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Parenting Advice From a Pediatrician is...

... dicey at best. Sorry, not sorry.


Because here's something you should know. I can't recall a single lecture or class on child-rearing in my entire medical education. Not undergraduate education, medical school, residency, or fellowship.


Not. One.


Seriously?


Yes. After the first 2 years of medical school, which are mostly made up of classes that teach foundational concepts like which muscle attaches to which bone and which drugs will kill you at what dose, there are 2 more years of medical school in which students observe and begin to see patients with full supervision from a physician. After that is residency, which is a lot like an apprenticeship. We practice with increasing supervision but still get a lot of help while learning the craft, so to speak.


A lot of education in that late medical school/residency time period is done at the bedside. You can't cram every bit of knowledge into a formal classroom setting. And sometimes the lessons stick better in real-time. So we listen to our supervisors, hear what they say to patients, and take that wisdom with us. The beauty in that system is the passing of knowledge and experience from generation to generation. After all, some of the most valuable things I've ever learned aren't in textbooks.


The flaw in the system is the same. Our understanding of child psychology has evolved over the last several generations. But many physicians haven't kept up with that evolution. Whether it's because they aren't interested enough in child psychology to seek out that information, they're drowning in the flood of information that is constantly evolving the face of medicine, they operate on their personal cultural perspectives of child-rearing, or due to the difficulty finding and interpreting psychology studies on the topic, much of the advice given by pediatricians is antiquated and out of touch with our current understanding of child development. All that to say that pediatricians aren't universally equipped to give parenting advice.


And We're Human


We're also as likely as anyone to fall prey to the Dunning Kruger effect. If you're not familiar with the Dunning Kruger effect, it is a kind of cognitive bias. It describes the thing that happens in people with limited knowledge or competence in a particular topic. These people tend to greatly overestimate their own knowledge or competence. You know someone who is super confident about their knowledge on some topic, but they really don't have a clue. As our actual knowledge increases, we become less sure of ourselves and realize that much of what we thought we knew was oversimplified. By the time we become true experts, we may still feel less confident than those who think they know everything. Doctors do this too.


How To Tell the Difference


Don't get me wrong. It's fine to ask your pediatrician about parenting issues. But do so with the recognition that your pediatrician is a human being who has received about as much formal training on parenting as you have. They may or may not have sought additional education on the subject after their required formal education was done. Their personal values and background will definitely color their responses. And they may assume they know a lot about parenting just by virtue of being a pediatrician, without having actually done much research on the topic.


The best pediatricians to ask about parenting issues are those who acknowledge nuance. They talk about the differences between children, avoid fixed timelines for skill development, and don't prescribe a uniform approach to all children. They ask about your family values and preferences and use those to guide their recommendations. They avoid hard-line stances that disregard your child's feelings. And they encourage you to pick your battles.


If you want more parenting resources, I'd recommend looking outside of your pediatrician's office. Here are my favorites:


Self-Reg by Stuart Shanker


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