By Dr. Anthony Policastro

I spent many years taking after-hours call for pediatrics. Some of those calls involved treating patients in the nursery. Some involved inpatients. Some involved emergency room consults. All occurred in the hospital. Decisions were driven by science. I was able to treat patients according to standard practice guidelines.

For example, many newborn issues were common. Scientifically approved practice guidelines existed for those conditions. When the nurses called me, I would follow the guidelines. That meant that we did things consistently. Therefore, very few things fell through the cracks.

Another part of taking after-hours call was answering phone calls from the parents of sick patients. Many of those calls just required telephone advice. However, some of the children were sick enough to be seen.

I would plan to meet them at the hospital so I could examine them and decide on the best treatment. That usually meant multiple trips to the hospital during a weekend of call. However, it also meant that I could see the patient and make the correct decision. It allowed me to practice medicine using the science that was available.

It wasn’t always that easy. Occasionally, I would receive a call from a parent whose child was sick enough to be seen. I would offer to meet them at the hospital. Sometimes, the parent would balk at that. They knew what their child had. They knew what medication I needed to call in. That often resulted in a request for an antibiotic to be called into the pharmacy.

What the parent did not realize was what a poor decision that was medically. Perhaps their child had something that did not need an antibiotic. Perhaps their child had something that needed a different antibiotic. Perhaps an unnecessary antibiotic would result in an allergic reaction. The outcome would not have been what they desired.

Sometimes, they would reluctantly agree to be seen. I would take a history. I would do an exam. I would come to a conclusion based upon all that information. Those were the things I learned in medical school. Those things were very important pieces of medical care.

I might determine that the child did not really require an antibiotic. The response I would get was, “So I brought my child in for nothing!”. Well, we didn’t know that beforehand. The history influenced that. Further questions about the history based upon the physical findings influenced that. The physical exam influenced that. There were a lot of things that occurred. It was clearly more than “nothing”

Unfortunately, people tend to have a lot of medical beliefs that have no foundation in science. Some of them are superstitions. Some of them are conspiracy theories. Some are paranoid beliefs. Some of them are propagated by social media. Most of them are wrong. 

The scientific approach has been the key to the success of modern medicine. It is something that should not just be followed by physicians but by their patients as well.