Thursday, November 17, 2011

Fired For Refusing Immunizations

I have fired patients before in my career.  The main reasons are:

  1. Abusive to the doctor or the staff
  2. Narc seeking or selling
This article in the USA Today talks about how more and more pediatricians are firing patients (parent and kids) who refuse to get their kids vaccinated.  As brutal as this may seem, there is now MORE than enough evidence showing that there isn't any link between vaccines and autism.   Pediatricians, as this article states, are just fatiguing on this issue and are willing to let families find healthcare in other places if mom or dad disagree on this issue.  I believe these docs have a valid point but firing them seems kind of harsh.   Maybe pediatricians just don't have enough patients who are:
  1. Abusive to the doctor or the staff
  2. Narc seeking or selling
If they did they may get a better perspective on who they should keep or not. 




8 comments:

Schultzy said...

I think firing these patients is the only real option. These parents are not only a pain in the ass to deal with, but represent a significant health risk to the rest of the pediatric population. If these people want to gamble with fate and immunology, well they are idiots playing with fire. I wouldn't want other patients or the clinic getting burned.

Pat said...

How about the parents of kids infected in the clinic decide to sue? How about the parents of the non-vaccinated crying "but the doctor didn't stress the urgency of getting immunized!!"? How about the bedraggled pediatrician trying to protect their other patients, and themselves? Its up to the clinicians do work within their own comfort zones.

Pat said...

How about the parents of kids infected in the clinic decide to sue? How about the parents of the non-vaccinated crying "but the doctor didn't stress the urgency of getting immunized!!"? How about the bedraggled pediatrician trying to protect their other patients, and themselves? Its up to the clinicians do work within their own comfort zones.

Christopher said...

Doug-

As a pediatrician, I do see kids whose parents refuse to vaccinate or won't follow the ACIP schedule, but I know other pediatricians who will ask you to leave their practice if you don't follow the schedule. The reason they give is always fear being sued if that child should contract a vaccine-preventable disease. I always have parents sign a very strongly worded waiver if they deviate from the ACIP schedule, but I don't feel it is worth living my life afraid of being sued over every little thing--but given we live in the most litigious society ever, I understand their fear of being sued.

Also, one of the main reasons so many parents won't vaccinate is because Dr. Robert Sears (son of the Dr. William Sears) put out a book on vaccines telling parents it is ok to delay or even skip vaccinating. Sadly, groups like the AAP and CDC continue to refuse, even after 5 years and now a 2nd edition of this "book" to openly condemn his very-well-selling book of lies that has misguided so many parents (yet they are all sitting around scratching their academic noggins trying to understand why vaccination rates have dropped so precipitously these last few years)

Sadly I think it is going to take some really big vaccine preventable disease outbreaks and their associated morbidity and mortality before parents realize the benefits of vaccines far, far, far outweight their risks.

Chris Hickie, MD, PhD

Sir Lance-a-lot said...

Sorry, but as we all know too well, you can't treat stupidity.

I believe that it is entirely ethical to fire non-vaccinating parents.
I also believe it is fine to fire patients who are fat or smoke cigarettes, if they are not making progress toward losing weight or quitting.

You will never "educate" these people, as they are incapable of learning, so why not just cut them loose and make everybody else's day a little bit brighter?

dhaugen said...

I am alarmed at the depth of anger and disdain shown here in response to the issue of parents choosing to not vaccinate their children. Physicians cannot prevent patients from making what they as practitioners may consider a poor choice, whether it's getting a gall bladder removed before pancreatitis sets in, allowing a diabetic foot to get gangrenous, or refusing to vaccinate a child. If physicians tossed out all their non-compliant patients, their practices would be greatly diminished. Get parents who refuse shots to sign a very strong informed consent statement, as suggest by Dr. Hickie.

So why does the issue of questioning vaccinations raise such hackles here? Research is skewable any way you look at it. Who is sponsoring the research. Who is paying for it. How are the subjects chosen. More importantly, what were the criteria for removing subjects from the study (outliers that might cause problems?). How big is the pool of subjects (15 or 1500?). I have seen many many research studies promoted by pretigious medical bodies that would not stand up to close scrutiny.

The public has been burned by the old saw that seven out or ten women will die of breast cancer, a statistic prominently promoted by the Cancer Society in the 80s and 90s. In fact, I still see that statement come up now and then. Most of your readers probably already know that the rest of the sentence is "if women live to be 109 years old." The Cancer Society, to my knowledge, admitted they didn't mention the rest of the story because they wanted to frighten women into getting mammograms.

If I had children who needed immunizations today, I would be very wary, not so much of the shots themselves, but rather at the huge number of shots given children today. To my knowledge, no one is actually looking at the interaction of all these shots. Taking numbers out of context is a serious problem (like leaving off the 109 years).

I've seen research which admits some children seem to be more prone to the risk of autism with shots, perhaps genetically so. I've also seen research that says the few cases of autism which might be caused by the immunizations is worth it to protect the majority of the children. I'd much prefer to see some effort to identify and protect children who might be at risk for autism rather than a frenzy to vaccinate all children regardless of the risks to a few of them.

The risk of an epidemic -- fear mongering, if you will -- in no comfort to those families who have to deal with raising an autistic child day after day.

What ever happened to "first, do no harm"? Until physicians can respect their patients, even when their patients disagree with them, physicians will be basing their practice on an adversarial relationship which in the long run is going to deal the quality of health care a far bigger blow than government regulation.

Gary from Kansas City said...

I would support the pediatricians who fire such patients, due to the actions of their parents.

Last time I checked, a pediatrician's office is either a private business, or a branch location of a business. It is not a utility that functions as a local monopoly, such as the water company or the power company.

Businesses that are enlightened understand that the customer is NOT always right, and there are some persons that are more trouble than they are worth for whatever reason, and once that trait is identified, the rational business owner will try their best to convince that customer to take their business elsewhere.

Sprint did this within the past 5 yr. They terminated the contracts of persons who were extreme outliers for using "free" customer support.

The point is that if a pediatrician wishes to fire a parent who wishes not to comply with reasonable vaccine recommendations, they are well within their rights!

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