Author Topic: Trust in medical expertise  (Read 4410 times)

Offline biobook

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Trust in medical expertise
« on: August 24, 2021, 11:53:04 PM »
The discussion of an article on the Tweets thread was getting non-tweety, so I'm continuing it here.

The second aspect of his article that I disagreed with was his suggestion that by giving short, concise public announcements, the CDC could cause people to distrust them.  "Remarkably, the CDC is still proclaiming that vaccine breakthrough infections are rare - but when normal people hear that their barber, their cousin’s husband, and seemingly half the New York Yankees’ starters have experienced breakthrough infections, they might assume the CDC is lying."

The idea that public health experts are not trustworthy has been mentioned frequently on DDF.  For example in this thread:


those who are somewhat educated and capable of nuance (like most people here on DDF) just get turned off and distrustful by that kind of thing. [oversimplification]

When you lie by omission, or exaggerate the positive and diminish the negatives in the interest of public health, people will lose trust.


For large segments of our community the issue is one of lost trust in the medical community. IMHO, some of it is deserved, some of it not. If we would be getting more honest talk from public health officials with less whitewashing, and more humility about what is known and unknown due to the newness and ever changing nature of the virus, and the constantly changing data about its treatments and vaccines, there would be more trust. There would also be more trust if vocal officials would be willing to own up to things they got wrong.

I thought I could dig up some earlier examples from the past year, but turned out it's not so simple.  Anyway, I don't understand this attitude.  All of the things you describe here - oversimplification, omission, or exaggerate the positive and diminish the negatives - all of these would just leave me -and I think most DDFers on this board - asking further questions to clarify what I don't understand.

Why would someone react to these by calling them lies and losing trust? 
And is it that you yourself distrust the public health experts, or is it your perception that those around you react this way?   

Offline jj1000

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Re: Trust in medical expertise
« Reply #1 on: August 25, 2021, 12:04:47 AM »
When's the last time medical professionionals disgareed on so much?

With the rapid change over the past 20 or so months of opinions on the many aspects of COVID, I can understand why people are losing faith.

I don't agree with it, but I can understand it.
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Offline yelped

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Re: Trust in medical expertise
« Reply #2 on: August 25, 2021, 12:10:21 AM »
People don't like when science is ignored and new theories and discoveries are not given coverage or any consideration, and known facts are not given any credence until one day, GMA.

This is related to government and political bodies, not personal doctors.

Offline biobook

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Re: Trust in medical expertise
« Reply #3 on: August 25, 2021, 12:19:52 AM »
When's the last time medical professionionals disgareed on so much?
When's the last time most of us took such an in-depth look at what medical professionals thought about any disease?  There's always this sort of disagreement.
Quote
With the rapid change over the past 20 or so months of opinions on the many aspects of COVID, I can understand why people are losing faith.

The rapid changes just mean that many scientists are intensively studying this one disease.  As new research results appear, the researchers change their opinions. That's just the way science works.

Offline jj1000

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Re: Trust in medical expertise
« Reply #4 on: August 25, 2021, 12:26:53 AM »
That's just the way science works.
Pretty sure this sums it up.

You know how science works.

Imagine not knowing how science works. It can look like a bunch of bafoons. And now you can understand how most of the world sees it.
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Offline moko

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Re: Trust in medical expertise
« Reply #5 on: August 25, 2021, 07:40:26 AM »
The discussion of an article on the Tweets thread was getting non-tweety, so I'm continuing it here.

The second aspect of his article that I disagreed with was his suggestion that by giving short, concise public announcements, the CDC could cause people to distrust them.  "Remarkably, the CDC is still proclaiming that vaccine breakthrough infections are rare - but when normal people hear that their barber, their cousin’s husband, and seemingly half the New York Yankees’ starters have experienced breakthrough infections, they might assume the CDC is lying."

The idea that public health experts are not trustworthy has been mentioned frequently on DDF.  For example in this thread:

I thought I could dig up some earlier examples from the past year, but turned out it's not so simple.  Anyway, I don't understand this attitude.  All of the things you describe here - oversimplification, omission, or exaggerate the positive and diminish the negatives - all of these would just leave me -and I think most DDFers on this board - asking further questions to clarify what I don't understand.

Why would someone react to these by calling them lies and losing trust? 
And is it that you yourself distrust the public health experts, or is it your perception that those around you react this way?
wow. Sounds just like kashrus.....

Offline hvaces42

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Re: Trust in medical expertise
« Reply #6 on: August 25, 2021, 07:46:27 AM »
When medical professional tell you X, Y or Z and you know from personal experience over multiple cases that it is not true you distrust.

I can give you personal examples from my family's experiences with COVID and you will tell me its anecdotal. Thats fine for you to believe but based on these personal experiences I can say I distrust a lot of the information that is going on.

I have a daughter who is an RN. She works in an urgent care so she has the clinical front line experience. She also works for a medical referral agency managing extreme COVID cases interacting with doctors and others in facilities such as Johns Hopkins, Mount Sinai and Yale New Haven hospital.

An example: When a doctor on Twitter alleges that Remdesvir is unsafe in pregnant woman and that pregnant women should get vaccinated because there is no safe treatment and you've seen 12 pregnant women in every stage of pregnancy get Remdesvir and survive, you would saybits ancedotal and that you want to see the data and I would say this doctor doesnt know what she is talking about.

When a social worker in Yale New Haven hospital spreads lies that her facility is doing nothing different than any other NY area hospital and we have sent over 200 patients there with NONE over age 75 dying, I would call it lies and you would sat its ancedotal...show me the data.

Data and research must start somewhere. It starts with ancedotal data. There is plenty of reason to distrust if you know and experience ehat I and my family have experienced.

So you can ask for data all you want. Facts on the ground dont lie. Medical professionals may lie or may just not be familiar with what is available or going on elsewhere. The CDC is the last to know.

My personal opinions and experiences here. Not up for a debate on my experiences.
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Offline CountValentine

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Re: Trust in medical expertise
« Reply #7 on: August 25, 2021, 07:55:12 AM »
I don't agree with it, but I can understand it.
Help me understand it.
Isn't there pretty much agreement in the medical community if you should get vaccinated or not? Where is this distrust coming from?
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Offline hvaces42

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Re: Trust in medical expertise
« Reply #8 on: August 25, 2021, 08:00:09 AM »
Help me understand it.
Isn't there pretty much agreement in the medical community if you should get vaccinated or not? Where is this distrust coming from?
When they dont talk about natural immunity that sows distrust.

When they discount T cells that sows distrust.

When they ignore facts that sows distrust
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Offline CountValentine

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Re: Trust in medical expertise
« Reply #9 on: August 25, 2021, 08:16:57 AM »
When they dont talk about natural immunity that sows distrust.

When they discount T cells that sows distrust.

When they ignore facts that sows distrust
How about someone like Dr Birx. Do you trust her?
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Offline EJB

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Re: Trust in medical expertise
« Reply #10 on: August 25, 2021, 09:11:48 AM »
When they dont talk about natural immunity that sows distrust.

When they discount T cells that sows distrust.

When they ignore facts that sows distrust

How do you know they are ignoring facts? Perhaps they are making recommendations in spite of what you believe to be facts?

If you're going to trust Dr. Google over the overwhelming consensus of the medical gedolim worldwide, are you at least consistent and will do the same if a relative of yours chas vishalom needs specialized medical treatment? I hope not.
« Last Edit: August 25, 2021, 09:15:18 AM by EJB »

Offline jj1000

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Re: Trust in medical expertise
« Reply #11 on: August 25, 2021, 09:19:03 AM »
Help me understand it.
Isn't there pretty much agreement in the medical community if you should get vaccinated or not? Where is this distrust coming from?
I personally know MD's that don't recommend the vaccine for recovered patients, pregnant women, and even people on a cocktail of other drugs.

I don't know MD's that say that for any of the other vaccines we have today.

And this isn't just vaccines. Remember when they told us masks don't help? Remember when they told us intubating as soon as possible when ox levels start to drop? And the list is massive of things that were done wrong and improved since. But people that thought otherwise before it was the general recommendation feel they knew better.

Also again, even now you have tons of MD's disagreeing on so much. With school starting each school has their MD they consult with, some require weekly testing, some require masks, some require nothing, some require one test after vacations, etc etc. There is no one answer to many problems like people want there to be, therefore they decide to just phooey the whole system, as it seems no one agrees on what to do anyway.
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Offline CountValentine

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Re: Trust in medical expertise
« Reply #12 on: August 25, 2021, 09:27:22 AM »
I personally know MD's that don't recommend the vaccine for recovered patients, pregnant women, and even people on a cocktail of other drugs.

I don't know MD's that say that for any of the other vaccines we have today.

And this isn't just vaccines. Remember when they told us masks don't help? Remember when they told us intubating as soon as possible when ox levels start to drop? And the list is massive of things that were done wrong and improved since. But people that thought otherwise before it was the general recommendation feel they knew better.

Also again, even now you have tons of MD's disagreeing on so much. With school starting each school has their MD they consult with, some require weekly testing, some require masks, some require nothing, some require one test after vacations, etc etc. There is no one answer to many problems like people want there to be, therefore they decide to just phooey the whole system, as it seems no one agrees on what to do anyway.
You have valid points but much of it was we just didn't know and they did the best they could. It has changed since more data has come up.

Anyone that looks hard enough can find reasons to distrust someone.

I guess a better question would be is the trust warranted? How about Dr Birx as an example.
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Offline jj1000

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Re: Trust in medical expertise
« Reply #13 on: August 25, 2021, 09:35:31 AM »
You have valid points but much of it was we just didn't know and they did the best they could. It has changed since more data has come up.

Anyone that looks hard enough can find reasons to distrust someone.

I guess a better question would be is the trust warranted? How about Dr Birx as an example.
I'm not trying to explain if the trust is warranted or not. Only where it might be coming from. And sure a scientist or someone familiar with the scientific method understand that when you approach a problem you try multiple hypothesis, and as you get more data you learn more and eventually through peer reviewed articles, double blind studies, you get real data and recommendations. But many many people don't know about that and don't want to, or think they could be doing it better...

I don't know Dr Brix. What she do/say?
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Re: Trust in medical expertise
« Reply #14 on: August 25, 2021, 10:08:14 AM »
I don't know Dr Brix. What she do/say?
I use her an example because she was highly respected by both sides. That changed when she gave her interview. Then all of a sudden one side turned on her. IMHO this is the root cause for most of the distrust.

https://en.wikipedia.org/wiki/Deborah_Birx
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Offline srap

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Re: Trust in medical expertise
« Reply #15 on: August 25, 2021, 10:20:32 AM »
I think there has been an evolution in our society which has led to this distrust.  We have become an entitled, arrogant society that throws away items instead of washing or fixing them and cancels that which we don't like or don't have the patience to fully understand.  Since we know best (and are "fully informed" with Professor Google/Dr. Google), we now question, distrust, and cancel the medical profession, as well.

Offline aygart

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Re: Trust in medical expertise
« Reply #16 on: August 25, 2021, 10:32:17 AM »
I use her an example because she was highly respected by both sides. That changed when she gave her interview. Then all of a sudden one side turned on her. IMHO this is the root cause for most of the distrust.

https://en.wikipedia.org/wiki/Deborah_Birx

Maybe you should read the article you had posted better.

Either way, you are absolutely correct IMHO that the distrust comes from those who used COVID as a political weapon. It is when the politicians and political journalists began offering medical opinions as "science" when it was really to further their own agenda then people don't believe science anymore because they have difficulty discerning what is really science and what is politics. This gets even worse when some who should be following science become political, which is something we have seen during COVID as well.

Who is to blame for that? Some have been worse than others, but there is more than enough blame to go around.
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Re: Trust in medical expertise
« Reply #17 on: August 25, 2021, 10:39:27 AM »
Maybe you should read the article you had posted better.
Are you referring to political bias comments about her?
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Offline iwlw2

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Re: Trust in medical expertise
« Reply #18 on: August 25, 2021, 10:40:31 AM »
The discussion of an article on the Tweets thread was getting non-tweety, so I'm continuing it here.

Thank you, I was also starting to feel like that thread was getting a little hijacked by this.  :D I saw your long response to me there, and I'll try to address a little here and stop clogging up that thread.

The second aspect of his article that I disagreed with was his suggestion that by giving short, concise public announcements, the CDC could cause people to distrust them.  "Remarkably, the CDC is still proclaiming that vaccine breakthrough infections are rare - but when normal people hear that their barber, their cousin’s husband, and seemingly half the New York Yankees’ starters have experienced breakthrough infections, they might assume the CDC is lying."

I don't necessarily think the CDC is lying per se, not having a tinfoil hat handy, I don't know what possible reason the medical establishment that I would trust for any other ailments I might have would have for lying. However, it would leave me with the impression that the CDC and such are maybe not the best people to look to in such a quickly evolving and novel situation. For example, I don't think Dr. Fauci is a bad guy, he's just way out of his zone. Because the process of scientific advancement is messy and complicated, it should be nowhere near actual public policy and messaging. It's great to follow scientific advice once they get to a conclusion and a concensus, but much like eating a hotdog wouldn't work as well if you saw how it was made, the messiness of the scientific process does not do wonders for inspiring trust when we see it happening in real time. I am far from an expert or involved even in either the medical or scientific field, but my laymens opinion from seeing what goes on is that the CDC and medical establishment is a slow, cumbersome bureaucracy which has a very hard time adjusting to the fast-moving and ever changing facts on the ground, and as such at least in public, tends to simply discount much of what is going on. "We need to follow the data and the science" is a weak slogan seemingly intended more to cover their rears than actual evolving along with the situation. Scientists are not supposed to be setting policy, yet thats where they found themselves, and it's not a good look on them.

I recognize the limitations of this crazy situation make that difficult, but there are things that can help with that. First of all, avoiding as much as possible absolutes, rather saying over and over again we don't know, but this is what our best guess is. I have personally spoken to doctors about various aspects of COVID as it related to myself and family members, and paradoxically the ones who prefaced every statement with "we really don't know, but this is what we think and our educated guess about how to be safest given the currently available information" were the ones I trusted the most.

Secondly, as you wrote below, its not as easy as you might think to go back and find concrete examples, but has there not been any statements which you felt that even at the time they were said too strongly and seemingly contrary to some basic available information? Again its somewhat due to the nature of the process and so on, but getting up after the fact and admitting openly and clearly "yes, we were wrong about this and we are now advising something else" would also go a long way. I hear what you're saying about that being almost inevitable with the way this works, but its all about the presentation. We are not all scientists nor do we usually see how the hotdog is made.

And that brings up a third point which I think evolves from that. Scientists should not be telling us how to guard our health or get better, that is the job for our doctors (of course based on the conclusions and research done by the scientists). In my opinion there should have been a much greater stress since the beginning that everyone should consult their family doctor for their personal guidance. It is simply ludicrous to have one general medical guidance for 300 million people. Each situation needs to be judged individually and for that you need a personal doctor. Not only is there a pre-exsisting relationship and trust (for most people) already there with their own doctor, but they can also tailor their advice directly. As such, while I don't think it would necessarily be good public policy to announce that anyone who thinks they had covid does not necessarily need 1 or two shots, a personal doctor can help decide that. Would it be so terrible for the CDC to say "We are still evaluating the data about natural immunity, discuss your situation with your doctor?"

Why would someone react to these by calling them lies and losing trust? 
And is it that you yourself distrust the public health experts, or is it your perception that those around you react this way?

At the end of this whole megilla (sorry ;-)), the recognition than in a pandemic, people are scared and looking to scientists and doctors to guide them, should optimally induce humility and transparency, rather than a knee-jerk heavy-handed certainty, kind of "my way or the highway" that sometimes comes across. And again, this is my impression from any number of pronouncements by the CDC, the government, "top" doctors and scientists and "medical advisors", and while by no means is it all, I think you'll agree that there was quite a bit of that.

Offline aygart

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Re: Trust in medical expertise
« Reply #19 on: August 25, 2021, 10:50:27 AM »
Are you referring to political bias comments about her?
yes and how they began prior to the interview you are referring to.
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