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Why Parents May Push for Meds Against Doc's Advice

Survey dealt with hypothetical diagnosis of digestive disorder in young child

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

MONDAY, April 1 (HealthDay News) -- When doctors use quick-and-easy disease labels to sum up symptoms of concern in an otherwise healthy infant, parents are more apt to want to treat their child with some type of medication, even if they're told that drugs won't help, new research says.

The finding was gleaned from the results of a survey administered in a general pediatric clinic setting. The poll had asked parents how they would react to being told that their child's excessive crying and spitting amounted to a diagnosis of gastroesophageal reflux disease (GERD), rather than being given no specific disease label at all.

The study highlights the powerful impact that a physician's choice of words can have on parental decision-making, while emphasizing the importance of good doctor-patient/parent communication.

"The disease label seems to send the message that there is an illness that requires medical treatment," explained study lead author Laura Scherer, an assistant professor in the department of psychological sciences at the University of Missouri. "But, depending on the situation, medical treatments may be necessary, or not. In the case of GERD, an otherwise healthy infant probably will not benefit from medication. So in this case [that] label can be misleading."

Scherer and her colleagues published their findings in the May issue of Pediatrics.

Though the survey results speak to the potential impact of disease-labeling as a whole, the authors noted that the issue is of specific interest with respect to GERD. A growing concern is that this particular condition is both overdiagnosed and overtreated among basically healthy children.

Between 2011 and 2012, the investigators surveyed 175 parents (whose average age was about 35) either while in a pediatric clinic waiting room or an examination room. Most participants were mothers and described as highly educated. The average age of their sons and daughters was 4.5 years. About one-fifth of these children had been previously diagnosed with GERD.

Parents were randomly given one of four hypothetical scenarios: Their infant had GERD and existing drugs were ineffective; their infant had GERD without any comment on medications; no disease label was offered in the context of drugs being ineffective; or no disease label or drug information was offered.

The result: Those parents who were given a GERD diagnosis ended up being interested in treating their infant with drugs despite being specifically cautioned that drugs wouldn't work.

By contrast, parents who were not offered a single disease label to describe their infant's crying and spitting symptoms only expressed an interest in drug treatment if the physician did not raise the issue of the drug's ineffectiveness. This left parents to assume that the relevant drugs worked.

When medicinal ineffectiveness was discussed, these parents expressed no eagerness to launch a drug treatment.

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