Mar 13, 2017
Myths persist because they are essential to the human experience
and our development as a society.
They fill the gap between what we know and what we think we
know.
Where does this gap hurt us the most? In our vulnerable
populations, for example, in our care of children.
The “myth incarnate” in medicine: defective dogma. Not all dogma is
bad – after all, dogma means “that which is believed universally to
be true”. The problem with medical dogma is that our critical
thought processes are curtailed by wholesale acceptance.
Medical dogma is a special kind of myth, because it’s difficult to
define. We repeat defective dogma for three reasons:
“It is known”. Sometimes the dogma is all that is known on the
subject, or it is simply the majority consensus. Be careful with
this one – because there may be a reason for this specific teaching
– not all dogma is bad.
Dogma is sentimental. We learned from our teachers who learned from
their teachers. We want to honor those who taught us, and we get
attached to some ideas. Sometimes – even subconsciously – we allow
our attachment to an idea to give it more credence than it
deserves.
The third driver of dogma is insecurity. “I know what I know”. In
other words, “don’t make me reveal my limitations.”
Myth: “They’re all fine”
Remedy: Remember to look for the subtleties in children. Early
warning signs are there, in the history or in the physical exam. If
it doesn’t add up, investigate.
Myth: “Only pediatricians are experts”
Remedy: Don’t delegate decisions. You can do this. You sometimes
are the only one that can.
Myth: “I will break them”
Remedy: Children are not another species. Use all of your skills
for all of your patients”
Powered by #FOAMed – Tim Horeczko, MD, MSCR, FACEP, FAAP