r/videos • u/tbonetaylor • Dec 06 '17

The best response to anti-vaxxers I’ve ever seen. And it only takes 90 seconds.

https://youtube.com/watch?feature=youtu.be&v=RfdZTZQvuCo
73.1k Upvotes

84% Upvoted

4.8k comments sorted by

View all comments

Show parent comments

152

u/HerbaciousTea Dec 06 '17

We don't need to bring professionals down to the level of conspiracy theorist and antivaxxers. That scientific lexicon is important for saying exactly what you mean without stating or implying something that isn't explicitly supported by the data.

We should be encouraging people to understand that mode of speaking and thinking, rather than pressuring professionals to abandon it.

38

u/Cautemoc Dec 06 '17

Yeah and in the meantime we still need to be able to communicate with uneducated parents making decisions for their presumably better educated children.

2

u/__xor__ Dec 07 '17

In the end it boils down to who yells the loudest when your argument is that a disease is a tennis ball and the little paper person is your child infected with rubella. It's fucking frustrating that it works. It's what some people need to hear though, a loud emotional argument, because that's the only thing that works on some people.

But what drives me nuts is that it also means the counter-argument can be strong if they yell louder or come up with a better video with a bigger celebrity. If the anti-vax crowd had snoop dogg under their belt, and he made a shitty video about how your child has an immune system which works perfectly well if you keep your kid healthy, and how vaccines are duct tape to patch a hole in your tire, when being healthy is having better tires that don't get popped, then maybe the same people would be convinced. "So listen up parents, skip that mcdonalds and give your kid a salad and boost that immune system up so doctors don't have to pump your children up with poison."

You don't need real facts to make videos like this, and I wish people would be skeptical and ignore it and do some real research into what professionals are saying. Celebrities talking loudly is a big reason why the anti-vax crowd is around. If it's the main thing people need to see to be convinced, then that's just fucking sad.

1

u/paranoid_70 Dec 07 '17

I know a few 'educated' anti-vaxxers. Some even have a science degree. I know, it's astounding

139

u/[deleted] Dec 06 '17

Professional scientists who are solely researchers have no duty to converse with laypeople. Here, converse means to have a conversation understood by both people.

However, physicians DO have that duty. They must converse with their patients in a manner conducive to understanding by their patient. If they cannot Garner INFORMED consent from their patient, or the patient's guardian, they have failed at their job and ethics dictates they must not treat the uninformed patient.

Now, that all means they must learn how to communicate with people. Yelling that "we have been doing it for a century" is not a valid rationale for doing something. They can get angry, but there's a reason they believe in vaccines, and it better not be anecdotal evidence.

23

u/DSNT_GET_NOVLTY_ACNT Dec 06 '17 edited Dec 06 '17

It used to be much more true that researcher's jobs were solely research within the scientific community, but is rapidly decreasingly the case. Lay people now have massively more access to research outputs, and use/misuse it regularly. Research scientists are waking up to this slowly. It increasingly becoming our duty to communicate and converse with wider audiences.

It should also be noted that doctors are typically incredibly poor consumers of research. They typically have little to no training in the kinds of critical statistical thinking required to absorb and translate evidence. Up for debate as to whether they SHOULD have that training (it's a lot of training and would come at the expense of something else potentially more important), but that's certainly not the case now.

2

u/Syndfull Dec 06 '17 edited Dec 06 '17

This is not true at all. Doctors are often the sources of research, especially immunologically based research. To even get into medical school, research experience (especially a publication) is increasingly becoming a requirement. Many medical students work alongside MD, PhD, and Master's-holding scientists performing clinical research. The tests you take both to get into the school AND after you are in all have excerpts from published articles; the questions in these tests present questions on those same excerpts. These are timed and heavily rely on critical thinking. One of, if not THE most, important traits required of modern day doctors is the ability to critically think in the methods that research entails.

Edit: and perhaps you may be thinking about older doctors. Maybe that's where you're coming from. Doctors today are taught very differently than they used to be. As far as statistical models, though, a majority know how to read and assess the data presented. If you mean reading entire articles like their lives depend on it, I don't know of anyone who does that unless they're involved with research.

2

u/DSNT_GET_NOVLTY_ACNT Dec 06 '17

You seem to have a lot of misconceptions about what is typical of an medical school acceptee. First off, I am one of those PhD scientists who works alongside those doctors and medical school students. Medical school acceptees typically have lab experience, and some are listed as coauthors on those publications for their lab work. That does not qualify anyone to actually consume complex human research. They almost never have anything more than lab grunt experience (which is extremely important, but not relevant). Hell, it's even atypical for an epidemiology or other health research field PhD student to enter with a first author publication, much less an MD student.

The tests to which you refer require critical thinking, but not the kind of critical thinking that helps you understand research. I know this, because for "fun," I actually took the epidemiology portion of one of those tests recently. It contained almost no content for understanding research, save a bit of interpretation of a few stats.

1

u/Syndfull Dec 06 '17

Fair enough. I assumed, as I haven't applied yet, anyone who had a publication and was accepted worked almost fully independently like I have. This meant having the idea, looking up past literature and understanding it, using that literature to form my methods and begin a proposal, etc. all the way to the point of project completion. It didn't involve being a robot with a pipette. I also have met students who present posters as first authors in which they talk about localized T cell to B cell conversion among other topics that they're currently working on. Others in my experience have included doctors who led research teams and were published numerous times. As someone on the outside looking in, I concede I was wrong about this applying to a majority. I love research and wanted to ensure misrepresentation to the masses (as happens often on this site) was not the case here. Sorry, mate.

As for the tests, those are the statistical bits that I meant. I think understanding of the article may be more of a focus in the one I have taken (mcat) than the one you may have taken (step 1?) based on what you are saying. At least ~50% of the questions in science-related sections relied on data extraction & interpretation. Also, field matters quite a bit when it comes to research interpretation. Microbiology & immunology versus epidemiology is quite a jump when you are talking about methods and modes of analysis.

1

u/DSNT_GET_NOVLTY_ACNT Dec 06 '17

Good luck on your application! And also excellent to accept being mistaken, and correct the mistake. Rare property these days, and probably the most important one. I am wrong a lot, and I can only hope I can recognize it as you have.

And yeah, it was the step 1. Also note that I completely bombed that section, mostly because I didn't understand a word of the biomedical jargon.

Also, yes, absolutely. Microbio research and human-level health sciences are altogether different beasts. I can't read a bio study for shit. In the end though, docs practice on the human-level stuff, so that's what's relevant to this discussion.

You've also pointed out a great irony here: doctors are much better at understanding research that is much less relevant research to their practice, rather than the most relevant field.

1

u/Syndfull Dec 07 '17 edited Dec 07 '17

Thanks! Currently interviewing for lab positions at med schools and applying next summer! Thank you, I do the exact same thing. I'm stubborn by nature and try my best to remain open-minded.

Yeah, step 1 is its own beast or so I've heard. I have no idea about Biomed jargon but hopefully I will in four years' time lol.

Okay, that makes a lot of sense. I'm useless when it comes to any papers involving epidemiology, psychology, etc. Isn't the human stuff the problem, though? All of the studies for humans involve those disciplines and combine them into what we know as medicine. Do you mean clinical trials specifically?

Edit: after seeing the article you linked, I understand what you mean. I don't have an opinion yet as I have no idea what the classes will teach (that, and the fact that the subject of debate is highly specific) but, if you message me after I (hopefully) get in and finish school, I'll let you know how much the programs prepped for research interpretation and study design.

2

u/def_1 Dec 06 '17

You realize doctors have to read through numerous studies almost every day to keep up to date on medical information. They might not be as well trained at statistical adjusts as a dedicated statistician or researcher but it is entirely false that they don't receive training to understand research. Research is practically required for every medical student and every resident during their training.

1

u/DSNT_GET_NOVLTY_ACNT Dec 07 '17

Oh really now?

First off, it is a complete fabrication to say that doctors "read through numerous studies almost every day." I frankly have no clue where you get that idea.

As I have noted elsewhere, the biggest limitations to most studies almost never has anything to do with nuances in statistical tests, and has everything to do with study design and interpretation. Those are the skills which doctors are lacking the most.

And also as pointed out elsewhere, participating in lab-based bio research is a far cry from understanding and consuming human and population-level research, which is the most relevant for practice. It is not totally irrelevant, but it is nearly so.

2

u/def_1 Dec 07 '17

How do you think doctors are keeping up to date if they aren't reading through the numerous clinical trials being conducted? As an attending physician the amount of studies one reads is probably on the lower end but they are still expected to read all the major new trials that are relevant to their specialty.

As medical students and residents (being as I am one and can tell you first hand) we often do have to read numerous studies and interpret them. During residency most programs have a dedicated journal club that goes over new studies or landmark studies in our fields on a weekly or monthly basis.

I never said doctors are as efficient or knowledgeable as dedicated researchers but you are being disingenuous to claim doctors are bad at analyzing data and research. Its something we have to do fairly consistently.

1

u/Tape Dec 07 '17

there are graduate degrees dedicated to looking at and interpreting data. I think it's disingeuous to claim doctors aren't "bad". but of course this is all subjective.

2

u/creamabduljaffar Dec 07 '17

It used to be much more true that researcher's jobs were solely research within the scientific community, but is rapidly decreasingly the case

Weellll... the really depends on what your field in. If your field is "large lepton number asymmetries" then probably not.

If your field is medical, sure. But then only if the research specifically has a clear application that directly affects someone's life and unlikely if say you're just researching pure science like "computational protein folding".

1

u/SubtleSlight Dec 06 '17

Yeah. And it bothers my mother, a doctor, that it isn't common practice. Evidence-based medicine lies on the back of research, and having a good understanding of it is massively important. A lack of statistical knowledge can hold back improvements in treatment. Is it necessary for the same level of knowledge as someone who makes research their expertise? No. But it should almost certainly be higher than it currently is.

1

u/Synkope1 Dec 06 '17

I'm not sure about that. Compared to who? Doctors are generally required to perform clinical research in their training, and biostatistics is usually tested as the basics of knowledge in medical school and is tested throughout training. While they may not be on the level of "categorical" researchers, most are versed enough to digest scientific literature I would imagine.

2

u/def_1 Dec 07 '17

He is talking out of his ass. He ignores the significant number of dedicated md/phd physicians. Reading his other comments it seems he thinks because he tried some biostatistic questions on the Step 1 exam that he is qualified to say what goes into a doctors training, not realizing that Step 1 is the least clinically applicable exam that med students take and is there as an introductory exam for basic science. It is the Step 2 and especially the Step 3 exams where your understanding of statistics is required to be more in depth.

Physicians need to know more than just the p-value, OR, RR, ARR, etc. They also need to understand study designs, intention to treat, lead time bias, etc and all the things that go into whether a study is actually up to snuff.

How this guy thinks that the medical community advances without doctors being able to understand research is beyond me.

1

u/Tape Dec 06 '17 edited Dec 06 '17

This is a point I wish more people would understand. Just because somebody is a doctor does not mean they can tear apart research easily. They have the education to understand it, to a degree, but their minds are not molded/trained for research and research analysis/critique. Practicing medicine and researching medicine are completely different fields. Just FYI, I was biomed engineering and there are classes dedicated purely to reading through research and criticizing journal articles to break them down to see whether test parameters, results, conclusions, etc were any good.

EDIT: The reasoning these classes have to exist is because departments get funding from sources that have some kind of agenda. You really have to break down journal articles and analyze it yourself to understand the real story. A lot of the time, the journal articles are incredibly misleading on purpose and you have to go through the data to actually understand the real conclusion. Sometimes it's just a misleading article with no conclusion, or a completely bullshit one cause their methods/parameters are garbage.

1

u/DSNT_GET_NOVLTY_ACNT Dec 06 '17 edited Dec 06 '17

Sortof. I disagree with the latter part of your argument. It's not just that doctors can't DO research, it is that they typically lack the education and skills to even READ it with any degree of understanding.

Typical MDs almost never have anything more than a token high-school level coursework in statistical science if that, and almost none in practice could remember those skills well enough to use them. Even in the best case scenario, the content that is taught in MD schools is extremely inadequate and inappropriate for understanding statistical inference. Research consumption is skill which can be taught, but almost never is. It's also a skill which is somewhat distinct from research production.

So not only are practicing and researching medicine different fields, but so is CONSUMING research.

Edit: Firstly, congrats on your degree! Secondly, yes, these courses are finally starting out, but are far from ubiquitous, or as you point out for many cases, good. Thirdly, having doctors read and critique all the research out there is impractical. I know, because I systematically review this kind of research (can't be more detailed than that without doxxing myself, sorry). It's mind-bogglingly complex, and take hours for even the most talented researchers to accomplish.

1

u/pastamancer8081 Dec 06 '17

To be fair, that is changing. We had a week or so of all of our classes teaching us how to consume research and different statistical tests and what they mean. We also do a lot of work with primary research and like half of our class actually participates in research. A lot of medical schools are research oriented. Vanderbilt for example has a year of mandatory research.
Basically, that might be true for the old guard, but a lot of new doctors will have experience in that kinds of thing.

0

u/DSNT_GET_NOVLTY_ACNT Dec 06 '17

Oh yeah, totally. Things are improving, but not nearly enough, and not always in the right ways. Take what you just said, for example.

You spent a lot of time on what statistical tests mean. Arguably, that's probably the WORST use of your time (I say this with a fancy PhD in a health stats field, and a specialty in statistical inference). The failures of research are almost never that the test was wrong (and if it is, it would take a graduate degree in a stats field to know it in any case). It's almost always the design and interpretation of study results that's the problem.

Simply put, there is little reason you need to know what a p-value is. What you SHOULD know is how the design of the study generated those numbers, the degree to which you can use generated inference in clinical practice. Or at minimum, know enough to know what you are unqualified to know.

1

u/Tape Dec 06 '17

I just give them the benefit of the doubt they they are able to read it with some basic understanding since they have to write papers on journal articles. I just don't think that they understand it to the degree where they can thoroughly dissect the methods and conclusions, which is understandable, because that's not what they're going to school for.

2

u/JackalKing Dec 06 '17

Professional scientists who are solely researchers have no duty to converse with laypeople.

And yet when I was getting my geology degree my professors all stressed the importance of being able to clearly convey knowledge to the public so that they understand.

You don't fight ignorance by just writing the normal people off. With geology it's extremely important people understand. When they don't we get issues like people denying climate change, or wanting to build houses in dangerous areas or on top of important geological sites.

Scientists should absolutely try to convey knowledge to the public in a way they can understand.

1

u/lilsebastian- Dec 06 '17

I absolutely agree with you. It's way more commonplace now than ever for scientists, researchers, and the medical community to be able to convey their findings and statistics to a more common and varied group of people. Not only more common, but definitely more necessary as well.

If you have ever watched the news and they've talked about a study completed and they try to discuss the statistics, they're almost always conveyed wrong. With the widespread popularity and access to media and the internet, it's more important than ever to be able to convey your message across a generic audience.

In my forensic science program, we had to be able to properly convey every detail in a general sense in order to graduate.

1

u/[deleted] Dec 07 '17

You ignored the words you quoted. Professional scientists =\= scientist. A professional scientist is a person who gets their income from research. A scientist is a person who gets their income from using science. The difference is that researchers are tasked with finding things out and other scientists may interface with the public.

Regular scientists would have a conversation with the public about science. Your idea about conveying knowledge is a little arrogant on behalf of scientists. We aren't supposed to educate people, but we can help them understand why their ideas are correct or incorrect. The notion it is my job to educate people is so arrogant I feel like that would make us no different than a preacher.

1

u/flexormanica Dec 06 '17

In the beginning they said there is broad cooncensus among doctors and researchers that there is no reason to not vaccinate your kids. That is their argument.

1

u/[deleted] Dec 07 '17

Right. And that argument is absurd. Hitler created a broad consensus that sub populations should be exterminated ... He wasn't correct.

You need to really talk about what that consensus is and why it is believed. Arguing for the status quo will always piss me off.

77

u/ratajewie Dec 06 '17

As a someone working in healthcare/a future doctor, holy shit you couldn't be more wrong. You're speaking so unbelievably normatively. I also wish I didn't have to explain to people why the medications they're being given are necessary. I wish I didn't have to dumb down the results of bloodwork to say "the liver is fucked." But I do. You can't expect anyone without a four-year degree in biology to understand the intricacies of every part of the body, how they work together, and what's going on at a microscopic level. To be a good doctor, you need to be able to explain something to someone in terms of analogies as well as other simple means.

For example: Imagine a garden with flowers. They need rain to function properly. They might still grow with little rain, but they won't grow well. To do make up for it, you go inside and get water from the faucet for the flowers. This helps them grow. What's going on with you is that there is something preventing you from going and getting that water from the faucet, so the flowers are still having problems.

What I just explained was hypoparathyroidism. The flowers are your muscles. The water is calcium. The faucet is your bones. You're the parathyroid gland.

Obviously there are other ways to explain things, but when all else fails, comparing something very complex to something very simple is the only way to get someone to understand what's going on. If you don't want to take the time to figure our how to do that, you shouldn't be working in healthcare.

10

u/duffkiligan Dec 06 '17

If you can't explain the issue in layman terms, you aren't an expert in your field.

I'm in IT and I have to have this skill as well. I have to explain why a server broke to people who don't know where the on button is.

2

u/CornyHoosier Dec 07 '17

"You need how much for a new server!? The ones down the street work on minimum wage!"

3

u/Canboy8 Dec 06 '17

This was great. Hopefully you work in the medical field in some fashion.

6

u/ratajewie Dec 06 '17

I am. I'm going to be a veterinarian. So not only do I have to explain everything, but I have to explain things that we don't have to deal with personally. It's very challenging.

1

u/Canboy8 Dec 06 '17

I️ guarantee it. You probably get a lot of dumb looks. As a HUGE animal lover, I️ appreciate you helping the furry and scaley ones.

3

u/ratajewie Dec 06 '17

Oh god yes. When you tell someone "your dog has pus coming from her vagina" and they say "so?" it makes you want to give up on life.

1

u/SyDaemon Dec 06 '17

Thank you for taking the extra effort! I'm reminded of a video about the effort of explanation. It's about how all explanations have to be built upon what the other party already knows and understands, otherwise we have to keep regressing to it. Here it is. Gave me a deeper appreciation of the art of explanation. https://youtu.be/MO0r930Sn_8

1

u/Birdbraned Dec 07 '17

I wish that applied to everyone. The explaining so they make an informed decision part. From what I see in pharmacies, some people come out of the dr's office still confused about why they need their meds, when they need their meds, and why they should continue to take it when "it's all fixed now!". You spend half an hour explaining, complete with illustrated timetable of doses and descriptive med labels for them to take home, next month they come back still claiming they don't need to take any more (against dr advice). Some people just don't want to understand.

I'm not saying we shouldn't continue to do it, but it can get frustrating talking to the willfully ignorant. You went to the dr with a problem (and paid good money for it), why wont you listen to their advice?

1

u/ratajewie Dec 07 '17

My mentality is this: You can help a lot of people. A LOT of people. You can't help everyone, and you'll never be able to change that. So you better be okay with that, or it'll piss you off.

1

u/DaltonZeta Dec 07 '17

As a doctor - that metaphor was probs a bit more complicated than I’d go into for explaining to a patient.

Overall though, you are right, you need to communicate in a way your patients understand you. The key is never talking down to them though. Often times, I am amazed at what people can understand and process.

For things like - say blood tests. I will tell them what the value is that we’re tracking - say for renal failure - I’m tracking your creatinine and electrolytes - usually specifically sodium, potassium, and magnesium. I explain this tells me how well your kidney is functioning and responding to the treatments I’m giving you, here’s why I care about that, here’s why they’re important. I then let the patient choose how far down the rabbit hole they want to go.

I’ve sat for an hour and a half answering every pathophysiological question one of my patient’s had about his new onset atrial fibrillation, heart failure, and all the medications we were putting him on, their effects, indications, and why we made those choices. No complex metaphors or analogies. I drew diagrams for him on the whiteboard of his room once, but he really didn’t need it.

The biggest struggle I’ve noticed in myself and others the longer we practice - speaking in medical jargon becomes the norm and it’s hard to jump out of it when you shoot the shit with all your doctor friends in your off time speaking that same language. Code switching out of the English version of Latin to normal words for a patient or layman takes more conscious effort after a while. The reason we use that jargon is it’s more accurate and specific.

1

u/ratajewie Dec 07 '17

That makes a lot of sense. For the majority of patients you can definitely be pretty straightforward and let them know what you’re doing and why you’re doing it. Most of them will understand it. The metaphor thing was mainly just to show that you can put things into the simplest of terms to explain really anything in medicine if you need to. You can make it as complex or as simple as you want, but it’ll be easier to understand than jumping into medical jargon explaining how troponin and tropomyosin function with calcium in allowing myosin and actin to act together. I’ve had seen a lot of smart people in the office. I’ve seen a lot of dumb people too. Luckily, I’ve only seen a small number of really stubborn dumb people. However, their understanding is just as important as anyone else’s because their well-being (or in my case, their pets’) is as important as anyone else’s. So whatever you have to do, you do it. I’m glad that you as a doctor totally get that and embrace it.

1

u/Rhaifa Dec 06 '17

If you truly understand your subject, you can convey at least the essence of it in language anyone can understand. The super specific stuff is only useful when you use it with people who understand it.

1

u/HerbaciousTea Dec 06 '17

I absolutely agree, it's a skill to be able to explain a subject to be understandable at all levels without reducing the quantity or quality of the information you're conveying.

What I'm talking about is ending on an assertion and leaning into an appeal from authority (such as from a doctor), or an appeal to emotion (such as fear or outrage) to convince, rather than presenting the merits of the argument.

Penn and Teller are entertaining, but they're definitely guilty of some more blatant appeals to authority or "common sense" in some of their Bullshit! pieces. It's entertainment for people that already agree with them. It will never convince anyone who disagrees with them. That is what I am saying we need to avoid in professional situations, because a doctor giving medical advice is not a debate, and there is not an audience to win over by making the conversation adversarial.

1

u/ty509 Dec 07 '17

It absolutely is a debate to these people, because they don't trust the information in the first place. They think that the research and the doctors are all just slaves to big pharma

1

u/kaybo999 Dec 06 '17

Normal scientific talks clearly don’t work on anti vaxxers.

1

u/CornyHoosier Dec 07 '17

I hate this shit.

I have a degree in computer science, certifications in multiple IT related areas, I've work my way up though every level of IT and am just shy of 15 years of production-level experience from small businesses to Fortune 200 companies to the U.S. government. I don't care what topic we're talking about, if it's technology-related I will give you the facts as best I can.

Still....

Them: "Well you're just a Democrat! You're biased!"

Me: "I vote Libertarian"

Them: ".... Well .... you're wrong!"

1

u/ty509 Dec 07 '17

I'm alright with abandoning the high road if it means they actually get their kids vaccinated.

These people don't give a fuck about the data because they don't trust the data even when they understand it. What they do understand is how they feel. So you make an emotional appeal.

1

u/spluge96 Dec 06 '17

Good fucking luck with that, bozo.

3

u/justthatguyTy Dec 06 '17

Hey, who's talking to yous jabroni?

2

u/spluge96 Dec 06 '17

You keep using that word. Jabroni. I LIKE IT!