Why "Do Your Own Research" Doesn't Work

Reading medical literature is a skill most people don't have

RFK, Jr. and the anti-vaxx groups and other fringe groups have gotten people to reject many valuable modern medical treatments by telling them to “do your own research.” It’s a great theory: just sit down at your computer for a few hours and figure out the best treatment plan for your malady. The problem is - it doesn’t work that way. Stick with me; I’m going to tell you my background and why I can “do the research” and you’ll see why very few others who aren’t physicians or others with advanced medical training can.

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I went to high school as the vast majority of us did, graduating oh, so long ago in 1985. In high school, I took a lot of math, although a surprisingly small amount of science. I made up for that at LSU, where I attended college from 1985-1990. There, I took a BA in Sociology and a BS in Zoology. As you can imagine, I got a good science education. In my sociology degree, I also took statistics, including a couple of graduate level statistics seminars. Even before I got to medical school, I knew about p values, t values, standard deviations, chi squares, powering of studies, and more.

In medical school, I, of course, learned to be a doctor. The first two years of medical education are generally basic science coursework. (I think the structuring of the basic science and clinical work is getting a bit more blurred in med school these days, but I’m describing what I went through.) By the end of the second year, though, we were learning medical statistics and how to read medical journal articles. In our third and fourth years, we were on the wards and taking care of patients. (I was at Big Charity in New Orleans, one of the last hospitals to have literal wards with eight patients in a large room with only curtains for privacy. Crazy! But, we prided ourselves on giving excellent care.) Even though we didn’t have the internet, we were able to get journal articles from the library to read about our patients’ conditions. It wasn’t as easy as it is today, but we did read medical studies and interpret them with help from our attending physicians.

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After medical school, I went to a Family Practice residency in rural Kentucky. My colleagues and I continued to learn to care for patients. Part of that was reading the important journals in our field like the Journal of the American Medical Association, American Family Physician, New England Journal of Medicine, and Annals of Family Medicine. We discussed these articles in weekly Journal Club. We dissected the findings, compared the results with other studies, compared the structure of the studies with similar studies, and decided how our practice should change in the light of the findings. At times, it was like drinking from a firehose.

Finally, in 1997, I joined a group practice here in rural Wisconsin. My time reading studies in journals only increased. And, with the increasing access to the internet, I was able to read some articles from journals I might not otherwise have come across. I also was participating in a certain number of hours of continuing education each year, some of which was listening to presentation new findings, some of which was discussing particular studies, including the statistical analyses, harkening back to the days in college and medical school when I had learned those concepts of setting up experiments and analyzing the results.

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I give you this exhaustive listing of my education to show how much work it takes for a physician or other medical professional to understand the medical literature. When your doctor sits down to read a new study in one of their journals, they bring to it many years of education. They are almost always NOT just reading the abstract and moving on. They look at how the experiment or data set was created and how the statistics were done. Then, they look at the results. Sometimes, they decide that it’s a bad study and they won’t be using the findings in their practice even if the peer review had chosen to publish it. There may have been too few participants for it to be reliable. Maybe the results were contrary to every thing else that had been published, so the doctor might set it aside and see what new studies might show over the next few years. Or, it might answer a clinical question that the clinician had been asking, and the clinician will put the information into use in their practice.

So, to suggest that a person without an extensive background in medicine and statistics can just “do your own research” is almost laughable. That doesn’t mean that people should just take everything that someone tells them without question. For example, if someone is concerned about vaccines, the American Academy of Pediatrics has healthychildren.org and the American Academy of Family Physicians has familydoctor.org, both of which have prominent sections on vaccination. If someone has a study or two that shows harm from immunizations, they can ask their child’s doctor why that study is an outlier. Most doctors can see pretty quickly why a study diverges so far from the scientific recommendations.

Now, if you have a physician who is unwilling to talk to you about anything other than current recommendations, you probably need a new physician. Most doctors want to help their patients understand their recommendations and are even willing to consider other options, but they can’t convert a twenty minute visit into an hour visit. For example, when someone is diagnosed with a sinus infection, the treatment is antibiotics. Most doctors don’t have an issue with patients adding an herbal treatment like elderberry syrup to that plan, but they would still push for the antibiotics.

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This administration has deployed the term “shared decision-making” for some things like vaccinations. Shared decision-making is great for things like shingles when you can try gabapentin which might be a little less effective, but will probably have fewer side effects or pregabalin which might be more effective, but will likely have a few more side effects. Either way, you’re treating pain and it won’t affect the course of the illness. (I currently have shingles and have discussed in detail the pros and cons of various treatments with my doctor!) Shared decision-making is not appropriate for vaccinations because the literature is very strong on the vaccination schedule. We know that children are less likely to become very ill and die if they are vaccinated on this schedule. We also know that there are very few side effects associated with this vaccination schedule.

Here’s the bottom line: Get educated about your health. There are great websites from Harvard, Mayo Clinic, and lots of other sites that will give you reliable information about vaccines, heart health, blood pressure, menopause, and many more topics. Be a partner with your physician, chiropractor, nutritionist, etc. But, understand your limits. I’m not saying you shouldn’t read the primary literature, but read it understanding that you are probably not going to get a full understanding. Most articles have an abstract, so you can read the conclusion and see what the basic idea is. But, talk to your doctor to understand how that information can affect you.

I don’t want this post to be a downer about people being educated about your health. I just want you to understand how much education your physician has and what it takes to read the medical literature. Be a partner with your physician, and understand your role in that partnership. It’s your body; learn what you can about it. But you go to your physician for those 10-12 years of higher education. Let them use that education.