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Anyone gotten mad at a patient on COVID vaccine discussion??


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1 hour ago, Cideous said:

Either you are not watching or willful ignorance is at play.

No, I don't watch Fox news. And you are completely missing my point. The point is that outlets like CNN have spouted so much left-wing propaganda for so long, people on the right will have a legitimate hard time believing anything they say. CNN has no credibility. If they said the sky was blue there are segments of the population that couldn't buy it. 

I'll leave it at that, to avoid this thread getting exiled to the politics area.

 

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3 hours ago, CAAdmission said:

No, I don't watch Fox news. And you are completely missing my point. The point is that outlets like CNN have spouted so much left-wing propaganda for so long, people on the right will have a legitimate hard time believing anything they say. CNN has no credibility. If they said the sky was blue there are segments of the population that couldn't buy it. 

I'll leave it at that, to avoid this thread getting exiled to the politics area.

 

Before the inevitable "nuh-uh" from someone who doesn't see things this way, understand that the fact that a significant portion of America believes this, is part of the problem. It's a sort of "cry wolf" problem--the perception of a problem is a problem, and arguing over the underlying reality doesn't help. I had the opportunity to drag this out again elsewhere today, so why not post it here again, too: https://theoatmeal.com/comics/believe

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6 hours ago, CAAdmission said:

No, I don't watch Fox news. And you are completely missing my point. The point is that outlets like CNN have spouted so much left-wing propaganda for so long, people on the right will have a legitimate hard time believing anything they say. CNN has no credibility. If they said the sky was blue there are segments of the population that couldn't buy it. 

I'll leave it at that, to avoid this thread getting exiled to the politics area.

 

But maybe, just maybe, CNN is not sprouting far left wing stuff

 

We know the right will say anything/do anything/ignore the facts (not really a debate point, just look at the refusal to even call Jan 6 an insurrection - heck one Republican senator was saying it was "a normal tourist visit")

The best most sneaky way to move the needle right in this country to to sprout extreme right  views then claim the middle is extreme left - then hope for a compromise that is far right.  Pushing the needle right..... 

 

I am truly a centrist, but all the major networks are closer to the middle then FOX wants you to think 

This is not just my idea but instead it supported with data   https://www.adfontesmedia.com/static-mbc/

 

Feel free to say the data is made up (just like covid is made up, vaccine have microchips, and such) and I will not engage you as I am done with people that refuse to listen to logic/science and think tRump is god.

 I am tired of the right claiming the middle is far left and want the other centrists to start speaking up.

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Nope - I don't argue with patients. I've learned quickly that patients ( I mean customers/clients) will do and say anything as they please. 

 

What gets me pissed off are patients who are 1: not vaccinated and 2: refuses to wear a mask during triage and during their ED visit while citing "the mask is causing me to be sick because of the build up of CO2"

Had a 6 year old told their parent "its okay mom, its not a big deal we can wear a mask until we're done"

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Fox News kills. Every one knows that at this point. Just like dropping a quarter means gravity. It’ll be forgotten about. They won’t have to deal with any repercussion and they’ll keep doing what they do best going forward. Gaslight, rinse, repeat. Denying that is lunacy. The other side has their problems, but they also don’t actively try to kill people. 
 

The entire MA staff at my practice is unvaccinated for ‘some reason’. After talking to a few of them about hesitancy, providing EBM and facts about the vaccine, only one thing is clear beside the obvious lack of higher education-their political affiliation and choice of news outlet. If the idea of getting one of our patients severely ill does not bother you, something is amiss. 
 

But. There are plenty of free thinking conservatives that have followed medical advice. And there are plenty of far left like Robert F. Kennedy Jr. spreading vaccine disinformation. 
 

I give my unbiased spiel to my patients who aren’t vaccinated or have questions, but as soon as they start talking about magnets and stuff I drop it and move on.

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On 7/30/2021 at 11:42 PM, ohiovolffemtp said:

This!!!  I'm very frustrated with nurses who won't vaccinate - though 1 tonight did so at the recommendation of his endocrinologist.  He had had COVID-19, so at least he does have that immunity.  I confess I am puzzled as to how immunity conferred by vaccine is stronger than that conferred by the disease.

I'm puzzled too.  I've read a few articles that have shown immunity of those who had COVID-19 and is lasting immunity (up to 8 months now).  Pfizer vaccine has waning immunity which is why booster shots might be recommended.  I think the jury is still out on that.  The original SARS virus from 2004 has been studied and so far is still showing immunity against the original SARS ...17 years.  So why would someone who had COVID-19 be expected to get the vaccine?  It seems the vaccines should have been distributed first to those who did not have the disease.  Maybe instead of testing for COVID -19 with the free nasal swabs the CDC should have thought about giving free tests for the antibodies before vaccination.  That way the US could have collected data looking for herd immunity which I think is higher than what is reported and saved vaccines for those most in need.

The other questions I've had and so far no one has been able to answer?  As far as PPE....what type of masks are you all wearing?  N95?  that is the most effective mask.  My local large health care system does not provide N95's to the staff who have close direct contact with their patients.  Not even in the ICU.  What's up with that? Cloth and surgical masks are the standard masks I see worn and staff buy or make their own.

WHO has reluctantly admitted there is aerosolized spread of COVID-19 and CDC is somewhat on board with that but don't seem to discuss it much.  

If  a PA refuses to see a patient who is not vaccinated will you see a patient who had the disease?

When a PA believes that evangelicals, Christians and observant Jews are the scum of the earth because some have decided against taking the vaccine  is not the PA extremely biased and probably shouldn't practice medicine? 

We talk about disparities in health care yet we set up our own disparities by refusing to see patients and kicking them out of the office.  

Full disclosure:  I am no longer practicing but still am in close contact with PA friends who are and I know they all have COVID fatigue and compassion is very hard to maintain in these trying times. 

There are alot...I mean alot of studies available to read on masks.  One article I read was a review of all the studies done on the effectiveness of masks and it was very interesting.  You can find it at CIDRAP - the Univ of MN Center for Infectious Disease... Dr. Michael Osterholm, PhD is the head of CIDRAP.  His conclusion was that masks are generally ineffective except for the N95.  I believe he was consulted by Biden and he was interviewed on CNN or maybe it was MSNBC.  Now one doesn't hear much from him anymore.  Is he a crackpot or just canceled?  I don't know. 

Also, there have been legitimate injuries from the vaccine.  Myocarditis/ Guillaine Barre/Blood clots, ITP/Death which the CDC is acknowledging and J&J vaccine has warnings on it about the Myocarditis/clots.  So when someone has decided to bypass the vaccine please remember that it is your job to be empathetic with them and discuss their fears, not kick them out.  However if a patient is rude and obnoxious or appearing to get violent...then you can kindly end the appointment. 

When I was practicing I had a subset of parents who did not vaccinate or wanted to be on a different schedule than what the CDC recommends.  I was ok with that, we discussed the pros/cons of vaccinations.  Some parents did pick and chose what they felt best for their child and vaccinated.  They understood the risks vs benefits.  Isn't that what medicine should be all about?

I do agree medicine has gotten politicized and science is about dead...especially when I hear people say : the science is settled.  Nope, it's not settled.  It's an ever moving target of hypothesis and testing and studying, etc.  

Well some science is settled as to my knowledge only humans are born to humans.

I'm rambling

 

 

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58 minutes ago, Incognito said:

If  a PA refuses to see a patient who is not vaccinated will you see a patient who had the disease?

Well, in my particular case, it'd be unlikely, because in none of my settings is a symptomatic person tested any more: Sleep, eating disorders, and pain clinic will send a symptomatic patient home and reschedule.  My own clinic is not set up to take acute care visits yet, but yes, if I was equipped to diagnose Covid-19 I would see a symptomatic patient, even if I will not establish an ongoing relationship with a Covid-19 vaccine refuser.

 

58 minutes ago, Incognito said:

When a PA believes that evangelicals, Christians and observant Jews are the scum of the earth because some have decided against taking the vaccine  is not the PA extremely biased and probably shouldn't practice medicine?

I think the statements by others in this thread were intended to be hyperbolic.  Whoever stated that an anti-vax stance undermined the pro-life stance of evangelicals (Cideous, was that you?) made a great point. To the extent that anyone is advocating an anti-vax stance, they are behaving irresponsibly.  Remember, we are mandated reporters--do you think a PA who encounters anti-vax parents (that is, those declining schedule vaccinations without a legitimate reason) has any reasonable rationale to NOT notify one's own respective state child protection agency?

58 minutes ago, Incognito said:

When I was practicing I had a subset of parents who did not vaccinate or wanted to be on a different schedule than what the CDC recommends.  I was ok with that, we discussed the pros/cons of vaccinations.  Some parents did pick and chose what they felt best for their child and vaccinated.  They understood the risks vs benefits.  Isn't that what medicine should be all about?

In addition to the obligation you have to the children potentially victimized by their parents' refusal to protect them, how did you ethically justify seeing immunocompromised patients (what, no transplant, ART, or RA patients in your practice?) when you intentionally allowed an unsafe place for them by tolerating vaccine delay or hesitation?

Vaccines aren't available to everyone; there are people with real medical contraindications.

Religious objections to vaccines are roughly as legitimate as the Church of the Flying Spaghetti Monster, with no particular offense intended to Pastafarians who never got the memo that it was a joke.  Seriously look up the Vermont study that found when 'personal belief' exemptions were eliminated, religious exemptions grew by a strangely correlated amount.

The big problem with religious objections to vaccines is that there are hardly any. Look up: John D Grabenstein. What the World’s religions teach, applied to vaccines and immune globulins. Vaccine. 2013;31(16):2011-2023. doi:10.1016/j.vaccine.2013.02.026  It's simply not true that any organized religion NOT associated with complete rejection of medicine opposes vaccines on religious grounds.  Those that do, oppose them on the basis of risk. Sorry, but poor statistical skills do not deserve to be treated as actual religious doctrines.

Yes, it's possible to be so Pro-Life that you'd rather die than get Rubella or Hep-A.  Well guess what? None of the mRNA vaccines use aborted fetal cell lines in their production. Oh, well, now we're going to move the goalposts and object because prototypes were TESTED, in the lab, against such aborted fetal cell lines.  Give me a break. Roman Catholic doctrine, which is about as absolutely pro-life as you can get, doesn't even forbid vaccination using vaccines manufactured using aborted fetal cell lines: it urges adherents to choose other options (so, mRNA vs. J&J or AstraZeneca), lobby for ethical alternatives, and follow their consciences.

"But I would be profaning my body!" Really?  Show me that in your holy book of choice?

Bottom line is that REAL religious objections are crucial to protect, but these arguments aren't, not any more than an untrained emotional support animal is the same as and should be accorded the same privileges of a trained service animal.

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1 hour ago, rev ronin said:

do you think a PA who encounters anti-vax parents (that is, those declining schedule vaccinations without a legitimate reason) has any reasonable rationale to NOT notify one's own respective state child protection agency?

That's an interesting hypothetical. I would speak to them at length and try to chip away at the resistance. But there's no way I'm calling CPS over this. The government has no business here. 

 

1 hour ago, rev ronin said:

how did you ethically justify seeing immunocompromised patients (what, no transplant, ART, or RA patients in your practice?) when you intentionally allowed an unsafe place for them by tolerating vaccine delay or hesitation?

Essentially the entire earth is an unsafe place for them - supermarket, church/temple, etc. A medical office, by virtue of attracting sick people, is especially dangerous. No way I would have them in if there was a telehealth alternative. It's up to them to judge the risk of coming in, too. 

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9 hours ago, Incognito said:

When I was practicing I had a subset of parents who did not vaccinate or wanted to be on a different schedule than what the CDC recommends.  I was ok with that, we discussed the pros/cons of vaccinations.  Some parents did pick and chose what they felt best for their child and vaccinated.  They understood the risks vs benefits.  Isn't that what medicine should be all about?

Ugh. This is absolute theoretical nonsense and perfect example of oxymoron devoid of science and medicine. The applicable analogies are endless here. There is zero, ZERO, EBM supporting this. Most pediatric practices will not continue care for those who refuse vaccinations for their children or prefer a “delayed schedule”. Your job is not to make parents comfortable, it’s to prevent children from getting deadly diseases. 

Edited by ANESMCR
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49 minutes ago, ANESMCR said:

Oh. And the tendency to approach them with religious and political bias/complacency is? 

No, I'm not sure that would be a good approach either. Perhaps try something in the middle?

The approach "I'm right, and you're wrong/stupid/a child abuser because... science" is an arrogant turnoff to patients and families. If you like this approach, if it makes you feel wise, powerful, superior and successful, by all means have at it, but it won't ultimately accomplish your goals or serve your patients well. 

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13 minutes ago, CAAdmission said:

No, I'm not sure that would be a good approach either. Perhaps try something in the middle?

The approach "I'm right, and you're wrong/stupid/a child abuser because... science" is an arrogant turnoff to patients and families. If you like this approach, if it makes you feel wise, powerful, superior and successful, by all means have at it, but it won't ultimately accomplish your goals or serve your patients well. 

Doesn’t make me/providers who practice EBM feel any of that that. Pack the pettiness. I will never support pseudoscience and neither should anyone here.

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20 hours ago, Incognito said:

So why would someone who had COVID-19 be expected to get the vaccine?

Per a recent article from NEJM, experts recommend vaccination against COVID after having COVID due to a tremendously amplified immune response across several important measured parameters of immunity.

Edited by mcclane
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Getting vaccinated is NOT political. It just IS NOT.

Public health is HEALTH and using science.

Getting vaccinated is a public health RESPONSIBILITY of citizenship and the COST of freedoms.

I will not accept any BS political conspiracy theory propaganda from ANYONE about any vaccine.

A 7 yr old DIED from measles when I was a student in an urban hospital. 100% PREVENTABLE. Heart wrenching, waste of life. 

We ditched polio, we mostly ditched smallpox, we have kept folks from DYING from tetanus.

NOT dying and not being intubated or sustaining lifelong lung scarring and a whole host of crap should be motivation enough to get vaccinated never mind your grandkids, nieces, nephews, neighbors, grandparents, cancer patient neighbor, etc. 

I don't care what flag is in your front yard or what Fox News said. 

So, wear the damn mask, get the vaccines, quit spouting political BS and follow science.

 

 

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6 hours ago, CAAdmission said:

I'd encourage you to print out this thread, show it to a few objective non-medical folks, and see what they think of the attitudes. It might be an eye-opener. 

I’d rather print out EBM and give it to them. Or have them talk to the parent of a dead kid from measles. Also, if they were truly objective folks, wouldn’t they be more concerned with the guy practicing subjective medicine? 

Edited by ANESMCR
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I think CAAdmission's point is well taken: the same position can be advocated from a number of different perspectives, and we should use the ones most likely to gain the best outcome for our patients... although I would add a "consistent with the truth" caveat there.

EBM is great, but EBM is at best an occasional add-on to the placebo effect.  That is, people get better, for the most part, because they are in healing relationships with trained, specialist healing people they trust. EBM isn't a substitute for caring, and to the extent it becomes so, we, the holders of EBM, drive people away from real science and into quackery, because at least the quacks care!

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Since like everyone else we’re seeing a huge influx of COVID19 patients, and therefore at that point it’s too late since they’re already sick and sought care in the ER, I don’t pontificate- the only time I mention something is that we confirmed they had COVID and are unvaccinated, so I ask them that once they recover would they please consider getting the vaccine so they don’t get so sick next time they have to seek emergency care

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5 hours ago, True Anomaly said:

they had COVID and are unvaccinated, so I ask them that once they recover would they please consider getting the vaccine

I know this is the current recommendation, but I'm having trouble understanding the basis for it. My understanding had been that actually having a disease would generate much higher, more durable antibody titers than being vaccinate against the same disease.

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58 minutes ago, CAAdmission said:

I know this is the current recommendation, but I'm having trouble understanding the basis for it. My understanding had been that actually having a disease would generate much higher, more durable antibody titers than being vaccinate against the same disease.

Per what mcclane said above, the evidence so far seems to be that...
Recovering from Covid-19 = good
Getting an mRNA vaccination series = better
Recovering from Covid-19 and then getting and mRNA vaccination series = best

At least, that's what I keep telling myself as kind of some Stockholm Syndrome-like reaction to essentially losing a weekend feeling almost as bad after my 2nd Moderna shot as when I had Covid-19 in the first place.  No cough, though.

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1 hour ago, rev ronin said:

At least, that's what I keep telling myself as kind of some Stockholm Syndrome-like reaction to essentially losing a weekend feeling almost as bad after my 2nd Moderna shot as when I had Covid-19 in the first place.  No cough, though.

I'm just wondering when enough is enough. You could go back next week and get a quadruple dose vaccine and I'm sure it would generate a big response, too. At the rate we are going, we will be having quarterly booster shots until the sun goes supernova.

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I will get boosters until the case and mutation rate for COVID 19 is not news. I will wear masks in perpetuity. 

Still most interested in not dying, not infecting my friends’ kids who are too young to vaccinate and not being on a vent. I like living and breathing. 

No conspiracies, just a shitty mutable novel virus that has altered our approach to most everything.

Medical science should not be politicized nor should public health.

Humanity has shown its ugly side and left skidmarks on my outlook for society. My trust in those around me is exceedingly limited now. 

I am quite seriously looking at where one can live with fewer nut jobs and a more conscientious society.

Deep sigh 

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9 hours ago, Reality Check 2 said:

I will get boosters until the case and mutation rate for COVID 19 is not news. I will wear masks in perpetuity. 

Yeah, more or less the opposite for me. Got my shot. Mask's been off since the mandate was lifted. (If it's put back in place, I'll put it back on; I'm not militant about it.) I've been to the theater, to amusement parks, and on multiple flights. As you infer, we only have one life to live. I'm living mine. 

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