Should you trust an expert or a fauxpert?

apples vs oranges

Elissa Strauss nails it!

Her new piece, Want to ask Facebook about your daughter’s binky? Go ahead., has added a new term to my lexicon: fauxpert.

As in: Internet discussions about natural childbirth, homebirth, breastfeeding and vaccination are dominated by fauxperts, self-appointed, self-proclaimed mommy experts.

Strauss is talking about the age old strategy of mothers seeking advice from other mothers, adapted for the internet age into mothers seeking advice on the web, particularly on Facebook. As Strauss notes, there’s nothing wrong with asking your internet friends for parenting advice:

Facebook parenting is fine, a totally reasonable behavior for any parent with a question about their kid and an internet connection. The only important thing parents need to remember is the difference between an expert and a friend — even of the Facebook variety.

Because:

The internet has borne many fruits, most sweet and a few rotten. Among the putrid is the way it has convinced countless regular folks to act as experts. These fauxperts tend to be the ones with the super strong opinions, those who try to convince us all that co-sleeping will turn our kids into dependent monsters or that crying-it-out will turn our kids into insecure monsters. There are also those who believe that home-births risk lives, and those who think epidurals get in the way of mother/baby bonding. And then there are the anti-vaccinations fauxperts, whose preaching has yielding far more insidious results.

What to do?

There’s no need to stop sharing, but mothers (and fathers) need to understand the difference between scientific evidence and personal anecdotes. Scientific evidence presents the experience of thousands, even millions of individuals, is arrived at by the community of scientists as a whole, independently verified, and can tell you the likelihood of various outcomes. Personal anecdotes tell you one mother’s experience, unverified, reviewed only by that mother, which may or may not apply to your child and you.

So how can you tell the difference between an expert and a fauxpert?

I’ve created this handy chart to help you:

Experts vs fauxperts

Let’s look at the differences.

1. An expert has formal education in the topic at hand, while the fauxpert has none.

This has several important implications. It means that the expert has been exposed to a wide variety of evidence and viewpoints. He or she tends to be familiar with ALL the scientific evidence, not merely cherry picked studies that the fauxpert has never read and wouldn’t understand if she did read. It means that the expert is fully conversant with any major controversies in the field, has thought a lot about them, has read both sides, and has come to a decision. The fauxpert generally views the controversy as a dichotomy between those with more formal education than the fauxpert and the fauxpert, who claims to have more personal experience.

2. An expert understands both science and basic statistics and can reach an independent opinion about the existing scientific evidence. A fauxpert has to take the word of someone else.

An expert is giving you an expert opinion. A fauxpert is giving you the opinion of someone she likes (generally herself) with all the attendant drawbacks of relying on empirical claims just because you like who said them.

3. An expert recommends what’s good for YOU. A fauxpert recommends what’s good for HER.

Experts rarely have a one-size-fits-all recommendation. Even in the case of vaccination for childhood diseases, which ALL experts (pediatricians, immunologists, public health officials) recommend, there are exceptions and every effort is made to find out if your child is one of the exceptions. That’s why you are asked about your child’s allergies, previous reactions to vaccinations, and family history of vaccine reactions. The fauxperts generally have one-size-fits-all recommendations; you should do what the fauxpert did, regardless of how your circumstances differ from those of the fauxpert.

4. Experts change their recommendations based on new scientific evidence. Fauxperts never change recommendations regardless of what the scientific evidence shows.

For example, over the years obstetricians have changed their recommendations about epidurals based on advances in technique, changes in medication, and newer scientific evidence. Natural childbirth fauxperts were opposed to epidurals 30 years ago, and they’re opposed to epidurals now even though the scientific evidence shows pretty clearly that current epidurals have no harmful effects on mothers, babies, or childbirth. It makes no difference to fauxperts what the evidence shows because fauxperts rely on unchanging belief systems, not science.

Experts also acknowledge when they are wrong. Consider this year’s flu vaccine. The experts, the same people who counseled everyone to get the vaccine, publicly announced that this year’s vaccine has only limited effectiveness. In other words, although they initially thought they had put together the most effective possible vaccine, they were wrong and they admit it. Protection for the flu virus that is most prevalent this year is not included in the vaccine. Therefore, although you should still get the vaccine, you should understand that it is not as effective as in years past. When was the last time a fauxpert acknowledged that he or she was wrong about a fundamental claim?

5. Experts take responsibility for their recommendations. Fauxperts wash their hands of you, or even blame YOU when THEIR recommendations cause more harm than good.

It’s difficult to overstate the importance of this point. Experts pay a price if they are wrong. You can take action against them, and they are well aware of that. It is in THEIR best interest, financial, professional and personal, to give YOU state of the art recommendations based on the latest science. Nothing ensures accuracy like having skin in the game.

In contrast, fauxperts take no responsibility for their recommendations. If they are wrong, YOU pay the price and they just keep giving out the same bad advice. They win if you listen to them, regardless of whether listening to them harms or kills you or your child. Sure, they dress it up by pretending that you are taking responsibility for your health, but you are taking the SAME amount of responsibility for your health when you listen to your doctor. The difference is not in your level of responsibility; it’s in theirs.

So feel free to ask other mothers, on Facebook or anywhere else, how they handle parenting their children. You may find that their experience gives you helpful suggestions about ways to manage your parenting dilemmas.

But never forget, they are not experts, merely fauxperts.

  • nomofear

    Sort of OT, but thought y’all might get a kick out of it. Times covering dolphin assisted birth, with a glorious comments section. http://newsfeed.time.com/2013/05/29/dolphin-assisted-births-are-a-thing/

  • Meerkat

    Totally OT, but a question for the many real experts ( OBs)who frequent thus blog. What is your opinion of menstrual cups?

    • Dr Kitty

      I love mine!

      There is a knack to it, and it is important to do your research and pick the size and firmness that will suit you best.

      I like MeLuna because they have the most options and are very good about explaining cleaning and sizing.

      If you empty and clean on schedule they are perfectly hygienic, and if the idea of a diaphragm doesn’t squick you out, no reason why a menstrual cup would.

      • Meerkat

        Thank you, Dr. Kitty! I actually have one, and just started using it. I was thinking that it is way too amazing, and why aren’t they more widely advertised. I did a lot of research before bying one, but then I started wondering if they were safe from a medical standpoint.

      • Cobalt

        Any different suggestions for IUD users who are on a constant light “period”? Do the IUD strings matter? Any known special downsides of everyday use? I’m spending so much money on disposables!

        • Dr Kitty

          Personally, I had no issues with using a cup with Mirena for any odd bleeding I had. You just have to make sure to centre the cervix in the cup and not have the threads trapped between the edge of the cup and the vaginal walls. You might want to have the threads trimmed a little.

          Anecdotally, women have used cups to manage spotting, staining and heavy discharge, and vaginas cope very well with foreign bodies (ring pessaries, NuvaRing, contraceptive caps and diaphragms), HOWEVER, there is no safety data for cups used that way and really, I wouldn’t recommend extended daily use.

  • Samantha06

    Not really sure what to say about this one…. it’s so insane, I don’t even no what to say!

    https://drjengunter.wordpress.com/2015/01/27/gwyneth-paltrow-says-steam-your-vagina-an-obgyn-says-dont/

    • Bugsy

      Eeck. I inadvertently crossed my legs a little tighter just reading the post.

      • Samantha06

        I know! Isn’t that the grossest? Why on earth would you want to steam your va-j-j???

  • rudeboyrg

    I wish more people would listen to this but I fear you are only preaching to the choir. For those who need to hear this most likely it has fallen on deaf years. They will only blame you for being a lying scientist, part of “bit pharma”, or a member of the establishment trying to make money off of them. Great article but I fear those who agree with you are those who always had. Those who will ignore this are those who will just see this as evidence of another scientist or doctor being afraid of their lies being exposed that the “truth” is finally coming out. I actually work in a healthcare organization. And it constantly sends out publications with fauxperts dispensing long disproven medical advice about diet and other unscientific nonsense. Quite embarrassing coming from a medical facility.

    • Sue

      Diet and nutrition are areas that are currently overrun with fauxperts – especially those pushing their books about paleo, fructose etc etc.

      Apparently having been overweight and then losing weight is a respected qualification. As is having a simplistic message. Having never become overweight in the first place counts for nothing, in contrast.

  • Young CC Prof

    Speaking of fauxperts, I’m having a local problem with fauxperts and would appreciate some advice.

    A community group sometimes invites health talks. Sometimes they are doctors, nurses, dieticians. Sometimes it’s a “holistic health coach.” I’ve tried to talk to the community group, they don’t see the problem.

    Now, a registered dietician is a legally protected term, requiring a 4-year degree in nutrition including basic science. Holistic health coach is a term made up by a small group of predatory for profit colleges. The certificate requires no basic science or mathematics and appears to involve about as much work as real college students do in one semester.

    Many of the attendees don’t know this, and, by inviting these fakes to give talks, the community group is endorsing them. Any idea how to fight back? I really LIKE this community group, other than this one deplorable choice.

    • Who?

      How annoying. Could you sit there and ask questions until the guest cries? Unfortunately they probably did a whole lot of communications training as part of their degree.

      Otherwise organise a really tempting alternative event and then say there’s no point having these guys back since no one turned up? I’m only partly joking about this one…

      • Young CC Prof

        I tried that last week. Thing is, most of what she said is actually true, and the rest nonfalsifiable. The speaker was pretty well versed in common-sense level nutrition, and probably should have gone to a real school.

        Doesn’t change the fact that she was inappropriately given a chance to recruit customers who didn’t really understand her credentials.

        • Sue

          How about a question like “You seem to know a lot about this – ever thought of getting formal training?”

    • Bombshellrisa

      http://m.bastyr.edu/academics
      Make a side by side print out of the academics required to be a healthcare professional and then what it takes to be a holistic health coach. When people see the classes listed that are required for both, most sensible people realize just how quacky the holistic health thing is

  • Sue
  • anh

    OT but also amazing news. I just got word my friend delivered a healthy baby girl. Almost exactly four years ago to the date she lost her baby girl at 39 weeks. I can’t stop smiling

    • Amazed

      And you shouldn’t! What a happy piece of news!

  • Sue

    OT but great news: Tenpenny anti-vax tour of Oz CANCELLED! Apparently she no longer wants to take her (cough) “vacation” here either. Oh, well.

    • Young CC Prof

      All the venues backed out when they found out she’d lied to them, eh?

      • Who?

        Some venues had groups of doctors as regular clients who said they would drop their regular bookings if the venues accomodated her.

        Sometimes capitalism works just like it says on the tin.

        Interesting line in the report-the organisers felt unable to guarantee the safety of attendees, including little babies. Not worried about them getting pertussis or measles-which seem to be around at the moment-but being injured by pro-vax protesters.

  • Sue

    Yep. They are everywhere at them moment: childbirth, vaccination, diet, climate change. Forget all that formal education – let’s all go out and run banks, build bridges, design skyscrapers, cos we’re all smart and can read all the docs, right?

  • Amy

    This one resonated with me as well, because I weighed it against my behavior in my area of professional expertise. When I make a recommendation about education in general and mathematics education in particular, I NEVER take a one-size-fits-all approach. I don’t WANT everyone to do things the way I did for myself or will do with my children; I want them to find the approach that works best for them, whether we’re talking about how to solve a particular problem, which courses to take, or how to study for an upcoming exam.

    Compare that to when people ask me for advice about breastfeeding. A lot of the crunchy moms in both my online and offline circles refer others to me with questions, because I overcame a lot to be able to nurse and successfully fed my children breastmilk exclusively even while working fulltime. I can only tell people what *I* did, how it worked for me, and what difficulties I had to overcome. I can and do offer the information I have non-judgmentally, but it’s still obviously very, very limited to my own experience.

  • EmbraceYourInnerCrone

    OT but wanted to mention this: http://www.fresnobee.com/2015/01/28/4352672/fresno-county-health-officials.html

    Fresno County health officials said a man with measles may have exposed to county residents, including mothers and babies in the labor and delivery area at Community Regional Medical Center.The man, a visitor to Fresno County, was on the third and fourth floors at the downtown Fresno hospital. He was there to visit a relative in the labor and delivery area on Jan. 22 and 25, both at 9 p.m.

    • Cobalt

      I would lose my mind.

      • EmbraceYourInnerCrone

        Me too. I don’t know any details, I just have friends with young kids who love in Orange County so I have been looking at California news sites more often. I wonder if he was not feeling well but went to visit his relative, or maybe was one of those people who did not feel sick.
        There is also a case in Arizonia this week were a person with what happened to be measles unknowingly exposed 195 people in the clinic at their local hospital. The mom of a 4 month old preemie who was at the hospital for her regular checkup was interviewed, and she was livid.

        • Cobalt

          This is why I’m getting my MMR booster just in case (no one knows if I got 2 or not) and I want to get my baby vaccinated at 6 months. This outbreak is going to keep spreading, measles is just too contagious.

          • nomofear

            ooh, while pregnant? The only ones I’ve heard so far are flu and Dtap, but if you’re hearing that more are safe, I’ll ask my OB. I’d take them ALL again if there’s even a chance they’ll provide my baby with some immunity in the womb.

          • Cobalt

            No MMR during pregnancy, my baby is already out and about. If you can, you can have titers checked and get vaxxed as needed as part of your preconception planning, but most people don’t do all that.

            DTaP 2 to 8 weeks before delivery is a big deal though.

          • nomofear

            Oh, gotcha. Yeah, too late for me too! At thirty weeks now. Getting the dtap soon!

          • Young CC Prof

            Injected flu and Tdap are killed vaccines, so it’s easier to be sure they are safe in pregnancy. MMR is live, so doctors are more hesitant, though of course they will use it if a pregnant woman known not to be immune is exposed to, or at high risk of exposure to, measles or rubella.

    • Stacy48918

      OMG…

  • Cobalt

    Good news today, I have a new little niece! All’s going well, everyone’s looking good if a little tired.

    My SIL requested a cesarean after 2 hours of pushing, and her OB agreed. Come to find out, the baby weighs not quite 11 pounds. Thank goodness for modern medicine, that would have gone differently 100 years ago.

    • attitude devant

      Hooray for appropriate health care!

    • EmbraceYourInnerCrone

      Congrats!And wow thats a big baby!

      • Cobalt

        No GD, and my SIL normally weighs about 120 pounds at 5’7″. My brother is 6’2″ and burly, though. So much for not growing more baby than will fit through the pelvis.

        Baby is super cute! And the same size as mine was at 9 weeks old.

    • Amazed

      Congrats!

    • Bugsy

      Congratulations!

    • Margo

      Margo woo zealand…no hint on the scan that baby big….no hint that she looked big in pregnancy…palpating didnt pick up big bsby. Congrats…but, wow…that’s a big baby that no one picked up antenatally .

      • Cobalt

        Last scan was at 20-24 weeks. They were expecting a big baby, but closer to 9 pounds than over 10. We’ve been teasing her about twins for weeks. Her dates were a bit fuzzy and she declined the first trimester scan, so the baby may have been a bit overdue. Or just big. My brother’s a big guy, and was a 10 pounder himself.

    • Samantha06

      Congratulations!

  • demodocus’ spouse

    And then there’s my (retired) school psychologist uncle who was telling me his friends’ fears of the vaccine schedule. I told him off. Nicely ’cause he’s 70 and I love the nutter.
    There are areas where there are no real experts, like how do blind parents keep an eye on an increasingly independent little kid, and then you do have to rely on friends’ anecdotes and your own guesswork. which reminds me, I need to sew bells onto a band to put around my kid’s ankle so Daddy won’t trip on him again.

  • Julia

    What do you do though if the “fauxspert” actually *has* the appropriate credentials? Here’s my example: a long time ago – way before I was thinking about having kids myself – I was dragged to a “vaccine info event” by a friend (we were actually on our way to somewhere else). It was a room full of mothers and a guy who was giving out information on what I now know is the “simpsonwood conspiracy theory”, along with advice to not vaccinate. Problem: the guy/fauxspert was a pediatrician! I actually got so mad at him that I challenged him on one of his more outrageous claims and he then quietly said, mothers should delay vaxxing rather than not vaxxing at all – sort of a 180 turn from what he had said minutes earlier.
    So, these women were listening to someone who by all means could be considered an expert. It’s scary.

    • Amy M

      Those kind are the most despicable—(yeah, Sears, I’m looking at you)—they take legitimately earned credentials and use them to swindle people. Was this pediatrician still practicing?

      • Julia

        I believe though. As I said, long time ago and I unfortunately I don’t remember his name…

        I remember wondering at the time if it’s ethical for an actual physician to give out such crap advice

      • Roadstergal

        Sears and Gordon. They still have their licenses – and they should have been stripped of them ages ago.

        They should be in jail right now, really. Their promotion of anti-vaccination to the public at large and their patients in particular has directly contributed to the suffering and death in the current measles outbreak. Does the society that licenses pediatricians not give a shit?

        • Guesteleh

          It’s because their patients are wealthy and pay for care without insurance–no need to bill Blue Cross! And if anyone tries to sanction them they call Sacramento and scream at their reps and then everyone backs off. It happened with Paul Fleiss after he helped kll Eliza Jane Scovill. The state was going to permanently strip him of his license and instead he was placed on probation. He did lose all of his hospital privileges so if any of his patients needed hospital care they had to be seen by a hospitalist. At least Fleiss is dead now so one less quack feeding anti-vaxxers in LA.

      • Courtney84

        Ugh, there is a cousin in my family who is a family practice doctor. She’s anti flu and pertussis vax. She also thinks Hep A vaccination is unnecessary. She’s a very likable person, and i feel sick when I think about the kind of risk she’s encouraging families with young children and the elderly to take.

        • The Bofa on the Sofa

          What is the downside of the flu vaccine? Even if it isn’t perfect, or even just marginally effective, considering the downside? Almost nothing.

          • Courtney84

            She thinks the aluminum in flu vaccine causes neurological problems…

          • Amy

            Oh God, does she tell her patients not to wear deodorant, too?

          • Stacy48918

            That was my ex’s thinking. Deodorant was ok, but not anti-perspirant (which is where the aluminum comes in).

          • just me

            Scary. I mean, there are some studies from years ago showing that there’s excess Al in Alzheimer brains or something–can’t–remember–so people started freaking out about the minuscule amount of Al used in water treatment–but actually I think there are no studies showing even an association between Al intake be it oral or dermal and Alzheimers. So it’s more that whatever happens with Alzheimers causes the brain to concentrate/retain Al rather than exposure to excess Al causing Alzheimers.

          • Stacy48918

            My former dentist argued with me about vaccines at my last visit.
            “What do you think about mercury in vaccines?”
            “Well it’s been removed from pretty much every vaccine and the autism rates haven’t changed.”
            “Well it’s still in the flu vaccine!”

            I am NEVER going back there and soon I’ll have a court order saying my kids aren’t to go there either. Ridiculous that even the dentist is anti-vaccine.

          • just me

            Even stranger that a dentist is anti mercury. The stuff is bad for the environment in terms of wastewater discharge from dental offices but I think there’s not good data showing health issues related to fillings. Though there’s lots of quacks surrounding that issue.

          • Stacy48918

            Yea, this practice is “anti-mercury” and will remove and replace folks prior fillings, all while wearing gas masks and ridiculous get-ups. They’re Quacks with a capital Q.

          • JJ

            My grandfather is a retired dentist and he said that people afraid of amalgam don’t understand chemistry. He also thinks it is too bad people are not using amalgam as much anymore because it is cost effective and very strong. But he is a shill because he loves flouride too 🙂

          • Samantha06

            I love flouride too! It’s not in the water where I live and when I moved here, I was totally freaking out, but the dentist puts the flouride paint on my teeth when I go for my cleanings. I haven’t had any issues, yet. I did get all my amalgam fillings replaced as most of them were real old and starting to leak. I have to admit, I do like having an all-white mouth! And speaking of “alternative crap”, a friend of mine told me she gets her teeth cleaned by a woman who is supposedly an actual hygienist, but has her own “business” and does it out of her garage!!! I thought that was just crazy!

          • Who?

            Oh ick. Hygiene for one, and how does she safely dispose of gloves and masks?

            We have a vet like that locally, I refuse to go to him because no one can tell me how he disposes of the waste ie body parts etc (he does sterilisation ops) and no one wants to ask him and risk his ire.

            He is both cheap and compassionate with the animals, though. The latter is generally true in my experience, as for the former I’m happy pay a little more to support someone playing the game nicely.

          • Samantha06

            If he’s doing sterilizations in his garage, he’s obviously not using GA! I asked Stacy, the vet on here about that, as I saw “the Incredible Dr Pol” does that and she said it’s NOT acceptable practice. Animals are supposed to intubated and anesthetized. I thought about the disposal aspect too, and how does one perform dental hygiene in their garage?? Does she have suction and so forth? And what if someone aspirated or something? I think it’s reckless and besides, I want that done in a medical setting with a dentist present to examine my teeth after.

          • Who?

            And you can bet neither have appropriate insurance should anything go wrong.

            Interesting re GA, I didn’t know about that but will ask one of his clients.

          • Samantha06

            Absolutely spot on about the insurance! They probably couldn’t get it anyway.

          • Who?

            Like my old dentist. Silly me for assuming being a dentist, being registered with the professional body etc would mean a basic standard of care was met. I should have twigged when he wanted me to take them off gluten and dairy, but I just told him we wouldn’t be doing that without advice from a doctor and dietician.

            No problems for one kid, big, painful, expensive problems for the other.

          • guest

            What about amalgam fillings ?
            Anyway even if he doesn’t use amalgam all the other dental treatments contain some sort of what they call chemicals!

          • Amy M

            I never understand why some people, who are perfectly willing to vaccinate their children/themselves against everything else, refuse the flu shot. Sure, you might still get the flu, but at the very least, it reduces your chances. I imagine these must be people who haven’t actually had the flu.

          • just me

            Or the people who insist they got the flu from the flu vaccine…

          • Young CC Prof

            The argument I keep hearing amounts to “It might not work, and I might avoid the flu even if I don’t get the shot.”

            Which is just the nirvana fallacy. This year’s flu vaccine is less effective than usual, only 23% reduction in the risk of infection. But I’ve had it, my husband’s had it, the baby and all his classmates have had it. Even a not so great vaccine works decently when everyone you know gets it. And of course it protects against H1N1, which is particularly nasty in the young.

          • Sue

            “What is the downside of the flu vaccine?”

            The opponents keep pushing the rare case of GuillainBarre syndrome apparently precipitated by flu vaccine.

            Know what is the most common precipitant of GBS? The flu.

          • The Bofa on the Sofa

            The only flu vaccine that has ever been associated with GBS is the swine flu vaccine back in the early 70s.

            Do you know how many cases of GBS were caused by that vaccine? Multiple choice:

            a) > 1000
            b) 100 – 1000
            c) < 100

            ……

            Times up. In fact, the estimate is 18 – 30 cases of GBS were caused by the swine flu vaccine. In something like 100 million doses.

            Because of that – 2 dozen cases of GBS, it was pulled.

    • JJ

      There are bad “experts ” here and there but they can usually be spotted when their conclusions disagree with all health organizations and nearly all their colleagues. It is horrible to hear that the other people may believe him just because he was a doctor.

      I think there needs to be something done about the anti-vax celebrity peds as well. I just read yesterday about Jay Gordon:

      http://www.cbsnews.com/news/doctor-explains-why-he-lets-kids-avoid-the-measles-vaccine/

      “This measles outbreak does not pose a great risk to a healthy child,”
      said Dr. Gordon. “And quite frankly I don’t think it poses any risk to a
      healthy child.”

      What about the unhealthy children or newborns? Too bad for them I guess!

      I am pregnant and I am actually already thinking about how I am going to keep my baby safe at their doctors appointments/church/ect. because we have such a high rate of personal belief exemptions in our area.

      • Mel

        Dr. Gordon has clearly lead a charmed life.

        An ear infection does not pose a great risk to a healthy child; my infant brother died of an ear infection that lead to sepsis due to an unknown compromised immune system.

        Once you’ve lived through that kind of loss, a “great” though unlikely side-effect can be enough to make you stop dead in your tracks.

        And the measles gives you a raging high fever for quite a while. My mom and dad both remember that from their childhood experiences with it. They vaccinated us because they didn’t want us to get sick – even a “minor” case like Dr. Gordon is so willing to give to children.

        • Samantha06

          I remember my mom telling me I was extremely ill with the measles… very high fever, horrible rash, etc. It must have been so scary for parents then. One of my friends close to my age had chicken pox last year. She was exposed to it as a child, but never actually got sick. She had the lesions all over her face, chest and trunk. She was extremely ill and it took her almost six months to completely recover.

      • The Bofa on the Sofa

        “And quite frankly I don’t think it poses any risk to ahealthy child.”

        Yeah, that is VERY disturbing.

        But you know what ELSE doesn’t “poses any risk to a healthy child”? Vaccines. Moreover, vaccines also HELP those who are unhealthy, either if they can get them, or if through herd immunity.

        Consider the chicken pox. Which is better…

        1) Getting the disease, so you have 10 -14 days of a fever with a nastily itchy rash needing bottles and bottles of calamine lotion and aveeno baths, with home quarantine, meaning that the kid is not in school and the parent has to stay home from work. Oh, and a 1/20 000 death rate.

        or

        2) A chance of redness and soreness at the injection site for maybe a day (if that – my kids never had any reaction), and no deaths.

        I don’t even care if it’s true that “the immunity wanes in time” compared to getting the disease, I’d rather have a booster shot every 10 years than subject the kid to the disease. And I can’t imagine anyone who isn’t a monster wouldn’t do the same.

        Fuck natural immunity. Let’s avoid it all.

        • Jessica

          The resistance some people have to the chicken pox vaccine disturbs me. I was a very healthy child – rarely got sick – and yet the chicken pox hit me hard. I vomited for hours, developed a high fever, was delirious, etc. I was not quite nine years old and I still remember it as the sickest I’ve ever been. I am thrilled that my son will avoid it, thanks to the vaccine.

          • The Bofa on the Sofa

            I am thrilled that my son will avoid it, thanks to the vaccine.

            Agreed. The whole, “It doesn’t kill many, and I had the chicken pox and survived” just bothers me. Yeah, I had the chicken pox, too. And it was awful. I was like 8, I think, but it royally sucked. I don’t care that most don’t die from it, it still sucks royally. You know what else people don’t die from? The chicken pox vaccine. In fact, you are less likely to die from the vaccine (have any deaths ever been reported for it?) than from the disease, so “no one dies from it” is not an argument for chicken pox over the vaccine. By ANY measure, the chicken pox vaccine is better than the disease. Complications or whatever.

            Moreover, it’s not like you can avoid getting the chicken pox yet these days. If you aren’t vaccinated, it’s still around and you are very, very likely to get it. So you can’t even say, “I’ll take my chance on not getting the disease.”

            It’s not even a question. Only a monster would not get it for their children.

          • Amazed

            I never had it, despite wiggling around the quarantine the Intruder and my best friend (and neighbour, literally in the flat next door) were under. Here, a vaccine from adults just isn’t available. And I’ll be very grateful if I don’t catch it from a kid whose mom thinks she’s so cute with the rush and it’s no problem taking her out while contageous because hey, everyone had the CP.

          • Amy M

            I have one friend who never had it either, and she’s been exposed multiple times. She had a baby last year, I’ll have to ask if she got the vaccine for herself before or after the pregnancy.
            I got it very mildly–like 3 pox, gave it to my sister, and then had it come raging back 3 weeks later in all its spotty glory. I guess I didn’t mount enough of an immune response to those first 3 pox. But my boys have been vaccinated against it—why should they have to go through it if there is a safe, effective vaccine available?

          • fiftyfifty1

            “Only a monster would not get it for their children.”
            Especially because it is much more dangerous if you get it as an adult. And extremely dangerous to both mother and fetus if contracted by a pregnant woman.

          • Samantha06

            Yes. One of my good friends had it last year. She was extremely ill and it took her six months to fully recover.

          • Stacy48918

            “Only a monster would not get it for their children.”
            My ex has already stated that he doesn’t want our kids to get the chicken pox vaccine, even with a court order….

          • The Bofa on the Sofa

            Case in point…

          • Stacy48918

            He would take them to a pox party if he could….
            F*ck, he’d probably have taken them to Disneyland if he could.

            Bastard.

          • Who?

            Well, as my grandma used to say ‘want will have to be his master’.

            Did you get the order yet?

          • Stacy48918

            Not yet. I’m going crazy waiting. Gonna call the court clerk office tomorrow and check on it.

          • Who?

            Hope it is there for you or they can give you a timeframe so you can get those appointments organised.

        • just me

          CP was awful. I was 13! Why would I want my kids to get that? Not to mention is have to take a couple weeks off from work.

          • Cobalt

            My mother says I had it as a toddler, so when the vaccine came out later she made sure my younger sibs got it. I don’t remember it, but she still gets the sad voice when she talks about treating me for it.

        • Guesteleh

          My kid got it after getting the vaccine–but only got pox on his knee. That was it. The imperfect immunity was still awesome.

          • Who?

            My daughter had the measles after full vax. She was hot, miserable and spotty for days. Can’t think what she would have been like without it, or what it would have been like caring for her then her brother who would also have got it.

        • Sue

          Here’s what I don’t get: are these people against human endeavour and progress in every part of life?

          My childhood happened before many vaccines, so I survived measles, mumps, chicken pox. In those days, there were also lots more childhood drownings, deaths from car accidents, backyard abortions, child abuse in care, all kinds of corruption, poisonings from agricultural and industrial chemicals etc etc. Human advancement has improved all of those things.

          Are these people also wanting to get rid of public health and safety measures, and return to “see whether you can survive childhood” attitude? I suspect they are the very same people who would sue an organisation if any of those safety measures weren’t followed.

      • lawyer jane

        OMG of course Dr Gordon is defending himself – he probably bears more individual responsibility for this epidemic than any single person! The death rate is 3/1000, and that doesn’t even say anything about the rate of serious disability. It is totally disgusting and shocking to me that a pediatrician would be encouraging parents to disregard a 3/1000 death rate.

        Also my little bro is about to start chemo in California and may end up with a bone marrow transplant. F-u Dr. Gordon for having to make us worry about measles in addition to his fucking CANCER!

        • The Bofa on the Sofa

          OMG of course Dr Gordon is defending himself – he probably bears more individual responsibility for this epidemic than any single person!

          Yeah, somewhere between Jay and Bob Sears. Sears has the book, of course, but then again, Jay had his hand up Jenny McCarthy’s back, using her celebrity as a mouthpiece to spread his crap.

          They both have a case as bearing the most responsibility.

        • Lauren

          Worst anti-vax response I’ve heard, when all the other arguments fall down around their ears:
          “So what if maybe 1 in 1000 people die? You’re more likely to die in a car accident or slipping in the shower! I have a right to do what’s best for MY child, and I don’t have to to worry about everyone else’s kids”.

          Seriously.
          She actually said that.
          And she’s not alone.

          • Bugsy

            The misuse of stats amaze me. Yes, you may have a 1 in 1000 chance of death. To the family that has a child who is the 1 in 1000, the stat is irrelevant. Their child is dead.

            And besides, we wear seat belts and put a slip-proof mat in the shower. Don’t we want to do anything we can to limit the risk of death to our family?

          • The Bofa on the Sofa

            Then again, the 1/1000 chance of death is pretty misleading, since it is (if even correct) at best the cumulative risk over a year’s time.

            The chance of dying by slipping and falling in the shower for every time you take a shower is less than 1 in a million.

          • Bugsy

            Heh, if my toddler could communicate clearly, he’d gladly use the 1-in-a-million stat to get out of having his hair washed in the tub. 🙂

          • lawyer jane

            I think innumeracy is also big problem here. A lot of lay people just think “one thousand is a LOT” and conclude that a 1/1000 risk isn’t a big deal. To them 1/1000 may as well be 1/1,000,000.

          • The Bofa on the Sofa

            I have a right to do what’s best for MY child, and I don’t have to to worry about everyone else’s kids”.

            Yes, you certainly have the RIGHT to be an asshole. Doesn’t mean you aren’t still an asshole.

          • Alexicographer

            Also, the risks are additive, not substitutes (well, once you’re dead, I guess you’re not at risk of measles, car accidents, or slipping, so there’s that). But people often discuss “as if” these were tradeoffs — choose this 1/1,000 risk or that other one — when in fact, you’re stacking risks. So! I’m already at 1/500 risk (2*1/1,000 or whatever — just using the example in the comment above) of dying in a car accident or the shower, and now you want me to add to that another 1/1,000 risk of dying of measles? No thanks!

        • Mishimoo

          Hope everything works out well for your little brother!

      • Sue

        What does he mean by “risk”? Measles infection poses a very strong risk of a moderately severe viral illness that may take a week or two to recover from – risk doesn;t just mean dying. If I can prevent a child having that kind of infection, which commonly involves a week of misery, why wouldn’t I?

        By that logic, you wouldn’t bother with injury or accident prevention because almost all kids fully recover from their injuries.

    • The Bofa on the Sofa

      Was this a pay-to-attend event?

      • Julia

        No it was free; someone hosted it in their home.

        • The Bofa on the Sofa

          In their home?

          There’s your sign of the quack.

          Doctors certainly do public service events, including vaccination information, but they don’t do them in someone’s home. That’s a bad sign.

          • Julia

            I agree completely – I knew he was a quack, but to the other attendees he definitely had the authority of being an actual doctor, which gave him credibility in their eyes, and therefore more dangerous.

    • Tosca

      This was a something I was also going to point out; the expert should agree with the scientific consensus on the issue. The above quack sounds like “Dr Bob” Sears. He is a licensed and practicing pediatrician, but is vaccine-unfriendly at best. He has made A LOT of money publishing his own, “alternative” vaccination schedule. Among his recommendations; no MMR before the age of THREE. No scientific evidence to back this up.

      Occasionally you’ll get an expert who challenges the consensus and is right – the poster boys are the drs. who proved that stomach ulcers are caused by bacteria, rather than stress and excess stomach acid. However, proving a new breakthrough like this is a long process, with a LOT of statistics, trials and debates about P-values and methodology. Laypeople don’t know enough to make a reasonable judgement, and for their own protection should wait until the experts have pronounced one way or the other.

      TL;DR; even a qualified expert can be a quack. Go with the herd.

      • Julia

        definitely – if someone “knows something nobody else knows” then chances are very high that person shouldn’t be taken seriously. Just like (almost?) all conspiracy theories.
        This is what troubles me with these doctor fauxperts: it’s easy to dismiss, say, Jenny McCarthy as someone with no actual training and expertise, and it’s not hopeless to get this point across even to someone who disagrees with you. But people with the right qualifications/expertise on paper? Sure, you can point out that they’re against scientific consensus, but people who want to believe them believe them precisely because of that. Because they’re not sheeple going with the herd.
        It just makes it so much more of an uphill battle to argue against quacks when they have actual credentials.

      • fiftyfifty1

        “Occasionally you’ll get an expert who challenges the consensus and is right – the poster boys are the drs. who proved that stomach ulcers are caused by bacteria”
        The H. pylori example gets cited all the time by alternative medicine advocates. They make the story sound like it was a lone brave hero crusading against the mean old establishment that wouldn’t believe him. The truth went more like this:
        Marshall: Ulcers are caused by this bacteria I have seen under my microscope, not by stress and too much acid.
        Establishment: Extraordinary claims require extraordinary proof.
        Later…
        Marshall: Okay, here’s evidence to prove it.
        Establishment: Ok, that’s excellent proof. We need to totally change the way we treat ulcers.

        • Sue

          EXACTLY, fiftyfifty. Marshall didn’t just whine and complain that nobody listened to him – he set about producing the evidence which, I believe, included ingesting some H pylori and getting ‘scoped himself. The evidence was good, it was reproducible, and practice changed.

          Contrast subluxation-based chiro and homeopathy – still stuck in past centuries, which science passes them by.

          • Samantha06

            Talking about chiro… I got into a discussion at work with some nurses I work with. One was saying how her chiro helped her neck, he “cracked” it. I was saying I don’t agree with it especially since I had one “crack” my neck several years ago and I’ve had issues ever since. I am sure he injured my neck. Another one chimed in about how wonderful it is, and on and on. I finally just shut up because they were so obviously enthralled by their “fabulous chiros.” They got extremely defensive and were not interested in hearing another opinion about it…

          • Mishimoo

            I know!! My dad is the same about his chiro, and got most upset when I questioned the ethics of this wonderful, helpful chiropractor that is going to ‘fix’ his back. (Dad has stress fractures and disc degeneration and has been told that he needs surgery. I seriously question the ethics and intelligence of anyone that is willing to do physical manipulation after seeing that kind of damage on a series of x-rays)

          • Samantha06

            I hear you… it’s pretty scary, actually. I would be worried about him as well.. hopefully you have planted the seed that will get him thinking about it and maybe re-consider.

          • Mishimoo

            Oh, I doubt it. We’re currently on the outs because he keeps trying to tell me how to ‘cure’ my health problems, which goes completely against my doctor’s advice. He’s also pushing an alternative medicine that claims to have no side-effects. Oddly enough, the herbals (books) I have list a lot of side effects!

          • Samantha06

            That’s too bad your relationship with your dad is on the outs because of alternative medicine! I wonder if people fall for that as they get older? My dad fell hard for it too. He thought everything was full of toxins, and wouldn’t let my mother use any kind of cleaning products except vinegar. When he would go out to the store or something, she would haul out all the big guns and clean! Then she’d open all the windows so he couldn’t smell anything. But you are right about herbals, some of them can have potentially dangerous side effects and can interact with other medications. I’m currently reading a textbook on anesthesia and OR procedures and it’s advised that anyone undergoing GA discontinue all herbals for two weeks prior to surgery to lower the risk of interaction with anesthesia.

          • SporkParade

            Could be. My mother-in-law is super into Ayurveda lately. Because diet coke is poison, but her supplements from India (20% of which have been found to contain heavy metals) are totally wonderful. The one upside is that she was smart enough to quit one of those cleanses on the second day the moment she felt sick.

          • Samantha06

            Why, why do people take stuff from a foreign country that hasn’t been studied or approved?? The woo has infiltrated everything… very scary..

          • Sue

            There are, of course, rational chiros who do manipulative therapy for back pain and sports injuries, much like a physiotherapist. The cracking is all for show, however, and “subluxation” is pure mythology.

          • Samantha06

            Well, that “cracking for show” injured my neck!

    • Amy

      Agreed. I think another category could be added to the fauxpert list. If the person does have credentials, are they celebrated/well known by their professional peers, or by lay people being told what they want to hear? There’s a fairly short list of well-known quacks that ALL the crunchies end up citing: Christiane Northrup, Dr. Oz, Joseph Mercola, Jay Gordon, the Sears family, Dr. Biter, Michel Odent, Grantly Dick-Read, Aviva Romm. (I may be missing a few, but that’s most of them.) That’s what, eleven people with MDs? Across the English-speaking world? (Do we count Weston Price, who was a dentist?) Contrasted with more doctors than that in the group practice my family sees who disagree with them, never mind every other mainstream medical practice.

      (As an aside, I note that half those names listed above are now retired or dead, but the same crunchies who are so quick to discredit Dr. Amy for being retired are more than happy to cite their favorite quacks.)

      • The Bofa on the Sofa

        Yeah, Amy, it’s what I call “the usual suspects.”

        When you see an vaccination story in the media, to get the anti-vax side, they talk to “the usual suspects.” To get the pro-vax side, they… call the local pediatrician.

        Clear sign that it is fringe lunacy.

        • Sue

          In Aus we’re gradually educating the media not to go to “the usual suspects” for “faux balance”.

          • KarenJJ

            For example the awesome and very direct Tracey Spicer.

      • Amy Tuteur, MD

        Many of those people aren’t fauxperts; they’re liars or fantasists.

      • Pregnant Guest

        There’s also Dr. Palevsky, a big-shot anti-vax pediatrician in NYC. A mom I know who takes her kid to him says he claims he can tell which kids are vaccinated and which aren’t just by watching them play. She goes on about how grateful she is to have a ped like him to help her “navigate the system.”

        • Young CC Prof

          The unvaccinated ones are afraid to dig in the dirt.

          • Samantha06

            Haha! That’s for sure!

      • KarenJJ

        On top of the qualification I was thinking we need to add that the expert needs to have substantial relevant clinical experience whereby they were fully or partly responsible for any outcomes.

  • Cobalt

    “Fauxpert” is the same series of sounds my baby makes when naturally warming his diaper.

  • Lisa C

    This was posted on the Baby Center board “None/Select/Delayed Vaccinations” under a post titled Do Docter’s get paid per shot (http://community.babycenter.com/post/a54870103/do_doctors_get_paid_per_shot). I think it is relevant to this discussion (as well as frightening and sad).

    “I know ego comes into it. When a stay at home mom (for example) schools the doctor on vaccines and he has no real recourse or valid comeback to any of her sources, it says he’s wrong along with his 6 plus years of education, and all those pharm sales reps that took him to lunch and made friends. I think the majority have way too much ego to simply say, you know what, let me brush up on my research and let’s come back to this in two days, is that okay with you? Let alone admit they take the sales reps word for it so they haven’t bothered even reading the product insert. Saved time in their busy schedule and those reps ought to know, right?”

    • Young CC Prof

      Or, you know, it could be that what the mom said is just so far away from reality that the doctor doesn’t know where to begin.

      • The Bofa on the Sofa

        That was my thought. The doctor is at a loss for words. He’s trying to figure out how to say, “That’s so far from reality that it isn’t even wrong” without hurting her feelings.

        • Lisa C

          I think the only way we will get through to people who believe this nonsense is to point it out their ignorance without regard to their feelings. I also think that insurance companies should refuse to cover treatments for vaccine preventable illnesses if you choose not to vaccinate (excluding people who cannot receive them for a medical reason). Let them put their money where their mouth is.

          • The Bofa on the Sofa

            I don’t disagree about what WE need to do, but doctors have things like professional standards and try to uphold them by taking the high road.

          • Young CC Prof

            Some doctors will just fire the patient, others will try to keep lines of communication open for the child’s sake.

          • Samantha06

            YES! When it starts hitting people in the pocketbook they might reconsider their stance. It’s unfortunate that it might take money over health for people to come to their senses..

        • Amazed

          We’re placing too much value on not hurting other people’s feelings. I have come to regard that as a widespread disease that I also suffer from in real life. You try to delicately point out that someone is wrong. They don’t get it. You don’t want to hurt their feelings, so you try again. They still don’t get it but get to feel victorious and right in their wrongness because you didn’t say, “Look, girl, you have no idea what the hell you’re talking about, so shut the fuck up, sit down here, and let me introduce you to reality.”

          At the end, things go wrong, sometimes tragically wrong, and they still don’t recognize the part their own inadequacy played in this outcome. But at least we let them feel good about themselves!

          • Samantha06

            My problem is my big mouth and just spitting it out. I know I’ve stepped on toes. I have a friend who is all fairy stories and of the, “if you just think positively, everything will be fine!” mindset. It drives me crazy! Sometimes I just tell her it’s time for a reality check and then she doesn’t speak to me for weeks. Totally ridiculous and immature, but denial is powerful and some people just can’t or won’t deal with the truth. Reminds me of that line from A Few Good Men- (I think it was that movie,) “You can’t handle the truth.” I’d rather be a realist any day!

    • Roadstergal

      “Do English Teacher’s weep when reading that post title?”

      • yugaya

        Not necessarily. I try to be legible when I comment but I don’t proofread myself or anyone else when I’m on my own time.

        In terms of communication the one thing that distinguishes professional response from amateur advice is the focus – professionals will, when you ask them a question from their field, think about what you are asking, try to condense what they know and brainstorm the best summary, look up specific things to make sure that what they “think” is adequate reply is factual and offer this evidence for everyone to evaluate openly, make sure that their reply is in the register that the person who is asking is coming from… When experts get into an internet brawl their replies will be consistent and neatly organised, while the fauxperts will just keep throwing link after link or piling arguments without stopping to think about any of it.

        Perfect example of this is dr. Grunebaum’s reply on Midwifery Today to a mother who was “looking for advice” on how to best ignore the fact that she is high risk and remain in care of her lay midwife. Initially MT resident fauxperts chimed in, then he replied, and then even mother came back with a vengeance and fauxperted back at him in an attempt to “school” him. If anyone has screenshots of that interaction please share.

      • just me

        Apostrophe’s in plural’s really irritate me. Why o why do people put them in plural word’s? Drives me nut’s.

        • The Bofa on the Sofa

          “One thing? I, like: about, Dear Miss Kinnian: (thats, the way? it goes; in a business, letter (if I ever go! into business?) is that, she: always gives me’ a reason” when – I ask. She”s a gen’ius! I cou’d be smart like-her, Punctuation , is? fun!”

          Charlie Gordon

      • Lisa C

        LOL! Probably, and sadly, the errors are entirely mine. I wasn’t paying attention when I typed it. My college English professor once told me I didn’t know how to use a comma and apparently its the same for apostrophes and spelling.

    • Amy

      Wow. I wonder what that poster would think about the sign up in my GP’s office advising sales reps that they will be seen only on certain hours at certain days, no lunches or gifts allowed.

      • Amy M

        It’s called the Sunshine Act—recently started (at least in the US) to reduce bribery, and shady business practices. I work for a pharma company, in the R&D dept—I never see MDs or patients/customers, but I still had to get the Sunshine Act training.

    • Sue

      What IS IT with anti-vaxers and “packet inserts”? Do they really think that reading a little disclaimer leaflet, placed there for legal reasons, replaces years studying the clinical sciences?

      (Yep, I guess they do. Sigh.)

  • Zoey

    Exactly. Anyone giving you advice, medical or otherwise on a message board or in a Facebook group is not an expert, no matter how confident they are or how many devoted followers they may have.

    I was in a local parenting group that I knew had several legitimate medical professionals: MDs, a registered dietician, a PhD psychologist. At first I couldn’t figure out why they would never weigh in to give advice on something related to their area of expertise. But then I realized that they have professional standards, and would have to take responsibility for their advice. So obviously, that ruled out giving out medical advice based on a parent’s vague description or poorly lighted photograph.

    Of course, that never stopped the chiropractor, a midwife, a craniosacral therapist, and a naturopath from giving out medical advice all the time. I think that speaks to the different standards that each of these professions is held to.

  • Bugsy

    YES!!!!!!!!!

    All of your posts are great, but this one particularly resonates with me, Dr. Amy. I’m bookmarking it to share with friends and family.

    • Amy Tuteur, MD

      Thanks!!