Doctors Take a Stand for Immunizations
Sep 02, 2011

Research has indicated that when it comes to immunization information, parents put a lot of trust in what their doctor has to say.  Certainly immunization recommendations are made by medical
professionals because they are confident that vaccination is in the best interest of their patients.  While it is certainly understandable for parents to want to educate themselves regarding the
immunizations recommended for their children, what are doctors to do when patients ignore, or even refuse, the recommendations?
Interestingly enough, NBC’s chief medical editor Dr. Nancy Snyderman aired a segment yesterday on the TODAY Show which explored whether doctors should ban children who are not vaccinated.  Coincidentally, I recently had the opportunity to talk with Dr. Scott Goldstein of Northwestern Children’s Practice in Chicago about his thoughts on this issue.
Dr. Goldstein explained that he takes a very active approach regarding immunization education.  Not only does he talk to parents at length in the exam room, but as a member of the Illinois Immunization Patient Advocacy Leadership Initiative, he invites parents to attend  immunization presentations that he gives every few months at a nearby hospital.
So picture yourself in the shoes of someone like Dr. Goldstein – entrusted with keeping your patients healthy.  You understand that patients who refuse or delay vaccinations are at a greater risk of contracting a vaccine preventable disease.  You realize that by accepting unvaccinated patients that you may be jeopardizing the health of others who share the same waiting and examination rooms.  You know that there are patients in your practice that are either too young to be vaccinated, immune compromised or who, for medical reasons, are unable to be vaccinated or who did not receive full immunity from their vaccines.
Now consider that you are well-versed in the countless studies that illustrate that vaccines are not only safe, but highly effective, and that you have been in the uncomfortable position of seeing someone suffer, or even die, from a vaccine preventable disease.  Imagine that after you do you best to present all the scientific evidence, and address all the questions and concerns, that one of your patient’s will go without vaccinations because their parents have chosen to disregard your advice and professional recommendations.
Unfortunately, situations like these are often a reality for doctors and why they are continuously questioning, and sometimes even altering, their policies.
Take for instance Dr. Goldstein and the other pediatricians in his practice.  They began the year with a “Let’s give them time” approach, deciding that they preferred not to kick patients out.  In Dr. Goldstein’s opinion, the biggest barrier to vaccination was misinformation.

“If parents have the right information, and they understand the overwhelming evidence that supports vaccination, than we feel they will come to understand why we, as doctors, feel so strongly in favor of vaccination,” he explains.

Unfortunately, as the year progressed, the practice began seeing a few cases of pertussis and meningitis, and the doctors grew concerned.

“That really got our attention,” explained Dr. Goldstein.  “There is a difference between people having a choice, and making choices for other parents.”

Additionally, the doctors began realizing that many patients were not adhering to the recommended schedule, but rather picking and choosing vaccines and creating their own schedules.
As Dr. Goldstein explained, “It was getting difficult for the practice to keep track of it all.”  Parents would come in to see the nurse and get a shot that they had initially delayed, but then not remember which shot the child needed.  The staff then had to try to determine which vaccine they were requesting, which was hard to keep track of because it wasn’t according to a set schedule.
“It was consuming a great deal of time and taking our doctors and nurses away from other patients,” states Goldstein.
In an effort to provide the best care possible for their patients, the practice decided to adopt a new policy in June.  They would only see patients who were vaccinating according to the recommended schedule.
In defense of their policy, Dr. Goldstein explains,

“We shouldn’t have to sell something that’s proven. The evidence in favor of immunizations is so overwhelming.”

He goes on to say,

 “All of the available research shows that the safest and most effective way to vaccinate children is on the schedule set by the CDC and AAP.  To go against that schedule goes against proven scientific research and puts patients who do follow the schedule at risk.”

Dr Goldstein is comfortable with this new policy since it reflects the collective convictions of the physicians in the practice.  He reports that their patient response has also been very positive, explaining that parents who were “on the fence” have resolved their concerns and that the strong stand that these doctors have taken has actually helped to boost patient confidence in vaccines.
“If we had so many leaving, we may question this, but we’ve only had about five or six families that I know of that have left the practice out of thousands of patients we see.”
Certainly, not every doctor will take this approach, and some doctors are concerned that there may be negative implications of this type of policy.  But it is important for parents to be aware that these policies may, or may not, be in place at the practice they choose to visit.
While some parents will continue to beleive that immunization is a personal choice, these policies make it clear that doctors are acknowledging that the immunization choices one person makes can  directly impact the health of others.  Parents who choose not to vaccinate their children often argue that they want to retain their right to file an immunization exemption, (which then allows their children to be admitted to school without fulfilling the proper immunization requirements).  If they are granted this choice, isn’t it understandable that doctors should be free to make a choice in their own practice that will best protect their patients?
There are certainly a lot of opinions in regards to this, so we look forward to hearing your thoughts.  Feel free to add your comment below, or join us on our Vaccinate Your Baby Facebook page to add to the conversation there.

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