The Important Reason Doctors Contradict Each Other

Sometimes, listening to us doctors, you’d think that we have no idea what we are talking about.

That’s certainly what anyone would think after reading Ava Nyer’s hilarious post in which she compiles all the sleep advice she read in books she bought to help her with her twins. Here are excerpts:

“You shouldn’t sleep train at all, before a year, before 6 months, or before 4 months, but if you wait too late, your baby will never be able to sleep without you…Don’t let your baby sleep too long, except when they’ve been napping too much, then you should wake them. Never wake a sleeping baby…Give them a pacifier to reduce SIDS. Be careful about pacifiers because they can cause nursing problems.”

What is so great—and so scary—about Nyer’s post is that she is spot on: every bit of advice that she quotes is advice given about sleep. And a lot of it is completely contradictory.

What makes it worse is that we doctors don’t just contradict ourselves about sleep. We contradict ourselves all the time. For example, here is some of the other advice we give parents about what to do with their babies:

Give them water. Never give them water. Pick them up when they cry. Let them cry it out. Swaddle your baby to calm them and help them sleep. Don’t swaddle your baby, because it can cause hip problems and you shouldn’t ever have blankets in a crib. Give prune juice for constipation. Don’t give juice to babies. Thickening feeds with cereal can help prevent spitting up and help babies sleep better. Never give solid foods before 4 months. When you give solids, start with vegetables so they don’t get a sweet tooth. Start with fruits because they are sweeter. Start with cereals. Don’t start with cereals, because it will increase your baby’s risk of obesity.

We tell you to make sure kids eat healthy foods—and tell you not to be too restrictive or they will sneak junk food or get an eating disorder. We tell you to change their diet and exercise habits if they are overweight—but we tell you not to concentrate on their weight for fear of giving them body image problems. We tell you to make sure they play sports and participate in activities—but we tell you to give them lots of downtime. We talk about the importance of giving them independence—and tell you to know where they are at all times and monitor their use of social media.

We’re not just contradictory with parenting advice, either; we contradict ourselves with medical stuff too.  Different doctors prescribe different medicines, do different tests and give different advice for the same problems.  Most of the time the differences are small—but sometimes they’re not.

It’s kind of embarrassing. And yet, it happens for an important reason.

Every child and every family is different, and those differences are crucial when it comes to deciding what approach to take to a parenting challenge. What works for one family could be a disaster for the next.

And medicine is far more nuanced than most people realize. It’s not just that research changes our understanding of medicine all that time, although that’s part of it. It’s that each person is different—their body, their medical history, who lives with them, how they live—and those differences matter. Plus, conditions affect people differently—each pneumonia, headache, broken bone or case of cancer is different from the next. It just doesn’t work in medicine to always do things the same way.

Now, that’s not the explanation for Nye’s blog. It’s not the explanation for all the other contradictory advice doctors give either. Because the people Nye was quoting are all emphatic that theirs is the right way—as are lots of people who give medical advice (it’s the only way to sell a book, but that’s a whole other problem and blog post).

But the fact that there are so many contradictions forces us to realize that, indeed, there’s no one right way to do anything.

I’m not saying you can’t trust your doctor. You just need to understand that doctors are humans like everyone else, and that medicine is as much an art as a science. So trust your instincts, and ask questions. If the answers you get are contradictory, think of it as a sign that there’s more to the story, and that you and your doctor have more talking to do.

Instead of being frustrated by the contradictions, parents should be empowered by them.

One thought on “The Important Reason Doctors Contradict Each Other

  1. This is the BEST-straight-to-the-heart-of-the-matter explanation for why I offer advice to my patients and their parents gently … because medicine is an artful science, and we create ideas that change and resonate for people who want to listen to them, and sometimes we are wrong. But sometimes we are spot on! ‘You and your doctor have more talking to do..” if you’re not sure how the advice I offer fits when you try it on. And I just love the art of conversation.

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