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.'"
Always torn on these cases (Score:3, Interesting)
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.
ask no questions (Score:0, Interesting)
So if I think that 27+ vaccines in the first 18 months of life are just a tad excessive, I'm a knuckle-dragging imbecile? If I raise the point that just maybe many of these doctors are in the pockets of the companies who make all these vaccines, then I'm tin-foil-hatted nut?
It's just the most critical period of mental development in the entire life of a human...I definitely think we should introduce as many foreign agents as we can, just to make sure.
Good! (Score:5, Interesting)
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.
Unintended Precedents (Score:4, Interesting)
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?
Re:...why? (Score:4, Interesting)
Turnabout is fair play (Score:5, Interesting)
I've often wondered... (Score:4, Interesting)
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.
OK genius (Score:5, Interesting)
A person who thinks a vaccine causes autism is liable to start blaming their doctor for whatever other ailments crop up in their kids life. Which is only no big deal if you don't have a family yourself or reputation.
Why would any doc want that?
Re:serves 'em right (Score:5, Interesting)
> 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.
I would be the same goes for smoking (Score:5, Interesting)
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.
Re:Always torn on these cases (Score:2, Interesting)
I used to agree with that, but the recent example with swine flu vaccinations and the strong indications that they're causing many narcolepsy cases suggest that the medical profession can't be trusted to make the best choice either.
By the time the vaccines were getting widely deployed in response to the 'pandemic' it was quite obvious that the flu in question was less deadly than even an ordinary seasonal flu, yet some countries went ahead with mass vaccinations anyway. With the result that many kids most likely got their lives ruined while potentially saving a fraction as many lives (comparisons between mass-vaccination countries vs target group vaccination countries show miniscule differences in mortality rates).
Re:as well they (Score:4, Interesting)
The problem is a thorny one of liability and ethics. Being forced by law to take responsibility for a patient that specifically refuses to take your medical advice is not a solution.
I have had (dental) patients in the past who give me a list of requirements on their first visit - no x-rays, no fluoride, no amalgam, etc. Those patients are gently shown the door. I may not necessarily disagree with their reasoning but the trust necessary for an effective doctor-patient clearly does not exist from the start.
And who knows what cockamamie lawsuits they'll file? I've actually had patients insinuate that they will sue if treatment doesn't happen exactly as they expect. Buh bye.
Not worth the headaches.
This attitude can be found in other doctors, too (Score:5, Interesting)
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.
Re:New Sign in the Doctors Office... (Score:4, Interesting)
You got some links to support this assertion?
http://investment-fiduciary.com/2009/04/17/why-doctors-dont-get-rich/ [investment-fiduciary.com]
In an anecdotal vein, my next door neighboor and his wife are both doctors. He is a pediatrician and she works in ER. He's been working at a private practice for 4 years and I'm not sure about her, but she's about the same age. They drive modest cars and have 2 children. The house is probably 2000 sq ft which is big but is not a McMansion. They each pay a 'mortgage' for their school loans and still have that to look forward to for another 10-15 years. So, sure they make good money, but there is a big cost to making that kind of money and it takes quite a while to net any kind of wealth. They also keep really long hours and question their career decisions from a family point-of-view. I, as a software developer, am much farther ahead than they are because I did not have 8 years of school to pay off and was able to start making money while they were still in school racking up debt.
So they made an investment in their education, expecting it would pay off in the long run. And this is not uncommon to doctors. So put your anonymous mask down and stop spewing half truths to make yourself feel victimized.
And besides, comparing a doctor to a community college adjunct professor is just ignorant.
Re:Consider me fired. (Score:5, Interesting)
My mom is a nurse, and her best friend was paralyzed from the flu shot. How's that instead of a @#$@ three days of down time?
And for every person paralyzed by the flu shot a greater number have been saved by it. No one is saying vaccines don't have risks, but that the benefits outweigh those risks. There's a reason we look at statistics instead of anecdotes.
Re:Consider me fired. (Score:4, Interesting)
"My mom is a nurse, and her best friend was paralyzed from the flu shot."
Thousands of people's lives are saved from the flu shot and one person had an adverse reaction and suddenly it's bad?
Show me the statistics and I'll give you an answer.
Now if they find a way to genetically test if you'll have bad side-effects, I could see having that done before getting a shot.
Re:Consider me fired. (Score:5, Interesting)
It can also be deadly. A friend of mine gave me the Chicken Pox which, within 2 weeks, lead to bacterial endocarditis, spinal meningitis, pneumonia and Reye's syndrome. Note that the US didn't start using the Chicken Pox vaccine until 1995; it hit me in the 1970's. Fortunately my parents found the doctors I needed and I'm alive today.
I wonder how many children die every year because their parents don't want to get them vacinated.
Re:Seems reasonable.. (Score:5, Interesting)
Re:serves 'em right (Score:2, Interesting)
Parents can refuse immunization for their children on religious grounds. If ANYONE in the school develops a communicable disease for which their child has not been vaccinated (Measles Mumps etc) their child must remain home from school for the incubation period. This means the kid is home for two weeks and the parent needs to deal with it. My wife(a school nurse) has found that when this happens the parents almost universally show up at school the next day with a vaccinated child and a doctors note to prove it.
Re:New Sign in the Doctors Office... (Score:5, Interesting)
Re:New Sign in the Doctors Office... (Score:3, Interesting)
Your assessment of the medical profession is rather out of range.
1) My wife incurreed less than 150k total, most of it in med school, not undergrad. Its really not that difficult to get most of your undergrad paid for, if you aren't capable of this it means you put no effort into finding grants. There are litterally even grants for people who's parents make too much fucking money, so there is NO excuse for you to exit undergrad with massive debt other than your own
2) Doesn't get paid off, nor does it accumulate interest, just like every other graduate program. Medicine is no different.
3) Doctors get paid for residency, they don't pay someone else for the privledge of doing it. They are working at that point, just watched closer (though less than they should be!),
4) Bullshit. The cost compared to income is fucking trivial. You can pretend its bad, but my car insurance is more than my wife's malpractice costs, so again trivial compared to income. If you're doctor is paying high malpractice rates then you're intelligent move would be to find a new doctor cause yours has been sued one too many times, which indicates a pattern you might not want to be part of.
You're also pretending that someone called an 'engineer' after undergrad is impressive, except they aren't, and they really don't do anything like a doctor does. They may lay out a parking lot, or survey some land, but thats the end of it. Anyone who wants to do anything notable ALSO has to go to graduate school.
Being married to a doctor, I can assure you that your assessment is rather wrong and you've fallen into the trap of believing the greedy fuckers in the industry who make you think they really do have it hard.
Re:Seems reasonable.. (Score:4, Interesting)
As a parent of a 1.5 year old child, here's a few question for you...
What about HepB? given at birth? 1 month? 2 months? Are you spreading those over 3-4 times that recommendation?
What about RotV? Both currently licensed version (Rotarix and Rotateq) are live virus in an oral suspension. The old "proven" one was discontinued in 1999 (apparently seemed to cause higher instances of intussusception), the CDC estimated that 500,000 infants die around the world each year from RotV.
What about DTaP? It's a mixed (only the "P" part is acellular) They recommend 5 doses of this puppy. Are you gonna stretch that one out 3-4x or take the old verisons seperatly? Because when you get older they usually use recommend a totally different one. Gonna test a new experimental vaccinee schedule on you kid?
What about Hib and PCV? They are generally polysac+protein vaccine (no live viri), but they recommend 4 does, up to age 1, are you going to stretch that out to age 4? or age 8 given separatly?
What about IPV? It's inactivated, and it's old, but who gets polo?
See the problem? It's easy to toss some platitude like "I'm not gonna give my kid any new vaccines" and "I'm gonna spread them out", but when you dig into the details, you see that many of the vaccinnes are necessary in short intervals bacause the baby's immune response is so weak and the recommended vaccines already either well tested, or manufactured using more modern (cellular/protein response oriented) techiques.
Also, If you spread them out even 2x, which of these terrible diseases are you willing to risk? I'm not doing this to ridicule anyone's position on vaccines, but after you look at the problem (since I've done this recently), you realize it really isn't about educated risk at all, it's about realizing that developing a new drug protocol or vaccine schedule for your own kid using your own limited knowledge is not probably a prudent thing to do, when the standard protocol has been well studied and has documented (but non-zero) risk. Should my child be a clinical trial of 1?
Part of wisdom is recognizing what you don't know. I really don't know this stuff at all, nor do I really know the reputations of any of the sources of data, so any calculations that I do with any accumulated data is likely garbage-in, garbage-out. I'm really just forced to apply occam's razor to the problem. Do I believe there is a global conspiracy concerning giving vaccines to infants and covering up all the negative evidence, or do I believe that the general good of vaccines is illustrated in the preponderance of the evidence and the existance of a National Vaccine Injury Compensation Program for the small percentage of infants that have side effects. Applying this principle, the general good of vaccines seems a simpler explanation, and often simpler is more likely correct. That was enough for me. Your milage may vary.
Re:Consider me fired. (Score:4, Interesting)
A friend of mine in junior high school was killed during a baseball game. He pitched the ball, the batter hit it back, he got hit in the temple, he lapsed into a coma and died. Clearly, this means that baseball is an extremely dangerous sport and should be banned entirely.
Either that or my friend had a one in a million event happen and the entertainment benefits of baseball outweigh the tiny risk. Just as the health benefits of vaccination vastly outweigh the tiny risk.
(In case you're wondering, that story is true, by the way.)