TWR Posted February 18, 2015 Share Posted February 18, 2015 I practice Family Medicine in Houston and have a question regarding 2 recent children visits. One was a 2 year old new pt. that was seen for well child visit. When asked why she left her pediatrician she said that the Dr. would no longer keep her daughter as a patient as she has no vaccinations which was mother's choice. Second child was seen by me yesterday for a "cold" and when I queried about immunizations I was told that mom boes not believe in them. Child was 2.5 years. My question to you is should these children be kept as patients in the practice I am in or discharged for the same reason the pediatrician did. We have a LARGE waiting room which is usually filled to capacity with lots of kids. What do you think. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted February 18, 2015 Moderator Share Posted February 18, 2015 I think we're rapidly approaching a time in this country where it's going to come down to the rights of a child's health to the rights of a parent making decisions for their child, and the impetus for this would be a child dying of one of these diseases that they used to not die from because of a lack of immunization. I'm also afraid this thread will ultimately result in a flame war as it did the last time the issue of vaccines was brought up on this board Link to comment Share on other sites More sharing options...
AliB Posted February 18, 2015 Share Posted February 18, 2015 Of course it's not always practical for a clinic to have two waiting rooms, but my children's pediatrician has one for well visits and one for sick visits with the check-in/office space between the two. You also exit through the waiting area where you entered. That's too extreme for segregating unvaccinated patients, but why not have a limited window of appointments during a given week where unvaccinated children can be seen? Most pediatricians that I have used routinely asked if the child is current on their vaccinations at the time they book the appointment. If the answer is 'no, we don't vaccinate', then the only available appointment is between 2:30 and 4:30 on Thursday, and don't book any of your vaccinated or sick patients during that window, and if an urgent/sick patient HAS to be seen in that window of time, there's no waiting -- for THEM! -- they go straight to an exam room to avoid any contact with the unvaccinated in the waiting room. For the record, I am in favor of vaccination and all my children, existing and future, are vaccinated. I do respect the rights of others to make a different choice, but that choice comes with limitations, including separating them from my patients, especially those at risk. Clearly I also struggle with any medical provider's choice to deny care to an unvaccinated child (since it's due to their parent's choice), but I remind myself of one provider's comments that really resonated with me: 'If you don't trust me, as a medical professional, with respect to my medical knowledge about vaccinations, why would I have any confidence that you'll respect my medical knowledge about anything else related to your child's medical care?'!' Link to comment Share on other sites More sharing options...
TWR Posted February 18, 2015 Author Share Posted February 18, 2015 As this measle thing gets bigger, maybe a history lesson on the ramifications of measles infection on children and pregnant women is in order. I respect the right of a parent in choicing what they think is right even though there may be no hard evidence. I do get pissed when I hear a mother say "no" to vaccination because I know it protects them as well as the people around them. True Anomoly, Did I light a flame!! Link to comment Share on other sites More sharing options...
Timon Posted February 18, 2015 Share Posted February 18, 2015 I read an article on facebook the other day about a physician doing this exact same thing in his office where he is no longer seeing patients who refuse to vaccinate. https://www.yahoo.com/parenting/should-pediatricians-refuse-to-treat-unvaccinated-109319552502.html?fb_ref=Default A friend of mine who is not in the medical field made a good parallel regarding this in which they stated: "Well...I know that my dog can't go to a groomer, kennel, obedience class our wait in the Lobby at the vet if he isn't up to date on his vaccines. My vet well only treat him after all required vaccines have been administered. If my vet has an obligation to keep other pets safe. .. shouldn't a pediatrician have similar obligations?" I thought it was a great point.Although it really simplifies the issue of parents believing that the MMR vaccine causes autism. But we can only point to the data and if patients are not compliant with their treatment plans, at what point do you draw the line yourself and punt? I just received this article from the ASCP stating that the there are now 141 cases in 17 states. In the associated press article included in the email it states: Most of the people who have gotten measles this year were not vaccinated, the CDC has said. Some were children too young to get the shots. Cases have been reported in 17 states and the District of Columbia. Before a measles vaccine became available 50 years ago, most children got the highly contagious illness by their 15th birthday. Measles was declared eliminated in the U.S. in 2000, and until recently, it was unusual to see more than 100 measles cases a year. Those cases are usually brought in and spread by travelers from countries where the illness is more common. Measles is usually seen in winter and early spring. It causes a fever, runny nose, cough and rash all over the body. In rare cases, it can be deadly. The CDC count often lags behind the latest state counts. For example, the CDC's newest numbers report 11 cases in Illinois, but state officials on Tuesday said they've now had 14, all but one tied to the day care center. The Disney outbreak, which began last December, includes 125 people in seven states. Most of the cases - 113 - are included in this year's national tally. At what point do you say enough is enough as a healthcare provider? Link to comment Share on other sites More sharing options...
Gillz Posted February 18, 2015 Share Posted February 18, 2015 Generally speaking, you would think with so many people going unvaccinated and measles prevalence going up, there is greater chance for it to mutate and infect people who have been vaccinated. I don't mean to strike a nerve, but those who are not vaccinating their kids could cause health issues beyond their household. Something needs to be done. Link to comment Share on other sites More sharing options...
TWR Posted February 19, 2015 Author Share Posted February 19, 2015 look up the facebook comments from a young mother whose 15 day old was exposed to meaSLES. i TRIED TO PASTE IT BUT CAN'T. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted February 19, 2015 Administrator Share Posted February 19, 2015 Just let them know you're going to call the mandatory reporting hotline for medical neglect in your state. Then do it. They should self-correct if enough of us do it. Link to comment Share on other sites More sharing options...
Acebecker Posted February 19, 2015 Share Posted February 19, 2015 Here's a question - I am urgent care specifically for a family medicine/IM clinic, and more broadly for the community at large. Our family med providers take patients who do not vaccinate their kids - I of course have no say in that. I am obliged, in almost all cases, to see patients who are established at this practice. What would you all say to taking care of kids who have no immunizations in this setting? Should I be refusing to see them? Sending them to ER waiting rooms with the rest of the sick people? Link to comment Share on other sites More sharing options...
TWR Posted February 19, 2015 Author Share Posted February 19, 2015 They could always pay for a house call I guess. Link to comment Share on other sites More sharing options...
Guest Paula Posted February 19, 2015 Share Posted February 19, 2015 I've seen kids who are not immunized. I must keep in mind that they may end up with a condition that we thought was a condition of the past, such as epiglottitis. So my rabbit ears are up and if the kid is sick will do as much as I can in the office, i.e. check a strep, U/A , CXR, etc. if indicated and remember all the signs and symptoms of diseases we have probably not seen. Then document very well and give clear f/u instructions to the parent/caregiver on when and why the kid needs to be seen again. Clear instructions of when to go to ER. Be detailed and include a discussion on why you are recommending immunizations, cover all your bases, in other words. It can be a difficult discussion, especially with parent/parents who just simply don't believe the medical research and think it's a cover up of some sort. I've had one less than satisfying discussion and learned I need to polish my delivery a bit better! I believe we are to see all patients regardless of their immunization status. Link to comment Share on other sites More sharing options...
TWR Posted March 1, 2015 Author Share Posted March 1, 2015 I agree with you Paula. Of course I see patients regardless of the immunization staus. I just think it is wrong based on the evidence and they are inconsiderate imho. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 1, 2015 Administrator Share Posted March 1, 2015 (nevermind, I already said that in this thread) Link to comment Share on other sites More sharing options...
db_pavnp Posted March 1, 2015 Share Posted March 1, 2015 When a topic makes you so mad, you accidentally make the same post twice a week apart. thingsantivaxxersmakeusdo Link to comment Share on other sites More sharing options...
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