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A pediatrician's different perspective on why he doesn't accept unvaccinated children

post #1 of 292
Thread Starter 

It's probably not why you think! 

 

Anyway, I thought it was an interesting read and a new perspective on this issue. 

 

For debate, do you agree or disagree with pediatricians that turn away parents that don't vaccinate? 

 

http://www.thedailybeast.com/articles/2014/01/30/the-real-reason-pediatricians-want-you-to-vaccinate-your-kids.html

 

"The physician-patient relationship, like so many other human relationships, requires an element of trust. I certainly neither want nor expect a return to the paternalistic “doctor knows best” mindset of bygone years, but I do need to know that patient’s parents respect my training and expertise. Refusing an intervention I desperately want all children to receive makes that respect untenably dubious.

 

If I can’t hope to persuade them by making reference to the available research, what can I expect to be for them other than a rubber stamp for their ideas? If medical science can’t answer the meritless qualms they have about vaccines, when can I use it at all?

 

Any potential partnership we might create in caring for them together would rely on their belief that I have something other than a signature on an order form or prescription pad to offer.

They must believe I have a perspective worth understanding." 


Edited by teacozy - 1/30/14 at 10:17pm
post #2 of 292

"Refusing an intervention I desperately want all children to receive"

 

This doctor doesn't seem to take into consideration an individual child's medical situation. He's saying he wants vaccines for all children.

 

When you wrote, "It's probably not why you think!" and "a new perspective on this issue," I was expecting to read something interesting that I hadn't read before, but I've read about this reason many times. :zzz 

 

In an area with many doctors to choose from, it doesn't matter if an individual doctor refuses to treat a patient. It's only a problem if there are not enough other choices based on location or insurance. It's a problem if a parent cannot find a doctor for their unvaccinated child, and has to go without necessary medical treatment, or must go to the emergency room for things better taken care of at a doctor's office.

 

If non/selective vaccinating parents have other choices, I'm sure they would prefer to not see that doctor either.

post #3 of 292
This seems to disqualify parents research or knowledge or personal reasons ect ect by calling it merit less. For example many parents aren't worried about autism. If they would address those other issues and demand further neutral research for the other concerns parents may have more peace of mind. But that isn't happening so far. Just my view.
post #4 of 292
I think a doctor's role is that of an advisor. S/he offers an opinion (hopefully an expert, evidence-based one) and the patient decides whether to proceed or not.

I find the whole notion of being "fired" by ones doctor absurd. It simply doesn't happen where I live. People refuse all sorts of treatments/tests all the time - chemotherapy, x-rays, antibiotics, anti hypertensives. Informed consent does not exist if you don't have the right to refuse without the risk of prejudice.

I work in ED. If a patient refuses our proposed treatment then we are required to inform him/her of the potential risks of doing so and offer an alternative if one exists. We are also absolutely *not* allowed to withhold other treatment or care for the person any differently. For example, if someone comes in with a laceration which needs suturing and they refuse we still have to offer pain relief, cleaning and dressing of the wound, tetanus injection if indicated and appropriate follow-up. We would be in serious trouble if we just sent that person away.

Now, I guess one can argue that we are a public hospital and the rules are different for private practitioners but it is certainly not the norm here.

And I totally reject the argument that "if they don't trust me on this, they won't trust me on anything". Bollocks! That sounds like nothing but the whining of a fragile ego to me. Anyone with the slightest modicum of depth to their personality can disagree with another person on one matter and wholeheartedly agree with them on others. In fact, most of us do with all of our friends, relatives, spouses etc.

Good grief! He'll need to do a lot better than that.
post #5 of 292
Quote:
Originally Posted by teacozy View Post
 

 

 

"The physician-patient relationship, like so many other human relationships, requires an element of trust. I certainly neither want nor expect a return to the paternalistic “doctor knows best” mindset of bygone years, but I do need to know that patient’s parents respect my training and expertise. Refusing an intervention I desperately want all children to receive makes that respect untenably dubious."

 

He says he does not want a return to "doctor knows best" yet kicks people out of his practice for not following his advice.  He contradicts himself.

 

I have zero respect for doctors who kick children out of a general or pediatric practice, possibly leaving them with no physician, due to parental non-compliance on one issue.  What a ego trip!

post #6 of 292

I would add that it is against AAP advice to terminate a patient/doctor relationship due to reluctance to vaccinate:

 

"In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice. Although pediatricians have the option of terminating the physician-patient relationship, they cannot do so without giving sufficient advance notice to the patient or custodial parent or legal guardian to permit another health care professional to be secured.27 Such decisions should be unusual and generally made only after attempts have been made to work with the family. Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care."

 

http://pediatrics.aappublications.org/content/115/5/1428.full

 

Canada likewise:

http://www.cps.ca/documents/position/working-with-vaccine-hesitant-parents

(point 5)

post #7 of 292
Thread Starter 
Quote:
Originally Posted by kathymuggle View Post
 

I would add that it is against AAP advice to terminate a patient/doctor relationship due to reluctance to vaccinate:

 

"In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice. Although pediatricians have the option of terminating the physician-patient relationship, they cannot do so without giving sufficient advance notice to the patient or custodial parent or legal guardian to permit another health care professional to be secured.27 Such decisions should be unusual and generally made only after attempts have been made to work with the family. Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care."

 

http://pediatrics.aappublications.org/content/115/5/1428.full

 

Canada likewise:

http://www.cps.ca/documents/position/working-with-vaccine-hesitant-parents

(point 5)

 

Not accepting a patient in the first place isn't the same thing as terminating or "firing" one.  

 

I think his reasons make sense. He doesn't feel like there can be that mutual trust that he really does have your children's best interest at heart and that he really does know what he's talking about.  He doesn't feel like he can adequately do his job.  Like he said, he has had lots of experience with non vaccinating parents throughout his career and that has been his experience.   He knows it's not a good fit for him.  

 

My pediatrician's office has the same policy.  They ask upfront before you join if you plan to vaccinate on schedule.  If not, they politely ask that you look for a different doctor.  

 

This may not be as big of a problem in other countries as it is in the US, but a parent of a newborn who caught measles in the pediatrician's waiting room from an unvaccinated patient would probably have a pretty strong case in a lawsuit.   The US is a very sue-happy country, and it's a risk a lot of doctors are just not willing to take.  That makes sense too. 

post #8 of 292
Quote:
Originally Posted by teacozy View Post
 

 

My pediatrician's office has the same policy.  They ask upfront before you join if you plan to vaccinate on schedule.  If not, they politely ask that you look for a different doctor.  

 

 

Aside from the suing aspect, if they are not equally leery of parents who smoke or do not intend to breastfeed (certainly larger predictors of poor health than vaccine status), then it is straight discrimination.  

post #9 of 292
Quote:
Originally Posted by teacozy View Post
 

 

 

This may not be as big of a problem in other countries as it is in the US, but a parent of a newborn who caught measles in the pediatrician's waiting room from an unvaccinated patient would probably have a pretty strong case in a lawsuit.   

 

Yet the parent of a child who dies of a severe reaction to a vaccine--even if the parent has evidence that he asked to delay that vaccine--has no legal recourse except to go to "Vaccine Court," where the Department of Health and Human Services does everything they can to prove that the child would have died anyway.

We know this because even those who have won their cases in "Vaccine Court" have reported that it was a horrible, horrible experience where they were made to feel like criminals; they universally report that the system is rigged against them, EVEN WHEN THEY WIN.

post #10 of 292

Oh, >yawn<, nothing new here!

 

Vaccines are an invasive medical procedure with unknown consequences. Legally, vaccines have been considered "UNAVOIDABLY UNSAFE" since 1986, yet in a contradiction, mandated for educational access in this country.


Edited by applejuice - 1/31/14 at 3:30pm
post #11 of 292
Quote:
Originally Posted by teacozy View Post
 

 

Not accepting a patient in the first place isn't the same thing as terminating or "firing" one.  

 

I think his reasons make sense. He doesn't feel like there can be that mutual trust that he really does have your children's best interest at heart and that he really does know what he's talking about.  He doesn't feel like he can adequately do his job.  Like he said, he has had lots of experience with non vaccinating parents throughout his career and that has been his experience.   He knows it's not a good fit for him.  

 

My pediatrician's office has the same policy.  They ask upfront before you join if you plan to vaccinate on schedule.  If not, they politely ask that you look for a different doctor.  

 

This may not be as big of a problem in other countries as it is in the US, but a parent of a newborn who caught measles in the pediatrician's waiting room from an unvaccinated patient would probably have a pretty strong case in a lawsuit.   The US is a very sue-happy country, and it's a risk a lot of doctors are just not willing to take.  That makes sense too. 

good thing you are in agreement for now, chances are you won't always be, as in other relationships most don't work in the long term 

 

while vaccines are really easy to bully on new fearful parents, there really is far more to consider when an office tells you their policies  - it many not just be vaccines- most new parents don't know what the future really will hold

 

down the road your child's BMI may be a concern you don't see eye to eye on, and we do know in some states they are hoping Dr's take a strong stand with parents (and some are also removing the children when the Dr.s and the state feel the parents aren't following the Dr's orders)

 

want your child to play a certain sport? well the Dr many no longer treat patients who choose certain sports such as football and refuse to do physicals for them - I can certainly see the AAP and other groups pushing for not allowing patients who's parent's don't tow their line 

 

we already see issues with older children that a new parent of a 21month old may not realize - we see threads on here all the time over retraction, antibiotics (no matter what the AAP and other's say there are still tons of Peds that push antibiotics), ADD & ADHA meds, you many not agree and suddenly you are looking for a new Dr - it goes both ways doesn't it? Cancer care - well we certainly see this playing out in the news all over Dr's & parents not on the same page, end of life care, that thirteen year old tonsils patients - lots to consider when they tell you if they will take you or not

 

usually when you are told up front what they will tolerate from you, there usually is more that slowly comes out- good luck with things, unlike vaccines effectiveness rates you do, you simply have only a 50-50 chance in most relationships :wink and I hear when you leave and look for another Dr. they write all kinds of things about the parents in the children's charts-might want to keep that in mind

post #12 of 292
Quote:
 ... when you leave and look for another Dr. they write all kinds of things about the parents in the children's charts-might want to keep that in mind

OT, but btw, schools do and will often do this also in your child's permanent record.
You are entitled to a copy of your child's permanent record at any time; do not let a school office clerk/administrator tell you that you never get your child's record. You are entitled to it!

 

Editted to add that the author of the NVICA is retiring http://www.ageofautism.com/2008/10/congressman-hen.html

He has represented that district for 40 yrs, 20 terms. There is a very high number of his young constituents who refuse vaccines for their children or who selectively vaccinate. There are three pediatricians that I know of that refuse to administer vaccines to their patients in his district.  


Edited by applejuice - 1/31/14 at 11:11pm
post #13 of 292
How is this anything new? Of course it's exactly what I expected it to be. Just more fear mongering. "If I don't go along with them my child will have no one when they get sick. And they WILL get sick. Very, very sick."

I am so glad that I live in an area where there are lots of unvaxxed kids and selective/delayed vaxxed kids. Docs who would refuse service to a child because of their vax status would not do well in this town.

Our family doc is a naturopath so he doesn't even go there. We also have a nurse practitioner who comes to our home if needed. She is pro-vax but respects our views. LOVE her.

I could careless about a doc who refuses to honor our family's choices. Before he could fire me I would drop him/her like a hot potato. That is a big red flag as far as I am concerned.
post #14 of 292
Wow, the idea that because I don't vaccinate I won't respect my pediatrician's experience and trust her judgment about other things is absurd! Vaccines come up in well visits. We do occasional well visits on our own schedule to check in, keep up our relationship, and make sure there are no problems I may have missed. When I bring my kids in for other visits, its because I suspect (or know) something is wrong and think some kind of medical intervention may be necessary. So, because I trust and respect my pediatrician's opinion, I make an appt wink1.gif and more often than not, I follow the advice. I really doubt I'm some anomaly.
post #15 of 292
I see where this doctor is coming from. The consensus medical and scientific evidence for vaccines (ie saying their benefits outweigh their unavoidable risks) is so strong it is hard for people to understand the choice not to vaccinate.

And so it does look at first glance that if someone rejects advice to vaccinate they will reject all modern medical advice. I think I'm seeing comments above that this is not the case, but I can understand where the doctor would get the idea - can you?
post #16 of 292
He sounds like an idiot. "Meritless qualms." That's rich. Even the people who downplay vaccine risks admit they exist.
post #17 of 292
Vaccine risks occur. It's also risky to cross roads. But people would not think it reasonable (might even say "meritless qualms") if in response to the risk of crossing roads someone decided they would never do it - or stay in their house forever.

Crossing roads carries a small risk, and is unavoidably unsafe.
post #18 of 292
Quote:
Originally Posted by prosciencemum View Post

I see where this doctor is coming from. The consensus medical and scientific evidence for vaccines (ie saying their benefits outweigh their unavoidable risks) is so strong it is hard for people to understand the choice not to vaccinate.

And so it does look at first glance that if someone rejects advice to vaccinate they will reject all modern medical advice. I think I'm seeing comments above that this is not the case, but I can understand where the doctor would get the idea - can you? NO I can't.

But you really don't know what this is like do you? You can't be thrown out can you?SInce being in the UK with universal health care your Dr's can't do this and we do know there are many in the UK that are not vaccinating or selecting/delaying and can still seek care - they also can do so legally.

 

It's an insane statement to compare vaccines to a patient rejecting ALL modern medical advise!

 

Many places in Europe also offer assisted suicide, again something we are not offered here - one could just as easily say that if a person rejects all medical intervention at the end of like they are too rejecting ALL modern medical advise, but different places treat people differently and respect their decisions. We are seeing more and more here with parents dealing with their terminal cancer patient children, I would not think to say to a parent that does not want to see their child suffer, that they are rejecting ALL modern medical advise by doing so.

 

 

 

 Understating that a parent has legal right to object to vaccines here you can certainly see that saying if one does so they are NOT objecting to ALL modern medical advise - can't you?


Edited by serenbat - 2/1/14 at 5:44am
post #19 of 292
Quote:
Originally Posted by prosciencemum View Post

I see where this doctor is coming from. The consensus medical and scientific evidence for vaccines (ie saying their benefits outweigh their unavoidable risks) is so strong it is hard for people to understand the choice not to vaccinate.

And so it does look at first glance that if someone rejects advice to vaccinate they will reject all modern medical advice. I think I'm seeing comments above that this is not the case, but I can understand where the doctor would get the idea - can you?




You THINK you're seeing comments above that this is not the case?

What, you're not sure? Maybe you should go back and actually read them.

Believing that parents who refuse vaccines also refuse all medical procedures means that they would also refuse emergency procedures, like setting broken bones, treating stroke, heart attack, asthma, bacterial infections, allergies, dental procedures, etc.

How many parents do you know who fall into this category? I've never met a single one, and I'm quite active in the Vaccine Critic Community.

Even VoicesForVaccine writer Amy Parker's mythical super-crunchy parents gave her frequent antibiotics.

I do see where the doctor could have gotten his insane idea: from thoughtless, aggressive pro-vaxxers who completely misrepresent the position of vaccine critics.
post #20 of 292
Quote:
Originally Posted by prosciencemum View Post

I see where this doctor is coming from. The consensus medical and scientific evidence for vaccines (ie saying their benefits outweigh their unavoidable risks) is so strong it is hard for people to understand the choice not to vaccinate.

And so it does look at first glance that if someone rejects advice to vaccinate they will reject all modern medical advice. I think I'm seeing comments above that this is not the case, but I can understand where the doctor would get the idea - can you?

 

 

A doctor should not potentially leave a child without medical care because they are frustrated with the parents.

 

Liikewise, it flies in the face of informed consent to not be able to refuse a procedure without fairly dire consequences.

 

I get frustration (sure - why not?  I am frustrated with by pro-compliance vaccine arguments) but doctors are professionals.  They need to act accordingly.  

 

In any event, no, I do not really get why a doctor would think someone would reject all modern medical advice because they reject vaccines.  Would we assume someone who will not breastfeed or someone who will not quit smoking rejects all medical advice?  Of course not.  

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