I appreciate the appeal to reason and evidence, but these arguments miss the root: trust. Many people don't trust the medical establishment. If more people did trust the medical establishment to consistently provide optimal treatments and self-correct in case of error, the whole nonsense over vaccines would never have happened.
And if someone doesn't trust you, look in the mirror. I mean, look hard. The authors of TFA look in the mirror, love what they see, and ask the reader, "how can you not love me too?"
I guess the problem is that on the one hand he's imploring people to trust the science and those performing it, and on the other hand he's showing that those performing it aren't necessarily trustworthy.
It's hard for me to look at those two articles and reconcile the information from one of them with the information from the other.
Furthermore I have HUGE problems with people saying "LOOK SCIENCE!!" with anything other than physics or chemistry. In those areas where the interactions take place incredibly quickly and there are few compounding variables I love me some science just as much as the next guy.
When you start talking about organisms where everything is potentially a confounding variable it's a lot harder for me to excited about things being "proven" via science.
For example, fat used to be fine, then in the 80s and 90s it wasn't, now in the aughts and teens it might be again depending on which doctors you talk to.
I mean, right now you can't even tell if it's better to get small infrequent doses of no-sunscreen daylight (for the vitamin D) or not. The doctors and scientists are split on this one and there's no real discernable pattern as to which goes on which side. http://www.skincancer.org/healthy-lifestyle/vitamin-d/the-d-...
Given that 10 years ago there was no debate whatsoever and now there's a huge debate raging it makes a person a bit circumspect when taking the advice of those who purport to "know" something.
The issue has been looked at by various think tanks. The question of trust is relevant to public health policy of course, but also to other areas of governance.
If the response is simply "better messaging", that will backfire eventually. Then again, there may be systemic constraints on a more substantive response. A major breakthrough in obesity, chronic disease and/or aging would reset public sentiment.
"Both studies also found that about 25% of the time antibiotics were being prescribed for conditions in which they have no use, such as viral infections."
Anybody who's studied even high school level microbiology (or spent a minute on the Wikipedia article on antibiotics) knows that antibiotics only work on bacteria, not viruses. I imagine it's hard for people to trust doctors when they make basic mistakes like that. Even the CDC (http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-...) has stated that:
"Up to half of antibiotic use in humans and much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe".
So if doctors can't even be trusted to not prescribe antibiotics as treatment for viral infections, why would people trust them regarding other more complex matters?
The issue you bring up is the topic of the recent Science-Based Medicine post, "The Overuse of Antibiotics for Viral Infections in Children" (2 August 2013),
and that is far from the first time that the site has brought up that issue. Some doctors are rolling up their sleeves and taking personal time after work to inform other doctors about this issue and other issues for improving patient care.
Well then maybe if there was some kind of register of the doctors that did in fact practice science based medicine, public trust would be improved, although I imagine there's probably some legal or political obstacle standing in the way of that.
Doctors are overwhelmingly not the reason that this happens. Some are being risk averse (heading off unlikely 2ary bacterial infections to prevent lawsuites) and some are taking the path of least resistance with patients (who will doctor shop until they get some medicine).
This is just my firsthand experience with doctors and anecdotes. _Every single doctor_ is aware know the (lack of) efficacy of antibiotics against viral infections. I'm am completely comfortable with the blanket assertion, and I'm pretty sure you are wrong if you think otherwise.
Well if they're all aware of that yet some still prescribe antibiotics for viral infections due to pressure from patients, isn't that an ethical issue? If for some reason bloodletting came into fashion again among the populace, would doctors be acting ethically if they caved into patients' demands to give them that therapy? Doctors won't prescribe useless treatments like homeopathics to patients, so why can't they say no to patients asking for antibiotics when antibiotics would be ineffective?
Yes it is an ethical issue, for the doctors and the patients. I just feel like you're giving a free pass to patients that lack expertise demanding particular treatments from experts. I think they are more culpable than the doctors.
Well if patients are the problem then the whole thing's a moot point; patients are just getting what they deserve for refusing not only to trust doctors but also to do even a tiny bit of research for themselves. The problem is that such things can harm the whole population, even those who make sensible health decisions, due to how antibiotics overuse encourages the development of antibiotics-resistant superbugs. If doctors can't stop this, then who can?
Many doctors have given placebos to patients. Actual placebo pills, with no active ingredient.
The problem with prescribing antibiotics for a viral infection is not that it is useless -- it is no less effective than a placebo. The problem is that it contributes to drug resistance, while a placebo doesn't.
And if someone doesn't trust you, look in the mirror. I mean, look hard. The authors of TFA look in the mirror, love what they see, and ask the reader, "how can you not love me too?"