What is behind physician’s approach to immunizations?

Based on the number of comments from my last post on immunizations, this is a topic in which many people are interested.  I had no intention of arguing for or against immunizations, though not surprisingly some of the comments did take up that issue.  My goal was to bring attention to what I think is an improper and unfair approach by the majority of the medical community towards those who choose to not follow the standard schedule.  Based on the number of comments; I hit the nail on the head, that many parents have had unpleasant interactions with the medical community over the issue of immunizations.  In that post, I indicated that I have an opinion as to the reason for the hardline stance by most of the medical community on this issue and several asked that I expand on this, so here goes.

First of all, it is NOT because they make money from the vaccines.  I have seen this claim on forums, but it is just not true.  In fact, practices are happy if they do not lose money on immunizations.  The reimbursement by insurance companies barely cover the cost of the vaccine, much less all of the labor that goes into administering them. Vaccines are not a profit center for doctors.

The biggest reason doctors push immunizations is they really believe immunizations are critical to maintaining good health.  It is what they are taught throughout their training.  Numerous experts and professional organizations take the position that without the widespread use of vaccines, serious diseases would be rampant.  With all of this training and expertise supporting the use of vaccines, it just does not seem logical to them that a rational individual would object to their use.  Therefore, they conclude that anyone who objects to immunizations has to be either crazy or uneducated.

Secondly, they believe their role is to protect children.  Since, it is common knowledge that immunizations are so beneficial, it is critical that they do their best to overcome the objections of those parents who stand in the way of the children getting optimal health care.

Thirdly, the vaccines are not 100% protective.  Some individuals do not develop adequate protective antibodies when given the vaccines.  Therefore, if too large a portion of the population does not get immunized and thus the incidence of the disease increases, these immunized, but unprotected individuals are put at unnecessary risk.

Fourthly, the very palpable fear among physicians of being sued  has dramatically altered the way all physicians practice.    If a child ends up with brain damage following the administration of a vaccine according to guidelines, that physician is under no risk of being sued.  If a family tried to seek damages, it would be covered by the Vaccine Injury Act.  On the other hand, if a child is not immunized per parental choice and comes down with pertussis, for example, and has a bad outcome, the physician would be very exposed to the risk of being sued.

Next, we unfortunately live in a highly regulated society.  Every aspect of our lives is now controlled by some government entity or entities.  With regulatory agencies breathing down the necks of physicians it is problematic for physicians if a significant part of their patient population is not following the CDC guidelines.  This is even more true for those practices which are owned by hospitals and today most practices are owned by hospitals.

Last on my list is that it takes significantly more effort to care for families who do not follow the standard schedule.  If a child is brought in for his/her two month visit and just gets their shots according to the schedule, it is a very simple thing to roll out the typical two month shots and give them.  In contrast, dealing with a parent with concerns about vaccines or figuring out a schedule for those selectively vaccinating takes a significant amount of time.  Physicians are under significant time pressures, so anything that requires that they spend more time with a patient can put them on edge.

My last post was trying to promote a better understanding of those who do not immunize.  This one, is trying to improve understanding of the physician’s viewpoint.   I am not arguing for or against any of these opinions, just letting people know what is behind physician’s positions.

My next post will discuss why I give patients the freedom to choose.

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