Can Labeling an Ailment Increase the Likelihood a Parent Will Opt for More Dramatic Treatment?

Doctors’ opinions are (rightfully in most cases) often taken as gospel. When we are faced with terminology and/or a diagnosis that we are unfamiliar with, and an expert who understands said unknown, the most logical option is to listen to the expert. Even if what we are given as options for treatment may not be effective.

We have long been told that the words we say can have significant impacts on not only our mental health, but our physical health as well. According to recent studies, these words can affect a patient’s outlook on not only their diagnosis and/or prognosis, but the image they have of themselves and what they can and cannot handle. For instance, if a doctor uses aggressive or unfamiliar words to describe an ailment, a patient may be inclined to take more drastic measures for treatment. Again, even if they are told that the treatment may not be effective.

This behavior is leading to an increase in a commonly held fear with antibiotics and other prescription drugs. ‘Over-diagnosing’ can be leading to the rise in antibiotic resistant bacteria. It could also allow potentially harmful drugs to be a “quick-fix” to patient’s symptoms. An article I found on highlights research done regarding physician’s use of words, and patient’s subsequent choice of treatment.

The researchers behind one study were particularly interested in the over use of proton pump inhibitors in infants experiencing mild acid reflux. The drugs have been shown to cause more harm than good, despite providing relief to symptoms (note: a whole other blog post could be done on the reliability of the study done on proton pump inhibitors, this was just cited by the original article and I thought it would be consistent to include it). In the study, doctors gave “real parents” (an interesting choice of words by the author, I know), a hypothetical situation in which their child was spitting up and crying. One group of parents was told that their child had GERD (gastroesophageal reflux disorder), and the other group had no medical diagnosis attached to the symptoms (meaning, I assume, that they were just told their child was exhibiting the symptoms, then given options for treatment). Parents who had been given the medical diagnosis of GERD were more likely to opt for prescription drugs to treat their child, even though the parents were told the drugs were unlikely to help their child.

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Something I am confused about, is the scaling here. The results from the study were obtained through an ANOVA analysis. The study never mentions how many individuals were surveyed. This could lead to a false confirmation. There could be no correlation, but because their sample was so small, they could have found correlation. They are, however, careful to state that labeling diseases “may” promote over-treatment.  Never stating that it “will” promote over-treatment.

In addition, from the information gathered from the study, they gathered their data in one pediatric clinic. This could be another indication that their study is not representative of a larger population.

Though this study may not be the best indication of the effect of labeling and over-diagnosing, this is still a legitimate issue. Medical jargon is not widely understood, and it can be inherently scary to hear when it is being used to describe your health. Recently, I have been having issues with my tonsils. An interaction I had with one clinician brought up a similar kind of fear in me. He spewed a bunch of medical terms at me, then immediately following, told me that tonsillectomy surgery was the best option for treatment.  At first, I felt so hopeless that I almost scheduled a surgery. However, after talking with my parents, I realized I had many more options open to me than the doctor had made it seem.

The article on FiveThirtyEight looks into labeling other diseases and the impacts they have on patients. I am interested in doing another blog post about the cancer studies they cite.





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