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Doctors Drop Unvaccinated Patients

The decision to vaccinate a child shouldn’t really be a hard one to make. In fact, I don’t really think it should be a decision at all. Vaccines have been proven time and time again to be both very safe and extremely effective. And yet some people still choose not to have their children vaccinated. Personally, I think that’s a very bad decision.

There is SO MUCH bad information out there regarding vaccines, it’s very disheartening. Of course there’s good information, but the bad info is much easier to find. And it’s presented in a way that appeals to that person’s very basic instinct: to shield their child from possible harm. So as I think about it, it seems to me that most (if not all) of these people are doing it for what for them seems like a good reason

The problem is that they not only compromise their child’s health based on faulty information, but they contribute to a loss in herd immunity. This leads to the cases we hear in the news about vaccine preventable diseases affecting communities with low vaccine compliance. These cases are almost entirely avoidable.

Doctors have always taken the matter seriously, but recently, many pediatricians have been parting ways with patients of theirs who refuse to vaccinate. A story in The Wall Street Journal earlier this week reported on a rise in doctors refusing or “firing” patients who do not comply to the CDC and AAAP’s vaccine schedule.

In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason. By comparison, in 2001 and 2006 about 6% of physicians said they “routinely” stopped working with families due to parents’ continued vaccine refusal and 16% “sometimes” dismissed them, according to surveys conducted then by the American Academy of Pediatrics.

I completely agree with the pediatricians’ decision not to see unvaccinated children. Having an unvaccinated child in a doctor’s waiting room full of other children, some sick, is downright dangerous. Both for the unvaccinated child and the other people present.

There’s also an issue of trust. If parents don’t trust their doctor’s medical advice on one subject, why would they trust them on another? There should be a high level of trust there between doctor and patient.

When and if I have children, this will absolutely be one of the factors in choosing a pediatrician. I want to be able to trust that my child’s health is in good hands, and what better hands than someone’s who is willing to give up a select group of patients for the safety of the majority of her or his other patients? I’ll be looking for a doctor who practices science-based medicine.

So what do you guys think? Do you agree with the decision these doctors are making? There is certainly an argument to be made for both sides.

photo by: UNICEF Sverige

4 comments to Doctors Drop Unvaccinated Patients

  • Lightsleeper

    I would expect any doctor to “fire” a patient who refused to follow her most straightforward medical advice. If a doctor knows a patient with a broken arm won’t let her set it, how can she justify treating him and charging him? You’d have to question the skill and judgement of any doctor who permits parents to forego this most basic and efficacious therapy out of a misplaced political correctness.

    While I feel sorry for the children affected, I have to say as a parent I would find it unacceptable to have the added risk of unvaccinated patients in the waiting room. Doctors don’t have a great deal of leverage in these cases, so I really don’t see what else they can do. They can try to educate, but they can’t compel.

  • Jim Shaver

    I have children, and I agree with you, Mike. Doctors certainly have the right to decline to see patients who explicitly do not follow basic public health recommendations and the doctor’s own advice. As you said, doctors really owe it to their other patients not to increase their risk of exposure to preventable diseases.

    How soon will it be before we see politicians with extreme ideologies pushing bills that would criminalize such decisions by doctors? (My money is on “it’s right around the corner”.)

  • Pernille

    I absolutely disagree. I’m a GP, and I would never dream of not seeing a patient because he or she doesn’t follow my advice. My job is to help people, not moralize over their decisions, or punish them for not obeying me or the health authorities.

    Let’s look at the arguments one by one:

    1. Some people don’t vaccinate their children in spite of all the good information about the benefits of vaccinations. Well, people do a lot of stupid things: They smoke, they take drugs, they eat too much junk food and get fat, they get STDs … if I were to ban all the patients who do stupid things, I would be left with the ones that don’t need me at all.

    What’s even worse: The doctors who ban unvaccinated children are really punishing the innocent party. Is it their fault their parents don’t have them vaccinated? I think not.

    2. The parents should listen to the doctors, not all the «bad information». Yes, they should, but why don’t they? Because, as you say, «bad info is much easier to find. And it’s presented in a way that appeals to that person’s very basic instinct: shield their child from possible harm.»
    
In other words, you want to punish people for being mislead.

    3. There’s also an issue of trust, you say. Yes, trust is important in a patient/doctor relationship. But will parents trust doctors more if they punish them for not being «obedient»? I thought people in USA believed in freedom of speech, freedom of mind, and don’t want to be pushed around by authorities?

    Anyway, there are lots of ways people don’t «trust» their doctors. They don’t want to believe that they got COPD from smoking, and they don’t stop smoking even though I keep advising them to. Should I kick out all the smokers? What about diabetics who don’t exercise even though I keep telling them to? Girls who don’t take their birth control pills I give them, and then get pregnant and want abortions? I wonder, who should I NOT kick out?

    4. «Having an unvaccinated child in a doctor’s waiting room full of other children, some sick, is downright dangerous.» 
Yeah, scary. Actually, a doctors waiting room is a very dangerous place – there are lots of sick people there! They might have bronchitis, flu and diarrhea. Some of them don’t wash their hands after going to the toilet, so if you touch the door handle you’ll get diarrhea too. And think about all the newspapers and magazines laying around … if you touch them you’l get germs!

    
Seriously: If you’re so worried about your children catching something, you shouldn’t let them go to school or kindergarten, never take buses, and not let them play in public playgrounds.
    Or perhaps the unvaccinated children should be banned from schools too? 



    I’m sorry I’m getting so worked up about this, but I simply can’t understand these doctors. Perhaps it’s cultural: Here in Norway most hospitals are public, and most doctors are legally committed to serve whatever patients who need their help. We simply don’t turn patients away, unless they are stealing from the medicine cabinets, or attacking the nurses.

    In other words, in our country patients’ rights count more than doctors’ whims. And thank God for that. I certainly don’t want to treat only the nice and clean and obedient and well-behaved, who probably are the ones that need me the least.

    Regards from Norway
    Pernille Nylehn
    MD, GP

  • Vance

    “Or perhaps the unvaccinated children should be banned from schools too?”

    Some U.S. states don’t allow unvaccinated children to attend school; I live in one (Washington). However, I tend to agree with you insomuch as alienating people from medical providers seems, at best, a poor way to improve the public’s health.

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