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Medicine

Doctors "Fire" Vaccine Refusers 1271

phantomfive writes "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. Pediatricians are getting tired of families avoiding vaccines, which puts their children at higher risk of disease. From the article: 'Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are "firing" such families from their practices, raising questions about a doctor's responsibility to these patients. Medical associations don't recommend such patient bans, but the practice appears to be growing, according to vaccine researchers.'"
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Doctors "Fire" Vaccine Refusers

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  • Seems reasonable.. (Score:5, Insightful)

    by GreyLurk ( 35139 ) on Wednesday February 15, 2012 @02:51PM (#39048795) Homepage Journal
    Don't like my medical advice? Fine, go somewhere else. Seems perfectly reasonable and rational. If I were these doctors, I wouldn't want to feel responsible for the health of a child whose parents were demonstrably not interested in keeping their child healthy.
    • by OhSoLaMeow ( 2536022 ) on Wednesday February 15, 2012 @02:57PM (#39048915)
      No Shirt, No Shoes, No Vaccine: No Service. Go waste some other doctor's time. It's hard enough for doctors to make a living with Medicare cutbacks, insurance cuts, etc.
    • by fuzzyfuzzyfungus ( 1223518 ) on Wednesday February 15, 2012 @02:59PM (#39048953) Journal
      It arguably goes further than that: Depending on the nature of your practice, you might have patients who are dependent on herd immunity(immunocompromized, vaccine component allergy, etc, etc.) Would a doctor be responsible in keeping people who are voluntary infection risks around the rest of their patients?

      If it were merely a matter of not taking good advice, I'd be a trifle ambivalent, certainly legal; but seems a bit tasteless. However, the infection risk makes it more like firing a medical assistant who won't wash their hands: it isn't just their health they are risking...
      • by DarKnyht ( 671407 ) on Wednesday February 15, 2012 @03:10PM (#39049185)

        I find it ironic that one of the groups that are dependent on herd immunity (Vaccine Component Allergy) is one of the ones that said doctor will kick out of his practice. My son is highly allergic to eggs, which is in many vaccines. We were informed by our doctor that if we did not allow him to inject our son with something that he is highly allergic to we would no longer be allowed to be a part of his practice.

        It isn't that we don't want our son to be immunized, it is just we would rather not give him something that results in violent reactions. Especially at the young age that he is.

        • by MightyMartian ( 840721 ) on Wednesday February 15, 2012 @03:17PM (#39049351) Journal

          I doubt the doctors in question would throw you out, if the allergy is legitimate. You are not the kind of people being referred to, it's the completely retarded anti-vaccers who are the target of this. It is they who are putting your child at risk. Have a complaint, take it up with the evil fucking monster Andrew Wakefield.

        • by jandrese ( 485 ) <kensama@vt.edu> on Wednesday February 15, 2012 @03:18PM (#39049383) Homepage Journal
          If your doctor wasn't willing to make an exception for the child that is allergic to the vaccine, then you're better off with a new doctor anyway.
        • by kidgenius ( 704962 ) on Wednesday February 15, 2012 @03:18PM (#39049387)
          Your case is a little different. You have a valid, medical reason for not being able to have your son get all his vaccines. The autism-vaccine link has been shown to be non-existent. Thus, that is not a valid, medical reason for refusing vaccinations. A doctor should only be able to "fire" patients that don't have a medical reason.
        • by rrohbeck ( 944847 ) on Wednesday February 15, 2012 @03:26PM (#39049571)

          Are you saying the doctor would risk an anaphylactic shock after you told him your son is allergic to eggs? Bullshit.
          He'll either select a vaccine that's made without eggs or one that is known not to cause an allergic reaction in egg protein sensitive patients.
          Again, bullshit. Just like all the other antivaxxers.

          • by StikyPad ( 445176 ) on Wednesday February 15, 2012 @04:11PM (#39050649) Homepage

            Are you saying the doctor would risk an anaphylactic shock after you told him your son is allergic to eggs?

            Sure. Everything has a risk -- death is a potential risk of almost any medical treatment -- but the risks are usually far outweighed by the significant potential benefits. You risk death during almost any surgery, but the risk is so small in healthy individuals that it shouldn't be a deciding factor.

            Also, some vaccines, like the flu vaccine, are only made with eggs. Fortunately, the amount of egg protein present in the vaccine is so small that reactions are very rare. Typically it means waiting around for 30-60 minutes after vaccination to look for signs of a reaction, which can then be treated before it escalates. The odds of having a reaction that's unresponsive to treatment are so staggeringly small that no one should use it as a deciding factor (with the disclaimer that this is not medical advice).

        • by Anonymous Coward on Wednesday February 15, 2012 @03:29PM (#39049651)

          I find it ironic that one of the groups that are dependent on herd immunity (Vaccine Component Allergy) is one of the ones that said doctor will kick out of his practice. My son is highly allergic to eggs, which is in many vaccines. We were informed by our doctor that if we did not allow him to inject our son with something that he is highly allergic to we would no longer be allowed to be a part of his practice.

          It isn't that we don't want our son to be immunized, it is just we would rather not give him something that results in violent reactions. Especially at the young age that he is.

          Our son is as well. The allergist gives him his shots under a controlled and measured process.

        • by spiffmastercow ( 1001386 ) on Wednesday February 15, 2012 @04:25PM (#39050885)
          How old is your son? My son is also highly allergic to eggs (we have to carry the epi pen everwhere we go), and he's had all his age-scheduled shots so far with no problem, and he's almost 2. Which ones does your son need that don't have a non-egg version?
    • by x1r8a3k ( 1170111 ) on Wednesday February 15, 2012 @03:02PM (#39049015)
      Generally I would agree, but it depends on where is the line drawn? I have never gotten a flu shot. Is that enough to turn me away?

      The other concerning part is only in TFA though about a child who had a preexisting condition that was exacerbated by vaccines, and was still refused by several doctors without even discussing the issue.
      • by Dahamma ( 304068 ) on Wednesday February 15, 2012 @03:23PM (#39049507)

        No, of course not. Any doctor will tell you that flu shots are only moderately effective anyway, and of course have to be given every year based on guesses as to the season's strains. The slippery slope argument is the sort of FUD that is feeding the anti-vaccine kooks...

        These are pediatricians, so they are more worried about things like MMR, DTaP, meningiococcus, etc. Vaccines that don't just reduce the chance of a moderately annoying winter bug, but have unquestionably saved the lives of millions of children worldwide since their invention.

        And from TFA: "Her older child had gastrointestinal trouble and regressed development after receiving vaccines, she said, which she believes were related to the shots." This is the same "proof" by anecdote people wrongly use in the autism argument. Sure, one doctor signed a waiver, but same thing with painkiller addiction, it only takes one doctor willing to sign a prescription, they just have to look hard enough (or be a celebrity and no one will ask)...

        • by devilspgd ( 652955 ) on Wednesday February 15, 2012 @03:51PM (#39050197) Homepage

          The biggest joke of it all is this: Even of vaccines do cause the things people guess that they might, you're still better off getting vaccinated.

          With Autism rates up around the 5.5 in 1,000 range (that's under half a percentage), even if every single autism case is caused by vaccines, you're still better off getting vaccinated and taking a tiny chance of autism over order-of-magnitude greater odds of dying in an epidemic when once hits your area thanks to the loss of herd immunity that generally keeps us protected.

          This ignores the fact that autism rates for those who are vs are not vaccinated seem to work out to be the same, and that no study has actually managed to link vaccines with autism.

  • serves 'em right (Score:4, Insightful)

    by ak_hepcat ( 468765 ) <(moc.tacpehka) (ta) (todhsals)> on Wednesday February 15, 2012 @02:51PM (#39048805) Homepage Journal

    If some anti-vax moron doesn't want to use the help provided by the doctor, then the doctor doesn't need to keep them cluttering up his clinic.

    That's his right.

    It's also the right of the anti-vax moron to die faster, so hopefully they'll be weeded out in short order and we can get back to living better with medicine.

    No. Really. You anti-vax'rs are morons. Self-indulgent, blinded, murderous morons.

    • by scubamage ( 727538 ) on Wednesday February 15, 2012 @02:55PM (#39048869)
      The problem is that vaccines rely on herd immunity. One idiot can bring down a large portion of our house of cards because our immunities against these diseases simply aren't that strong.
      • Re:serves 'em right (Score:5, Interesting)

        by raburton ( 1281780 ) on Wednesday February 15, 2012 @03:10PM (#39049177) Homepage

        > The problem is that vaccines rely on herd immunity.

        Yes, this is an important point that not much has been made of in the comments so far. There are people who cannot be vaccinated or in whom the vaccine will not produce the desired immunity. So long as these people don't come in to contact with the disease they'll be fine, but if you don't want to get your child immunised and send them to school with some poor kid with a crappy immune system or on chemo or something then you might end up killing them too.

        Are there schools that ban unvaccinated children from attending? I think that'd be a more effective way than kicking them out off the doctors list.

  • by Anrego ( 830717 ) * on Wednesday February 15, 2012 @02:55PM (#39048875)

    I'm always torn on this kind of stuff.

    On one hand, I think parents should be able to chose what is best for their children. Doctors and the medical community have been wrong before, and while I doubt that is the case here, I don't think parents should be forced to submit to whatever the doctor says.

    On the other hand, parents are making decisions which are very likely not in their childs best interest, which isn't fair to the kid (and arguably, not fair to other kids/people/society in general in this case).

    I'm not a parent or a doctor, so at least my opinion on this is largely irrelevant.

    • by UnknowingFool ( 672806 ) on Wednesday February 15, 2012 @03:12PM (#39049221)
      A doctor's responsibility is to all of their patients. Parents who are not vaccinating their children are not just risking their children. These children may be brought into close proximity to patients that cannot be vaccinated (very young) or whose immunity has worn off (the very old). As such it puts more than themselves at risk.
  • by mehrotra.akash ( 1539473 ) on Wednesday February 15, 2012 @02:56PM (#39048889)
    Its not different than a tech support company refusing data protection to customers not using anti virus
  • Good! (Score:5, Interesting)

    by deweyhewson ( 1323623 ) on Wednesday February 15, 2012 @02:56PM (#39048897)

    Doctors aren't always right (like anybody in any profession), but this isn't about the doctors themselves. It's about the science.

    And the scientific evidence has shown time and time again that there is no link between vaccinations and autism, and that the benefits of eradicating these types of diseases far outweigh the potential mild side effects of taking them.

    As such, I have no problem with the idea of doctors who practice said science turning away patients who want to be in denial about it.

  • by Anonymous Coward on Wednesday February 15, 2012 @02:58PM (#39048937)

    I think vaccine deniers are dangerous fools, and I wish I were religious if only for the comfort of believing in a Hell waiting to accept "Dr." Wakefield.
    But before we jump on this particular bandwagon, perhaps we ought to ask:

    Can a doctor "fire" a patient for continuing to smoke?
    For continuing to drink? How are we defining "drink?"
    For continuing to overeat?
    For continuing to eat lots of red meat? Fried food? Salt?
    For not being on the caveman diet?

  • by JoeZeppy ( 715167 ) on Wednesday February 15, 2012 @03:00PM (#39048983)
    If pharmacists are allowed to refuse to dispense birth control based on their convictions, and churches can refuse to cover it due to their convictions, doctors should be allowed to refuse to treat idiots based on their convictions. Welcome to the free market, bitches.
    • by yodleboy ( 982200 ) on Wednesday February 15, 2012 @03:28PM (#39049631)
      Well, this isn't exactly the same as a Catholic pharmacist refusing to fill birth control scrips because the man in the sky said sex is bad. The doctors are making this decision based on solid scientific evidence, not some blind faith in something that can't be proven. Vaccines save lives. Un-vaccinated people are a risk to those with compromised/under developed immune systems. Those are facts and parents that refuse to accept them are welcome to find a free love, herbal pediatrician that will make them feel good while taking their money.

      I love it when these parents say "well my kid has no vaccines and has never gotten ". Yeah no shit Sherlock, it's because the rest of us are not spreading it around thanks to our vaccines. The day there's a new strain that flies around killing the un-vaccinated they'll say "Why didn't someone do something or warn us?!?"
  • by julienr ( 784549 ) on Wednesday February 15, 2012 @03:04PM (#39049045)

    Maybe it's the difference between the US and Europe, but here in Europe, not all doctors recommend all available vaccines. I wouldn't trust my doctor if he would recommend that I (or my children) get a vaccine against flue for example.

    I try to avoid drugs as much as possible because I think most non-severe illness (headache, flue, etc...) can just be cured by getting some rest and trusting your body. From my experience, the people I know that take the most drugs are the ones that are the most ill (and I'm talking non-server illness here, of course I'd take drugs if I had a cancer). I don't now if there is a causality, but I would tend to think so.

    So yeah, I have kind of the same approach to vaccination : I take vaccine for sever illness, but I would never vaccine against flue before I'm 90 years old.

    Now, I've lived in the US for some time and I've been shocked by the amount of drugs people take everytime they feel somewhat bad. I think there is a middleground between the "listen to your body, it will cure cancer by itself" bullshit and the "omg, I have a headache, let's eat these 3 pills". Same for vaccine.

    • by kidgenius ( 704962 ) on Wednesday February 15, 2012 @03:29PM (#39049665)

      non-severe illness (headache, flue, etc...)

      The 50-100 million people that died from the Spanish Flu may have a slight issue with your definition of "serious".

    • by Suddenly_Dead ( 656421 ) on Wednesday February 15, 2012 @04:03PM (#39050499)

      Maybe it's the difference between the US and Europe, but here in Europe, not all doctors recommend all available vaccines. I wouldn't trust my doctor if he would recommend that I (or my children) get a vaccine against flue for example.

      If your doctor recommended a flu shot, he/she thinks you're in an at-risk group. Influenza is not a harmless infection, it kills 250,000 to 500,000 people in a typical (non-pandemic) year.

      Now, I've lived in the US for some time and I've been shocked by the amount of drugs people take everytime they feel somewhat bad. I think there is a middleground between the "listen to your body, it will cure cancer by itself" bullshit and the "omg, I have a headache, let's eat these 3 pills". Same for vaccine.

      A flu vaccine isn't like antibiotics or painkillers or anti-depressants or other drugs that may be harmful is needlessly prescribed. A vaccine introduces your immune system to a foreign element, which it then remembers so, if introduced to it again (in a live virus), it will be able to attack it more immediately. Getting a flu vaccine needlessly isn't going to weaken you or cause you to be more likely to be sick.

    • by StikyPad ( 445176 ) on Wednesday February 15, 2012 @04:23PM (#39050855) Homepage

      From my experience, the people I know that take the most drugs are the ones that are the most ill

      Selection bias much?

  • by Millennium ( 2451 ) on Wednesday February 15, 2012 @03:04PM (#39049047)

    Has any study yet been done on autism rates in the unvaccinated children of antivaxers?

    Note that by "antivaxer" I mean those concerned about long-discredited hoaxes that claimed vaccines might have certain side effects which we now know they do not. There are other groups who don't vaccinate for other reasons, like the Amish, and some of them do indeed show lower autism rates. But AFAIK, in all known cases of such groups, there are far too many other variables in play to simply infer that these low rates are due to lack of vaccinations: they lead lives so different from the "typical" American public that any number of factors could be contributing, and that needs to be accounted for.

  • by Animats ( 122034 ) on Wednesday February 15, 2012 @03:06PM (#39049123) Homepage

    Vaccine refusal for standard childhood vaccines could be considered child neglect.

    There are parents who don't want their children to have the chicken pox vaccine and then expose them to chicken pox. [theatlantic.com] That's child abuse. The vaccine is far lower risk than actually getting the disease.

  • by Galaga88 ( 148206 ) on Wednesday February 15, 2012 @03:08PM (#39049147)

    If somebody doesn't trust vaccines, why are they going to a doctor in the first place?

    The sound science behind vaccinations is by and large the same sound science that doctor is going to be using when he diagnoses you and prescribes a treatment. You can't reject one without rejecting the other.

  • Good for them (Score:5, Insightful)

    by macwhizkid ( 864124 ) on Wednesday February 15, 2012 @03:10PM (#39049183)

    I think people today are generally spoiled by good customer service at large retailers like Amazon or Best Buy, where the business writes off 1-2% of asshole customers who consume most of the customer support resources as the cost of doing business.

    The problem is, that doesn't extend to small businesses, where one bad customer can quite literally eat up a majority of the proprietor's time and energy, and the business doesn't have the depth to just send the customer free stuff to make them happy. Had that happen with a scout troop I volunteer for a couple times, where one obnoxious parent consumed hundred of hours of volunteer time before they were told to leave.

    If I were a physician, I'd certainly trade one marginal (in the economic sense) customer for the freedom from losing sleep at night about whether their child is dying from one of any number of untreatable disastrous diseases. If my patients are going to argue with me about whether vaccines are, in fact, the greatest medical development for humanity in the past two centuries, how on earth am I supposed to be able to get them to consent to any other medical science?

  • by CmdTako ( 2503216 ) on Wednesday February 15, 2012 @03:12PM (#39049215)
    anti-vax morons "Boys who did not receive the measles-mumps-rubella (MMR) vaccine during the mid 1990s are now collecting in large numbers in secondary schools and colleges and this provides a perfect breeding ground for the virus" http://www.sciencedaily.com/releases/2010/03/100330082722.htm [sciencedaily.com]
  • by Tanman ( 90298 ) on Wednesday February 15, 2012 @03:15PM (#39049307)

    . . . patient stupidity.

    If a doctor recommends a vaccine for a child, and the parents refuse the vaccine, then the child catches the flu and dies. Guess what? The doctor is open to litigation. It is a sad state of affairs, but the end result of that lawsuit is probably either settlement out-of-court or a judgment against the doctor. After all, why didn't the doctor educate the parents how they were wrong about autism risks? Why didn't the doctor show studies to the parents so they could have made a more educated decision? The fault will not be on the parents' heads -- at the very least the doctor will have to pay an attorney to defend from the inevitable lawsuit.

    Why should a doctor saddle up with 1) Patients that refuse care and 2) Legal risk. If I were a family physician and I had people putting themselves or dependents at risk against my medical advice (A.M.A.), I would "fire" them, too. In the end, we aren't talking about emergency care here. We are talking about medical maintenance, and they can find someone else.

  • by fsterman ( 519061 ) on Wednesday February 15, 2012 @03:17PM (#39049361) Homepage

    My family doctor will give new patients 6 months to stop smoking or he refers them elsewhere. His line is that his job is to keep patients healthy and that he can't do that if they are smoking. These are caretakers, and they will inevitably come to care about their patients. If they wanted to make money, they would have gone into a specialized field.

  • by BenEnglishAtHome ( 449670 ) on Wednesday February 15, 2012 @03:39PM (#39049899)

    I love my endocrinologist. I have diabetes and she's superbly competent at helping me manage it.

    However, her initial speech to patients is fairly straightforward.

    "We'll discuss alternatives and your specific circumstances. Then I'll tell you what to do. You'll do it. I'll know if you do what I tell you because you'll bring in your meter and I'll download all the info in it at every checkup. I'll do the blood work. I'll know if you're following my directions. If you don't follow my directions, you won't have to worry about disappointing me. You'll just have to find a new endocrinologist because I'll fire you as my patient."

    I appreciated the straightforwardness. I think some patients would be mighty put off but that's why some doctors and some patients are a bad mix and should go their separate ways.

  • by goffster ( 1104287 ) on Wednesday February 15, 2012 @04:29PM (#39050965)

    They tend to "know better what is right for my child" on many
    other issues. Their children come in sicker than others because
    of the herbal remedies they try first and fail. "I thought
    I'd clear up the pneumonia with elderberry extract"

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