The claim of being “educated” about a health topic is the surest sign of ignorance

woman shouting

What does it mean to be educated in a particular discipline? Whether that discipline is architecture, anthropology, or law, being educated generally means years of study, thousands of hours of experience, and intimate acquaintance with the specialist literature.

Medicine is like that, too. It involves four years of college, four years of medical school, 3-5 years of hands on training for 80+ hours per week, countless textbooks and intimate knowledge of the relevant medical literature. No layperson is educated in medicine. The idea is simply ludicrous. Therefore, when a layperson claims to be “educated” about a particular health topic, like childbirth, or vaccination, or autism, you can be virtually assured that a stream of absolute nonsense will follow.

When a lay person claims to be “educated” about health, she certainly doesn’t mean that she went to medical school, has hands on training caring for individuals with the condition, or is familiar with the specialist literature. So what does she mean? When a layperson proudly claims to be “educated” about a health topic she means that she has adopted a cultural construction of “education” that has little if anything to do with actual knowledge of the topic.

‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK (Hobson-West, Sociology of Health & Illness Vol. 29 No. 2 2007, pp. 198–215) explores cultural construction of being “educated.” As the title indicates, the authors focus on vaccine rejectionism, but the principles apply equally to natural childbirth advocacy, autism cures, and any other form of alternative health.

When advocates of vaccine rejection or natural childbirth claim to be “educated,” they are not talking about actual scientific knowledge. Indeed, the scientific data is generally ignored. The claim of being “educated” on vaccine rejection or childbirth simply stands for a refusal to agree with health professionals and refusal to trust them. Agreement with doctors is constructed as a negative and refusal to trust is constructed as a positive cultural attribute. As the authors of the paper explain:

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

This characterization of vaccine rejectionists or natural childbirth advocates can be unpacked even further; not surprisingly, vaccine rejectionists and natural childbirth advocates are portrayed as laudatory and other parents are denigrated.

… instead of good and bad parent categories being a function of compliance or non-compliance with vaccination advice … the good parent becomes one who spends the time to become informed and educated about vaccination…

… [vaccine rejectionists] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

When a vaccine rejectionist or natural childbirth advocate claims to be “educated” on a topic they don’t mean that they have any education on the topic at all. They simply mean that they are defying authority. In their world, trusting experts is a mark of credulity, while ignoring expert advice is a sign of independent thinking and self-education. But, of course, since they don’t really know anything about the topic, they are inevitably forced to rely on the advice of propagandists, charlatans and quacks.

The person who proudly claims to be “educated” on vaccination offers as proof the fact that he ignores the expert advice of pediatricians, immunologists and virologists and embraces the teachings of … washed up Playboy Playmate Jennifer McCarthy. In their delusion, vaccine rejectionists fail to appreciate the irony. Far from being “educated,” they are unbelievably credulous.

The woman who claims to be “educated” about childbirth offers as proof the fact that she ignores the advice of obstetricians and pediatricians and embraces the teachings of … washed up talk show host Ricki Lake. Amazingly, she has no idea of how utterly foolish she sounds.

If the goal of being “educated” isn’t acquiring knowledge, what is it? The ultimate goal is to become “empowered”:

Finally, the moral imperative to become informed is part of a broader shift, evident in the new public health, for which some kind of empowerment, personal responsibility and participation are expressed in highly positive terms.

So vaccine rejectionism, like natural childbirth, is about the mother and how she would like to see herself, not about vaccines and not about children. In the socially constructed world of vaccine rejectionists, parents are divided into those (inferior) people who are passive and blindly trust authority figures and (superior) rejectionists who are “educated” and “empowered” by taking “personal responsibility”.

A lay person’s claims to be “educated” about a health topic is really a claim of defiance. The person is proudly defying the recommendations of health experts with years of education and years of training in order to credulously accept the bizarre conspiracy theories of people who have little or no education and training in the relevant discipline. When a vaccine rejectionist or a natural childbirth advocate claims to be “educated,” she means that she has thoroughly read and blindly accepted the propaganda of other people who are equally uneducated.

When someone tells you she is “educated” on a healthcare topic, beware! There is no surer mark of ignorance on the topic than the proud claim of being “educated.”

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  • Maddy

    What else can you use to explain the sudden and massive jump in average life expectancy that occurred in the last century or two?

  • Maddy

    This is where consensus becomes important. Are they in defiance of current, accepted, evidence-based medical practice? Well then they are statistically MUCH more likely to be misleading you than to be some progressive leader in their field.

  • Maddy

    Dr Amy, you are awesome.

  • Vivian

    Finding a compound that causes apoptosis in cells is easy. It is finding one that does so specifically in cancer cells where the challenge truly is at. A little knowledge can be a dangerous thing. In case you are wondering, I am a PhD candidate in immunology who got my MS in biochemistry working in an oncology lab.

  • Lenajeanne

    Thank you Dr. Tuteur,

    There is nothing like a big ole slap in the face when a person of the general public tries to “educate” me. Obviously we are not always right. Obviously you should always get second and third and so on opinions, but to tell me that I’m wrong about understanding decades of research when you can’t explain to me something as simple as a mitotic spindle let alone epigenetic modification heritage is the biggest form of idiocracy.

    This really made my day………and my career!

    • Amy Tuteur, MD

      Your career? You hawk organic cosmetics.

      • Lenajeanne

        Funny you say “hawk” Every part of my “organic” which isn’t a term I like, but one the general public likes is backed by peer reviewed published data. I can send every single primary article to you.

        However, I am a PhD biochemist who studies treatments for pancreatic cancer. I do not “hawk” anything. That in itself was quite rude.

        If you wish to discuss the new advances in skin care I would be more than glad to provide with references, articles, from even journals such as jbc.

        I will not nor will I ever say that any of my lotions are or ever have been a cure, but what we put on our body counts. Just like what we put in our body. I use the same ingredients that any other lotion company uses it is just not diluted down, making mine more expensive. I also have pharmacy grade hyaluronic acid which IS backed by primary data as an eczema treatment, such as in the original prescription of Hylira.

        Perhaps you should look into something before you speak about it. That in itself is a show of complete ignorance.

        My byline is “Biochemically designed lotions for today’s organic woman” which is what it is. It is a different style of lotion, which it isn’t a lotion at all. They are ointments and creams, but again the general public does not prefer that word. I can send you a sample so you may see the difference… GIve me your address and I’ll send free of charge a scrub and a 2oz bottle of my whipped facial cream. Then see what I “hawk”. ALong with that I will send you a list of references for all the peer reviewed journal published articles from lipids such as oleic acid to vitamin E found in avocado and grapeseed oil.

        Just in case you forgot. The entire point of being a MD/PhD is to learn and to educate while treating. I am surprised that this is not something you have been taught. Or perhaps you have learned it along the way. It is disappointing to say the least. Funny how I was just made completely disappointed in a clinician.

        There are many ways to address a person if they have issue with them…and you have seem to have forgotten proper bedside manner.
        Thank you

        PS. THe

  • Molly

    Awesome

  • Lisa Murakami

    This is such a great post. How many of the people “doing their own research” ever got off their butts and even went to a medical school library? They need to start saying “I googled it” instead of “I’m educated in it.”

  • ciara2

    Hello, everyone my name is CIARA from USA i never ever believed in spell until i meet a man called Dr CAFI who help me cast a spell that bring back my husband who left me for one years before our marriage, His spells works beyond my imaginations and today i am happily married two kids and me and my husband now husband are very happy more than ever before, what more can i say rather than to say thank you Dr CAFI for been there for me, contact him today and your life will never ever remain the same his email is cafilovetemple@gmail.com…….

  • Rebecca Coates

    Your diatribe against Attachment Parenting irritated me, but this is bang on the money. It beggars belief how anti-vaccination idiots are “too smart” to fall for the lies of Big Pharma (or so they say) yet are completely and utterly willing to believe any old bollocks so long as its posted on the Natural News website.

    Good article.

  • carlarose

    How can you describe medical doctors as health experts? What part of the medical training focuses on being healthy? Wellness? Nutrition? Doctors are experts on disease and how to treat disease with meds and surgery. Recently I was with an MD friend at his home. He offered my children diet coke with dinner. Really? A neurotoxin for children? I don’t think a health expert would serve children diet coke. MANY MDs and nurse are unhealthy and statistically die younger.

    I am not trying to be critical. I just feel there is a difference between a wellness based model and a disease based model of medicine.

    • Jocelyn

      This might seem obvious to most (but I guess not to you), but disease is a serious impairment that keeps one from being healthy. By being experts in diagnosing and treating disease (through not just medicine and surgery, but also through recommending lifestyle changes), doctors help people achieve total (or improved) health. They know the difference between health and the absence of health, and they know how to help people reach health. Thus, they are health experts.

    • Box of Salt

      carlarose “A neurotoxin for children”

      Please name the neurotoxin, and cite references for its toxicity in humans (in vivo).

      • Lizzie Dee

        Aren’t the main neurotoxins for babies their unsuspecting or over-confident mothers and careless or clueless care givers?

    • Amy Tuteur, MD

      Thanks for demonstrating the point of the post.

      Do you really believe every bit of crap you read on the web? Do you ever engage your brain to think logically about what you read? Apparently not.

      We’ve heard this nonsense before.

      http://www.skepticalob.com/2009/09/big-placebo-says-medicine-never-cures.html

    • Guest

      Gee I guess all that time we spend and the pamphlets we hand out regarding the importance of diet and exercise are not focussed on being healthy – who’d have thought? And the counselling regarding risky behaviour, vaccinations, and those referrals to the nutritionist and the osteoporosis clinic, well that’s not focussing on prevention either. I could go on and on but really, you have just demonstrated how little you know about the medical profession.

      • The Bofa on the Sofa

        Oh sure, you hand out pamphlets about diet, but they just say stupid things like, eat in moderation, avoid fats and carbs, eat lots of fruits and veggies, and fish is good for you. That’s not TRUE “nutrition.” I mean, the only supplements you might recommend will be fish oil and maybe Vitamin D, but only if you have a blood test first. Where are all the others? Where is all the instruction about organic and natural foods, and the toxins? Hmmm?

        • KarenJJ

          If you haven’t stuck the word ‘paleo’ into those pamphlets at least a dozen times it’s not really nutrition now, is it?

          • The Bofa on the Sofa

            Karen, that is such a great comment, you must be a nutritionist…

            (no offense)

      • auntbea

        All the foods you recommend have chemicals in them.

        • Maddy

          Yes, nasty chemicals like ascorbic acid and dihydrogen monoxide.

    • The Bofa on the Sofa

      Ironically, one of the most important tenets of toxicology came from the famed alchemist, Paracelsus, who noted that “the dose makes the poison.” Doctors are still taught this today.

      EVERYTHING is toxic if you have too much, which, in double irony, Paracelsus learned when he died from liver failure from too much alcohol (those crazy alchemists, somehow got the idea that alcohol was the “elixir of life” and therefore drank to excess; I am reminded of the pigs in Animal Farm when they discovered alcohol…)

      • As a toxicologist this comment makes me smile 🙂

    • Squillo

      You’re forgetting that much of primary care–including pediatrics and ob/gyn–is focused on preventive medicine. When I go to my GP or my kids go to the ped, unless we’re there for a specific complaint, most of the time is spent on checking for evidence of disease (early detection of disease and risk factors is part of wellness in my book) and counselling on reducing risks: diet, exercise, appropriate sun care, safe sex, mental health screening, reducing other risks (my ped always asks my kids: “do you ALWAYS wear a bike helmet?” “Does anyone in your family smoke around you?”)

      There is also a difference between personal behavior and counseling others. Have you ever done anything that might be considered less -than-healthy? If not, kudos. If so, does it mean you don’t know what healthy behavior looks like?

    • Guesteleh

      Doctors have longer life expectancy than average, not shorter. http://www.ajpmonline.org/article/S0749-3797(00)00201-4/abstract

  • I feel sorry for any women who had the misfortune of having you for her dr

  • Hear, hear! If I had things to do over again with my child, I would have used the delayed vaccination schedule. We went ahead with the recommendations and rammed through his early vaccinations. By ages 3 – 4, my child was getting sick in school a great deal. Testing showed that he had developed none of the immunities he was supposed to have developed to more than a few of the diseases he was vaccinated against and he had to have all of those shots again.

    Reading the literature and asking questions of your MD, wanting a bit of give and take, should not be as emphatically rejected as it often is.

  • There are people other than MDs who are perfectly well-trained on how to run a regression and read them and the mathematical testing that verifies that regression’s validity. That’s what a good number of the papers on medical risk are about. In my first pregnancy, I was tagged as a problem patient because 1) I had my cats tested for toxoplasmosis before I got pregnant and didn’t really want to repeat the test on myself when they were already negative and 2) I wanted the chance to have my miscarriage without a DNC, so long as my body didn’t wait to start the miscarriage after 10 – 11 weeks. I had a series of citations available to back up my reasoning and the OB agreed that I picked the point at which risk dramatically increased, but for having the temerity to question the doctor, I was tagged as a problem patient. That led to problems later down the road.

    • Yes, some physicians honestly seem to believe they should be the overlords of an oligarchy in which we “laypeople” (read: peons) keep their heads down and do as they’re told.

      • …they should be the overlords of an oligarchy….

        Now, Alan, why might that be? Could it be that they are in love with the idea that they are remarkably, unusually smart, and having thought deeply come to the conclusion that they know best, and if only everyone would see the rightness of their views and stop having contrary ideas the world would be a better place?

        It doesn’t seem to be a point of view restricted to physicians…

    • Amy Tuteur, MD

      Yes, there are other people capable of understanding the math. You have yet to demonstrate that you are one of them, however.

      • TexasMama

        Wow. Are you basing your derision of her on this comment alone? She did research, spoke calmly and logically with her OB, and reached an agreement. Would you rather she just blindly followed what the doctor said?

    • Lisa the Raptor

      Astounding. They put that in your chart? Problem patient? I don’t know why they would do such a thing. I’m sure you were not snarky at all about the issue.

  • Another_Mom

    From a patient perspective, one struggle is the move towards greater patient autonomy in medical decision making. As decision maker for my son, who has autism, I know that I am *not* a doctor (seriously – as an attorney, I get the difference between professional training and education and Googling your divorce). But I also find myself faced daily with making care decisions (which therapies? How often? Should we invest in AAC? etc) for which the relevant medical professionals aren’t always available (we see the ped once every six months, and we’re fortunate for that). I’m fortunate that my sister is a resident in med-peds, and I’m friends with a number of neurologists and PhD neuroscientists, who help me find the best research to guide my decisions. But in the end, the decisions are on me, and the responsibility for being a literate decisionmaker is also on me. And a whole lot of people don’t have friends who can hook them up with access to PubMed and JSTOR, but still have to make those decisions, often without a lot of medical guidance (though I’d imagine autism might be an outlier, since the tx approach to it is so fragmented between the medical and educational systems in the U.S.) (For the record, I think people who refuse to vaccinate are NUTS, and the whole concept of homebirth just perplexes me – why would you choose to introduce unnecessary risk?).

  • Rebecca

    There seems to be a tendency within the medical community to assume that anyone who refuses certain vaccines is automatically an idiot or “uneducated” as Dr Amy seems to prefer calling us. Some of us have justifiable medical reasons and yet can’t get the doctors to listen.

    We have been fired from 2 pediatric practices because we refused live-virus vaccines for our healthy now 1-year-old. Fired immediately and not allowed to explain our reasons why.

    We have an 8 year old who was diagnosed with an autoimmune diseas and is on chemotherapy. Exposure to the diseases in a live-virus vaccine could be devastating to her immune system. The little one cannot receive those vaccines until her sister can go somewhere else for several days. She is too medically fragile for that.

    While I may not be “educated” as to the nuances of medicine as they pertain to giving /or not giving these shots to my baby, I am absolutely aware of the effect they would have on the elder one.

    Since I have spent a great deal of time with our new family doctor teaching him about the rare disorder our daughter has, with which he had only a passing knowledge before we walked through his door, I would cry B.S. to the notion that it takes an MD to be an expert in a medical area. When your child is sick, and specialists are rare, you have to know more than the average doctor about her disease in order to get adequate care.

    Not everyone who refuses a disease is a quack, and sometimes the patients have to become experts. It would be nice if you would acknowledge that fact for the truth that it is.

    • Rebecca

      That last bit should read “Not everyone who refuses a vaccine is a quack”. It’s hard to type with a 1 year old in your lap.

      • sweetalker

        Oh wow, are you a mother? I wasn’t sure if you were a mother or not, you hardly mentioned it.

    • Maddy

      And patients should become experts, especially if they have a rare condition, much as a doctor can’t instantly diagnose you without finding out about your symptoms first. However, on average, the doctor will know more about human health in general than Layperson Jane. For a start, they probably know off by heart what a spleen does.

  • Child birth can be a killer for many women, and modern obstetrics have saved countless lives. Thank God for C sections and formula, because they save lives, namely, my life and both of my children’s lives. I have read many blogs about Midwives, natural home births and vaccinations, they are not factual at all. Thank God I had a wonderful obstetrician and a well educated CNM for my pre natal care. What many Americans do not understand is that , in third world countries babies DIE of malnutrition when their mothers dont have enough milk. Babies die when there is a birth complication. There are also many many Religious fanatics who believe in all of this pseudo science of Homebirth and no Vaccines. I have a couple of friends who were really trying to talk me into a homebirth for my second child, even though he was Frank Breech!! Thank God I cared more about my child’s well being than my “birth Experience” and went to a hospital to have him by C/ section. I just thank God for giving me common sense to do the right thing for my children. These people really need to shut up, they are scaring women about Doctors, C/ Sections and Vaccines. They are spreading unfactual myths, and they are making women feel inadequate for having C/ Sections or using formula. Shut up already!!