It’s time to gang up: a personal conflict on discrepancies in the medical community

  This article was exclusively written for the The European Sting by Mr. Federico Mazzola, a first year surgical resident at the cantonal hospital of Solothurn, Switzerland. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.  

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Paediatric emergency department, 10pm, 4 month old baby on the gurney coughing and breathing heavily. The routine question essential to any paediatric consultation: “Have you’ve been getting all necessary vaccinations at your paediatrician?”. An unusual, yet not uncommon answer: “We will. Our doctor told us that we should wait until our little one is 6 months old, when her immune system is stronger…” Flicking through the knowledge in my head, at the time a 5^th year medical student in his internship, lectures, study notes, vaccination plan – it didn’t make any sense to me – the recommended vaccination plan clearly dictates to get diphtheria, tetanus, pertussis, haemophilus influenza, and poliomyelitis at 2, 4, and 6 months of age.¹ Crucial to a child’s life, since it’s immune system is in desperate need of producing these protective factors.² Why would another doctor, a paediatrician, probably in her 50ies, having gone through years of specialisation and continued education, recommend parents to wait with vaccinating their child at such a decisive period? “May I ask? Did you personally decide to wait with the vaccinations, or was this a recommendation done by your paediatrician?” “ Sure. We didn’t want to vaccinate at first, especially not at such a young age. But our doctor tried to convince us and said it would be safest after 6 months.” My thoughts began to rearrange themselves. At least the other doctor got them to change their minds. There could be many reasons why the parents wouldn’t want to vaccinate their child: fear, mistrust, ignorance, misinformation amongst others – these factors are well known.³ But why would the paediatrician recommend the vaccination after 6 months, it really didn’t make any sense to me. Is it alright to make a rather careless, unscientific decision just to convince parents to get their child vaccinated, or should we, as doctors, be responsible to give the full information and enforcing evidence-based recommendations? Where do we draw the line? “I will discuss your baby’s condition with my superior and come back to you” I said with my mind full of questions, confusion, and disbelief as I walked back to the nurse’s station. My superior doctor will surely have a good answer to this situation. “That doctor always does it like this, always has, always will – a bit on the homeopathic side you know.” Most unsatisfying answer ever. How can it be that we all have the same medical education, same requirements for continued education, same governmental recommendations and a few doctors have the audacity to set up their own opinions on evidence-based matters? How can it be that we have such large discrepancies within our professional community, where knowledge and experience are highly respected, yet personal deviance does not get reprimanded? Maybe our own attitude has a large contributing factor than we might think? Other professions seem to be light-years ahead when it comes to unity and consistency. It is time to gang up and take a united stance on important issues, rather than working against each other. References

• Swiss Vaccination Plan 2018. Swiss Federal Office of Public Health FOPH. https://www.bag.admin.ch/dam/bag/de/dokumente/mt/i-und-b/richtlinien-empfehlungen/allgemeine-empfehlungen/schweizerischer-impfplan.pdf.download.pdf/schweizerischer-impfplan-de.pdf. Accessed 13. November 2018.
• Simon AK, Hollander GA, McMichael A. Evolution of the immune system in humans from infancy to old age. Proc Biol Sci. 2015;282(1821):20143085.
• Explorative Study on the Acceptance of Vaccinations in Vaccine-critical population group in Switzerland – Final Report (German: Explorative Studie zur Akzeptanz des Impfens in impfkritischen Bevölkerungsgruppen der Schweiz – Schlussbericht). PHS Public Health Service. http://www.public-health-services.ch/attachments/content/2015_06_22_schlussbericht.pdf . Accessed 21. November 2018.

About the author Federico Mazzola is a first year surgical resident at the cantonal hospital of Solothurn, Switzerland. He was the president of the Swiss Medical Students’ Association (swimsa) from 2016 to 2018 and currently represents swimsa as a youth delegate for Switzerland at the World Health Organisation. He has been active advocating public and global health on a local, national, and international level since the beginning of his medical studies. He believes in an unified approach to medical care and education, with a special emphasis on interdisciplinarity and communication.