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#1 of 15 Old 04-14-2014, 09:14 PM - Thread Starter
 
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I keep reading article after article advising doctors on how to "deal" with skeptical, "vaccine-hesitant," or other non-compliant parents. It seems like they're all looking for the Magic Bullet to win our compliance.

I'd like to turn the table and allow us to share what has worked best for *us* to deal with doctors. This could be really helpful for moms who are dreading well-baby visits. *All of this is assuming that as much as possible, you want to avoid serious confrontations. *

If you know for sure what you want to do regarding vaccines, or you are undecided and would like more time to think about it, how do you put yourself in the driver's seat and assert your needs and rights?

Whether you're dealing with a respectful doctor with good intentions who wants you to vaccinate fully-or a pushy one who resorts to threats and manipulation---what strategies have you personally found work best to work with these providers?

(NVers, if you want to contribute, I'll turn a blind eye. winky.gif)

I'll just start with one thing that's worked for me.

I tend to stay polite but use assertive language. "Well, for today let's go ahead and do Vaccines X and Y. I'll get back to you about A, B, and C." Or, "We've chosen to pass on that one. But I'm interested in knowing more about another one." A recent study taught them to use assertive language with YOU, ("OK, let's go ahead and get all of his vaccines done"), so be ready to respond with something equally assertive. thumb.gif

Anyway, what's worked for you?
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#2 of 15 Old 04-15-2014, 06:44 AM
 
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 Most doctors, as far as I know, whip out the needle at the end of the appointment.    This is a good thing - everything else will be done and you really only need to somehow refuse, collect your baby and get out of there.

 

While most new moms who intend to skip vaccines (in part or in all) will have a few uncomfortable conversation with the doctor, please do not get overly anxious.  Well baby visits are at 2, 4, 6 month and a year.  You  only have to make it through 4 visits in the first year!

 

I have found that vaccine talk does not typically happen at visits for illness - so it is just at well-baby check-ups.

 

I have always told them I am not sure I want to vaccinate.  We usually get into a discussion about it, I ask a question they cannot answer (typically on disease prevalence), and they send me home with advice to look at the Canadian Pediatrics Site.  

 

Everyone has to decide whether or not to be straight up with doctors early on, or if they want to stall their way out of it.  Both have their pros and cons.

 

If it were me I would probably stall at the 2 and 4 month appointment, then lay it on the line at the 6 month appointment. I would lay it on the line because I really do not want to sit through vaccine talks at every visit, and one thing I have consistently read is that doctors are to look at each visit as an "vaccination opportunity."    If the doctor reacts badly at the 6 month appointment, well at least you now have 6 months to find another doctor, and your baby has been seen by a hcp in the more crucial early months. 

 

Stalling tactics:

-DH is not sure, let me bring him the information you discussed and get back to you

-I am still in research mode - let's discuss this next visit

-not right now

 

More firm:

-At this point in time, we do not intend to vaccinate.  If we change our minds, we will let you know. 

If your partner is just as non-vax as you, you can bring him or her to that appointment. Sometime it is nice to have someone who understands in the room.

 

I will also add that in multi-doctor practices ask for who you want to see.  There are two dentists and a number of hygienists at my dentists office.  I straight up refuse to see one of the dentists and one of the hygienists.  They do not take "no" graciously for an answer on X-rays, and I have no patience for that.  


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#3 of 15 Old 04-15-2014, 12:40 PM
 
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Love this!  My best advice is to not be afraid to leave a practice you are uncomfortable with - it's really not the end of the world and can be a blessing in disguise to be "kicked out" too!

 

When first meeting the ped in my pregnancy she was warm and incredibly open to a delayed/select sched...just what I was looking for!  But once DD was born she was very different, very pushy.  DD's 2mo visit she had a med student with her and I was basically cornered, read a list of horrendous complications from each of the VAD's and told "these are the shots we're doing today".  I felt so unprepared for any of that and just whispered ok.  That was the first time she had reactions.  Now luckily I read up enough prior to recognize the subtleties and recorded them all and shared with the ped her reactions at the 4mo apt (and reported to VAERS myself).  Basically it was "yes ok those all sound like pretty bad reactions to her shots, let's go ahead and do her next ones now".  Now at the time she had just gotten over a cold and so I managed to spit out that I wouldn't be doing them that day and she scheduled me in for a "shot visit" at 5mos.  Went for that and managed to refuse Rota, but got the others.  By the 6mo visit I finally had enough of the bullying, I walked in and the second she brought up vaccines I declared we were done with them.  Didn't say much other than I wasn't at all comfortable with her reactions and that I was postponing indefinitely. 

 

From that point on it was a very rocky relationship, she was barely cordial, very short with questions, and basically made us wait only to rush us in for a 5 min glance and send us on our way.  I had to reschedule her 12 mo visit due to a work conflict and the ped herself called me that night to literally interrogate me as to why we cancelled.  I explained the work conflict and not having my calendar on me to reschedule at that instant but assured her I'd be calling in.  She made it clear right there that if I did not follow her visitation (not so much the vax but the actual appointments) schedule - to the minute - that she would drop us.  I think we were supposed to go at 15 and 18 mos and she left such a bad taste that I never called and didn't even think twice about it, because well, DD's a healthy kid!  Around her 2nd birthday was when we received the "comply or leave" letter which I just said the heck with it, requested all files be sent to me and washed my hands of them!  To say I felt relieved would be an understatement.

 

Best decision I ever made for us was to move to a Naturopath following her 2nd vaccine reactions and some subsequent food allergies/sensitivities.  The original ped always brushed off my nutritional concerns as nothing, stated my diet had no effect on my breastfeeding child and I finally stopped bringing it up because her lack of concern was so apparent.  The ND however has been incredibly supportive of all our decisions and I really needed that after so many visits being ignored and bullied.  I think it has built up my confidence significantly having someone like that and I feel like I can say no and not be pushed into a corner.

 

I think if they (docs) are going to take up an attitude of "they (patients) don't know they want to comply until we convince them" then we either have to feel comfortable to take a stance back, or just walk out and don't look back!  I hate face to face confrontation and I really don't think I should have to explain my decisions to them...therefore walking away was really the best bet!!

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#4 of 15 Old 04-15-2014, 01:46 PM
 
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1976, 38 years ago, Dr. Robert Mendelsohn was the first pediatrician in the US to advocate against routine childhood vaccinations. He told parents to be prepared to go outside the Medical Matrix and go to naturopaths, homeopaths, and chiropractors as their go-to family health practitioners. It is now 38 years later, and the ACA in my state does not include chiropractors, but it does include naturopaths, I think, so it is workable to find a doctor who will work with a parent with no vaccinating or a selective, delayed schedule. That and the internet connecting concerned parents and doctors who think alike or similarly.

 

What worked for me when my children were lo's, I found a highly recommended pediatrician, a DO by training, who made HOUSE CALLS in my area and worked with me with no vaccinations. I also brought my husband to some of the early visits.   Otherwise, I would have just used my Father or found a naturopath or homeopath.

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#5 of 15 Old 04-15-2014, 01:58 PM
 
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Get recommendations from people who share some of your health care values and concerns while you are pregnant or when looking for a new doctor. I know it seems very basic, but I know I have had made the mistake of just picking someone because of proximity in my life. 

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There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#6 of 15 Old 04-15-2014, 02:00 PM
 
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Originally Posted by Turquesa View Post

I keep reading article after article advising doctors on how to "deal" with skeptical, "vaccine-hesitant," or other non-compliant parents. It seems like they're all looking for the Magic Bullet to win our compliance.

I'd like to turn the table and allow us to share what has worked best for *us* to deal with doctors. This could be really helpful for moms who are dreading well-baby visits. *All of this is assuming that as much as possible, you want to avoid serious confrontations. *

If you know for sure what you want to do regarding vaccines, or you are undecided and would like more time to think about it, how do you put yourself in the driver's seat and assert your needs and rights?

Whether you're dealing with a respectful doctor with good intentions who wants you to vaccinate fully-or a pushy one who resorts to threats and manipulation---what strategies have you personally found work best to work with these providers?

(NVers, if you want to contribute, I'll turn a blind eye. winky.gif)

I'll just start with one thing that's worked for me.

I tend to stay polite but use assertive language. "Well, for today let's go ahead and do Vaccines X and Y. I'll get back to you about A, B, and C." Or, "We've chosen to pass on that one. But I'm interested in knowing more about another one." A recent study taught them to use assertive language with YOU, ("OK, let's go ahead and get all of his vaccines done"), so be ready to respond with something equally assertive. thumb.gif

Anyway, what's worked for you?

At my daughter's most recent visit (for 6th grade) when they called to confirm the appointment we informed the nurse as to which vaccines we would not be doing that day and she made a note on the chart. The doctor did bring it up at the appointment to which I replied that we weren't ready to consider those yet (meningitis and gardasil) but that when she neared high school/college we would revisit our decision as appropriate. Not another word was spoken on the topic.
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#7 of 15 Old 04-15-2014, 06:22 PM - Thread Starter
 
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I think if I didn't vaccinate at all, it would be a no-brainer to get all of my kids' health care through chiropractor or naturopath. A few non-vaxxing moms pop up and want a mainstream doc for regular visits and that's fine, too.

SassyFireChick, your posts got my brain wheels spinning. I like to flatter myself and think that I'm above all of those girlie people-pleasing tendencies. But I also think women in our culture have been so conditioned to this behavior that a lot of us have to fight it. When I was on the homebirth forum more regularly, we'd often see posts from somebody who wasn't sure how to leave an OB for a midwife. They were worried about how to explain it to the OB. But they shouldn't have to worry about explaining themselves or hurting someone's feelings. It's important to remember that a provider-patient relationship is a *business* relationship and not a personal one. It should certainly be based on courtesy and mutual respect, and it's OK to *like* your provider as a person. But when things aren't going well, you take your business elsewhere. It's as simple as that. Simple, but hard for all of us to accept at times.
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#8 of 15 Old 04-15-2014, 06:38 PM
 
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For me it's the anxiety of change!  I started up with the ND midway through all that and got on some supplements for likely MTHFR mutation and the anxiety was greatly reduced which made the leaving so much easier!!  So to some degree my anxiety is what made saying no to the pediatrician so hard....but seeing my LO in pain was enough to over-ride the anxiety thankfully.

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#9 of 15 Old 04-15-2014, 06:41 PM - Thread Starter
 
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On the same line of not owing explanations . . . . I frequently see posts in the vax forums from moms worried about how to explain their vaccine decisions to their providers. What studies should they bring in to show the doctor? What types of things might the doctor tell them, and how should they respond?

I disagree with this approach. It's important to understand that these doctors see it as their mission to convince YOU, so it's useless to come in trying to convince THEM. They study typical parental objections and memorize how to respond to them. Forgive my cynicism, but I've worked in sales, and it's just how sales works. They're trying to *sell* you on consenting to the vaccine schedule. (Unlike the drug manufacturers, docs don't make a lot of money on the actual vaccines). A debate would be a fruitless endeavor and create counter-productive tension.

So I don't explain reasons or engage in debate. I'll use a lot of Kathy's stall tactics. I will often ask for references or studies that they would recommend for me. Honestly, a 15-minute pediatric visit with a 2-minute vaccine discussion is inadequate for me to make decisions on such a complex topic, so I do welcome reading suggestions.

I will ask thought-provoking questions that they probably weren't warned about in their CME workshops and AAP newsletters. Sheepish.gif Seriously, though, I've found that asking questions lessens the tension and enables providers to let their guard down. It validates them because it reassures them that despite any disagreements, you respect their expertise.

I've had one encounter as an aggressive doctor, and I didn't handle it well. I wasn't mean, but I just felt flustered, humiliated, inwardly furious, etc. (Ah, the joys of first-time motherhood!) How this doctor thought that her tactics would convince me to vaccinate on schedule was beyond me.

As I've said it before, I believe that every exam room needs to be a safe haven. While in this space, NO patient should feel threatened, judged, condescended to, manipulated, or intimidated. You have a fundamental RIGHT to a safe space for health care and treatment. The best providers recognize this.
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#10 of 15 Old 04-15-2014, 06:42 PM - Thread Starter
 
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NM. That didn't make sense. I need to go to bed.

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#11 of 15 Old 04-15-2014, 06:45 PM
 
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I think if I didn't vaccinate at all, it would be a no-brainer to get all of my kids' health care through chiropractor or naturopath. A few non-vaxxing moms pop up and want a mainstream doc for regular visits and that's fine, too.
 

It's a $$ thing some of the time.

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There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

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#12 of 15 Old 04-17-2014, 06:08 AM
 
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Luckily my current doctor respects parental choice. She doesn't even carry combos when it's possible (aka no 5in1 or 4in1, only Dtap, ipv, mmr, chickenpox, hepb or hepa separately). She also agrees that there are too many boosters and supported us starting after 2 (when I said we are going for 3 dtaps she agreed that most people will get sufficient titers from it). No fighting over titers, she orders them when I ask. :D

 

Now, when I talked to the other doctors.... There are really only two kinds: the type A listen carefully little girl, we do what I say or I'll kick you out or the type that will listen, be respectful, respectfully disagrees but works with you. Since we were in the military, they can't kick out patients. Instead the guy I encountered once got choleric, rude outbursts - the strategy is to stay calm, not start lengthy discussion, stick with we have decided to do xyz - a good strategy is not to make decisions without your spouse/so to get them to back off. For all other types, see above strategies from other posters. ;)

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#13 of 15 Old 04-17-2014, 03:48 PM
 
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What worked for us is not what I'd recommend.

All our kids had severe reactions to vaccines.  The doctor wrote medical exemptions; he initially thought that vaccine reactions were "vanishingly rare" and only happened to starving kids living in filth in developing countries, but changed his mind after seeing several reactions.

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#14 of 15 Old 04-18-2014, 06:27 PM
 
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I agree with all of the above. I've found that there's two broad types as well…the respectful, willing to work with you one and then there's ER docs. :wink

 

With our kids' former peds and their current GP, none had an issue with delaying and they didn't argue or belittle or threaten. The peds were fine with delaying vaccines and by the time we'd moved overseas, they'd still not had one vaccine and the peds stopped asking about it. The current GP signed our CO form and when we approached him about selectively vaccinating in a way that would keep us off the registry and heavy-handed government radar, he was all for it (probably inwardly thrilled that we'd "seen the light" but he also knew not to push the issue, not to push for additional vaccines, nor combos that we didn't want).

 

ER docs…sigh…the best advice I can give is just to remain calm, don't argue, don't debate and just say, "I'll follow this up with my GP." IMO vaccines are not required on an emergency visit for a dislocated elbow or the like and bullying a parent during a visit for a completely unrelated issue is just uncalled for. I've had ER docs stomp off saying they were going to write to my GP to protest my kids' not being UTD (sure, knock yourself out, my GP never mentioned receiving a letter from a huffy ER physician), and the same ER doc told me, "Your kids will never be able to attend school anywhere in this state" and when I calmly replied, "Hmm. Interesting. They've been enrolled in three schools already," he stormed off. Ha, sometimes I'm not able to stop myself either, but I despise the out in out lying.

 

I get that in public health circles there's a push to get under vaccinated kids UTD and once they get them in an exam room, it's time to play catch up because the parents forgot to bring the kids in for all the boosters and last shots in their initial series. That's a different issue than a parent who says, "Hey, I am working with our GP and we have a game plan, so don't blow a gasket over it." I think anyone would be able to tell the difference between the aforementioned response and "Whaaaa? They were supposed to have a booster? I had no idea."

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#15 of 15 Old 04-18-2014, 10:13 PM - Thread Starter
 
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The problem with the ER are those NIGHTMARES I hear about how parents are treated when they bring in their babies with fevers. Unvaccinated = spinal tap, vaccinated = no. (Replacement serotypes? Non-vaccine-targeted meningitis strains? Never heard of them!) That's not to say that I wouldn't bring a baby in who had a fever, stiff neck, and creepy case of lethargy. But a couple in my old town once brought a baby in with a fever of 101. They refused a spinal due to its risks and, in the case of a low fever, limited benefits. The doctor called CPS, the baby was forcibly tapped and tested negative, and the couple lost in court. It's such a what-if scenario that I probably shouldn't worry about it. But I do wonder if some parents need to have an attorney on speed-dial for these situations.
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