctors such as myself (especially the young and
impressionable and easily offended types).  Would you be likely to
embrace advice from someone whom you suspect to be:  a) hostile towards
you and your peers, b) hostile towards the body of knowledge which you
study and practice, c) promoting an alternative belief structure which
you at best feel to be potentially helpful as a complement to your
practice or at worst you may even suspect to be dangerous (ie: being
opposed to childhood immunization, which is a belief among some
alternative practitioners, not all, of course, but in my experience
that's been the single most damaging issue that peds/fps have against
alternative practitioners).  Considering the matter from this
perspective, does it really surprise anyone that doctors aren't coming
around as quickly as they should be?

Frankly, I'm amazed I got past all that in the early days and made it
through to the point I am currently at.  If it hadn't been for the fact
that the 'lactivist' community rose to my support at a critical time
early in my own breastfeeding days, I may always have remained wary and
suspicious of what I considered to be 'radical' breastfeeding
information and maintained the mainstream cultural view (as in "sure
breast is best, but lots of people can't do it, don't feel guilty, look
at all the formula fed babies who turn out just
fine...yada...yada....").  Instead, I've been totally won over,
galvanized, convicted...

In case any one here might remember, about four years ago there was a
doctor who was told she was not permitted breastfeed her infant daughter
at a Sears portrait studio ("because children might see and that's
indecent!").  She called the national customer service center and
complained, but was brushed off.  So she turned to her internet friends
and asked them to pass on the word and write to Sears portrait studios
to complain.  Many lactnetters and other breastfeeding supporters
responded.  Literally *hundreds* of emails poured in from all over the
world.  The portrait studio people took notice and took measures to make
sure the incident was not repeated.  The doctor was overwhelmingly
impressed by the response.  The doctor also had cause to really read up
on her breastfeeding literature and was duly impressed and encouraged to
continue reading.  A month or so later, when her baby went through a
very difficult nursing strike, she was bound and determined to keep
nursing this baby whom so many people had fought for.  So she turned to
the wonderful lactation folks for advice and learned a lot.  And stuck
around to learn more.  She is now a tireless promoter and supporter of
breastfeeding.

And of course, as anyone can guess, she is *me*.  And that baby is now
almost four years old, and continues tandem nursing along with her 18
month old sister.  Thanks again folks.  ;-)  My children thank you.

My apologies if anyone was offended by any of what I have written.  I
have been wanting to post something like this for years, but have always
held back.  But recent discussions about "why pediatricians may have a
slanted view of breastfeeding" and of course "stupid doctors" have
encouraged me to speak up.  My purpose is not to berate or blame
anyone.  But we must admit that the relationship between MDs and LCs is
sometimes strained.  And I think we can safely say that we really need
to 'win over' more physicians.  Thus, I think a reminder to this effect
might be helpful.  Keep in mind that many MDs and other people may be
reading lactnet archives unbeknownst to you and that may be their *only*
contact with lactation professionals.  Whatever impression they come
away with may be lasting.  You never get a second chance to make a first
impression.

--
Catharine Decker, MD, FAAFP
Mama to tandem nursing Charlotte (04-11-97) & Clarissa (07-28-99)
mailto:[log in to unmask]

PS:  A little encouragement for you 'alternative' providers out
there--my experience with breastfeeding has really opened my mind to
other ideas and practices outside of conventional medicine.  :-)

             ***********************************************
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