Experience

As healthcare changes, adopting increasing evidence for its interventions, there is a body of work trying to understand exactly how clinicians and their patients make individual decisions. There are five accepted influences at work. One of these is the experience of the clinician (and to a degree of the patient who may be in a position previously experienced)

Arguments for decision making less dominated by public knowledge, "evidence", talk up the value of the clinicians' experience. Is this warranted?

Feeding Babies

This is not strictly a healthcare issue but healthcare professionals do get involved. For a while the word was that "breast is best" and this got extended to the idea that small babies should be fed exclusively on breast milk. This advice was given to mothers. It seems now some work suggests that an earlier introduction of other foods may be useful and is associated with less food allergy later on. So science progresses. Is this the final word? Probably not. However this report set off a tirade from the midwifery profession. "What do these people know" "We know best and best is breast" etc. Here's the point. Midwives, and many other groups of healthcare professionals, deliver care and advice but have no developed mechanism to generate new knowledge. The midwives are not about to do the next piece of research to help get to the bottom of this yet they become vituperative when their current stance seem in need of change. They feel threatened. The core their professional status seems in question. "How could others know more about this than ourselves?" But of course they do. This situation is widespread and those groups afflicted feel the insecurity of their position and accordingly adopt unhelpful inflexible postures. Yet this will affect everyone as healthcare enters the biggest transformations in its history. We need to understand and attend to this situation.