The Vaccine Debate: Why We Fight About Science
http://www.statesmanjournal.com/story/news/health/2015/03/03/vaccine-debate-fight-science/24313999/"...
Dr. Paul Offit, director of the Vaccine Education Center at The Children's Hospital of Philadelphia, said most lay people are not equipped to distinguish between sound and weak scientific articles. He said about 4,000 are published every day, and most are mediocre. Some are awful. A Google search of scientific articles does not make you a scientific expert.
For instance, a parent might "research" the chicken pox vaccine then choose not to immunize his or her child against chicken pox.
"What do they mean by research?" Offit said. "They Googled 'chicken pox' and read people's opinions on it. If you want to research, you should read the 300 studies done on chicken pox and the chicken pox vaccine."
To fully understand the studies on the reproduction of the wild chicken pox virus compared to the vaccine virus in the body, or the data on the safety and efficacy of the vaccine, one would need expertise on microbiology, immunology and statistics, Offit said. Most parents don't have that, so they rely on the advice of the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. Advice, he says, that has "dramatically decreased the incidence of disease in this country."
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Granted, the piece could have been much more in depth, but there are a couple of important points that are often lost when discussing science online.
= new reply since forum marked as read
Let's stop assuming that "laymen" = uneducated. The last few decades vastly expanded the availability of college and even graduate level education. What didn't expand as fast is medical coverage: people were often left to themselves in terms of figuring out why they felt ill or in attempting to decipher the signs of a serious condition that needed to be diagnosed (because it was disabling, required immediate ER or surgical attention, or would require a drug prescription that only a licensed physician could write). This was especially true in rural areas where there were few corporate jobs with cadillac health plans.
The Internet, however, allowed people to research their own symptoms. By research, I don't mean "gossip on forums" as doctors seems to arrogantly assume covers the extent of patient reading capabilities. Articles from many medical journals can be found online as well. And when the journal can't be found online, the reference can be found online, and some people even have access to academic libraries and can order up the relevant journals. Having a lot more time and attention than doctors have to spend on their conditions, patients can examine symptoms over a very long period and eventually draw their own conclusions. Since maintaining the respect of others is important to most people who are capable of doing this sort of reading, they tend to be conservative in their analysis, lest they be labeled a hypochondriac.
The problem is that doctors are very defensive about this situation and assume patients have the knowledge level of Internet gossip. In my experience, if a patient says, "I've had these symptoms, do you think I have X?" - the doctor will just clam up and refuse to diagnose you at all: they somehow see it as their job to "fend the stupid patient off" even though the patient is paying them for help. The patient is competing with their expertise and "pulling rank" on them in their eyes.
Of course the frustration for the patient is if they just list their symptoms, and the doctor is too busy to be attentive, they may not do any diagnosing anyway. The patient therefore ends up wasting a lot of time and money (and endures a lot of additional pain) coming in for many repeat visits over a condition they are 75% sure they already have, but they just need the doctor's expert option (perhaps with an alternative theory) and the appropriate lab tests to confirm it or disprove it.
So this is the situation with the modern "educated" patient. On the one hand the doctor indirectly claims they want the patient to be educated every time they complain about "Internet forums". Pretending for the minute that the complaint about the "stupid layman" isn't a strawman for arrogant doctors, let's go over again the reality check on how doctors behave when presented with the educated patient: THE DOCTOR DOESN'T DO THEIR JOB. The doctor is likely to leave the patient in pain, delay documentation the patient needs of their disability, or, worst of all, endanger their life by refusing to follow up on real problems.
Now lets take this one step further: we have educated patients who were, before the ACA at least, confronting a hostile/arrogant medical system. In other threads I've also talked about the historical post WWII historical context - especially of the 70s - that led to general distrust of Big Science. But the insurance situation made the issue more personal. Let's say your family was uninsured, but a child started to grow ill with "vague symptoms". Your Internet research eventually narrowed it down to a category of rare diseases. In the modern medical system you would have to get your kid past the primary care doctor and to the right specialist - but you don't even have the money for the primary care doctor. When you finally do scrape together the money, the primary care doctor gives you the "lifestyle speech". You keep scraping together the money, the doctor keeps giving you "the speech". Irritated, you start underscoring the symptoms you want the doctor to focus on. The doctor senses you are "competing" or being an "Internet doctor", and refuses to diagnose. You've wasted all the money you've invested so far. You might be correct about the diagnosis, but you can't get to the tests you need to prove it, and the doctor won't consider it because he doesn't respect you.
Under these hostile circumstances it is easy to start projecting about the hostility and evil intentions of the entire medical establishment - and the conspiracy may expand from there (to Big Science, Big Pharma, Big Government, etc...). What you do know is that you - with your COLLEGE/GRADUATE SCHOOL EDUCATION - were able to research the "truth", and you are trying to protect your child - but you find yourself blockaded by a cold, mean, overpaid (compared to you who doesn't even have insurance) medical establishment.
I don't have any children, so part of this is extrapolated from the attitudes I hear from mothers about how they would do anything for their children. But I have gone through the long period with no insurance, and I have experienced frustration with doctors who didn't understand I had already been diagnosed with a genetic disorder a couple of decades ago - but those records had been lost, so until some crisis actually happened to prove it, I had the frustrating experience of trying to get doctors who were conditioned to "resist" knowledgeable patients to re-diagnose me with a rare disease. I can certainly imagine how this experience might play out across a broader uninsured population.
I also think it's a lot more fruitful to understand where conspiracy theories come and to treat fellow human beings with respect rather than to just categorize some as "stupid" and bash them until they grudgingly do what you want. I've been playing "cassandra" in a lot of threads since I believe the backlash would sneak up to surprise future Democratic candidates. I hope people in this thread listen to my take on this as it is intended and not just lump me in with the "science illiterates" and pile on me, too (as has happened in several other threads). 
