Guest Commentary: More Skeptical Sentiments . . .

This past February, I wrote an editorial for this journal called "Skeptical Sentiments."¹ In that essay, I mentioned the satisfaction I had derived from helping children and families during my 30-year career as a pediatrician. I also listed a series of things and situations I have learned to distrust. Chief among them were:

• Doctors who refer to a baby or child as "it."

• Parents who say they "go outside to smoke" during Michigan winters.

• Pediatricians who have "never seen a case of child abuse."

• People who advise women to deliver their babies underwater.

• People who are certain that children benefit from hearing music in utero.

• Politicians who cut funds to programs that benefit children.

• Doctors who believe a circumcision without appropriate anesthetic doesn't hurt.

• A system that places children in foster care without giving foster parents a child's medical history.

I invited readers of Consultant For Pediatricians to e-mail me their own skeptical sentiments. Here are some of the "I don't trusts" I received:

• "Cash only" doctors.

• Doctors who say they can diagnose "strep throat" just by looking.

• Emergency room doctors who tell me a febrile 1-year-old needs to be admitted for "pneumonia" when the respiratory rate is 20, the pulse oximeter reads 100%, the child is eating well, and no urine culture has been done.

• Parents who say their 2-year-old knows "not to touch the stove."

• Patients who tell me they're using the medication "like you told me to," but can't tell me what the medication looks like--or when they last used it.

• Obese parents of obese children who insist "it's genetic."

• Parents who believe that the size of their home is more important than their presence in it and their availability to the children who live there.

• Parents who say their cat-killing adolescent is basically a "good kid."

A couple of readers and colleagues took me to task for a few of my skeptical sentiments. One reader objected to my observation that I don't trust doctors who listen to a patient's chest through his or her clothes. She wrote: "If a child is apprehensive, I will first listen to his chest through the clothing. In some children, this affords the only chance I'll get for a good cardiac examination while they are quiet." I see the reader's point.

I had also written that I distrust that breast-fed infants exposed to a bottle and a pacifier will develop "nipple confusion." A reader disagreed, commenting that "nipple confusion does happen." I concede that a baby might decide that it's less work to get milk from a bottle than from a breast. Perhaps it's the term "nipple confusion," rather than the concept of an infant's preference, that bothers me.

Thanks to all who responded. I learned a thing or two.

References:

REFERENCE:

1. Fischer H. Skeptical sentiments.

Consultant For Pediatricians.

2006;5:54.