They don't shun doctors but they don't go seeking them out a lot, either. Basically use them only when necessary. I think Josh thought he would get away with thestars because he had gotten away with so much since he was at least 14. And in the family, it was kept quiet. It didn't occur to him that outsiders might talk - in his mind it would be shameful for those women to admit sex outside marriage, with a married man. But he wasn't taking into account that they're grown women, unashamed of their choices, and not mentally abused into submission from birth!!!
You give him credit for a lot of thinking.