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Pediatricians in Canada discharging unvaccinated children
http://www.thestar.com/living/article/1167428
Pediatricians in Canada are starting to discharge children whose parents refuse to have them vaccinated.
More and more, doctors are taking a stand when their medical advice is being ignored, said Dr. Hirotaka Yamashiro, chair of the pediatrics section for the Ontario Medical Association and president of the Pediatricians Alliance of Ontario.
?There have been some pediatricians who are very concerned about that, and may not take on the patient in the beginning,? Yamashiro said. ?If you are going to fundamentally disagree with one of the things I think is good for your child, what else are we going to have a problem with??
Dr. Fatima Kamalia, a Thornhill-based pediatrician, says she discharges patients whose parents refuse to have them vaccinated.
?Their whole philosophy on care is not consistent with how I practise my medicine,? she said. ?So it?s probably better that they find a doctor who they?re comfortable with, who they can talk to, and who can handle their specific needs better than me.?
Of her more than 3,000 patients, Kamalia says she discharges less than 1 per cent, basically those with parents who ?adamantly refuse? immunization. Doctors have the right to end a relationship with a patient when there is a ?breakdown of trust and respect,? according to the Ontario College of Physicians and Surgeons.
Children receive their first set of vaccines at two months and in Ontario are required to get vaccines for diphtheria, tetanus, polio, measles, mumps and rubella in order to attend school. However, an unvaccinated child can attend if a medical note or a statement of conscience or religious belief is provided to the Medical Officer of Health.
Within the first month of a newborn?s life, Kamalia discusses how parents will proceed with their child?s vaccinations.
If parents have concerns about potential risks and side effects, she gives them updated medical literature to read, cites cases of people who developed illnesses because they weren?t vaccinated, and emphasizes that she has no ties to vaccine companies.
If parents are still resistant, Kamalia offers a modified vaccination schedule, and has them sign a waiver indicating that this was their decision.
Discharging patients is a ?last resort,? she says. Unvaccinated children put her other patients at risk, and ?at the end of the day, I have to make a decision as to how I run my practice.?
Right now, Kamalia says she has no unvaccinated patients, and a maximum of five are on modified schedules. She says in the last three to four years she?s had fewer parents raise concerns about vaccines.
Yamashiro estimates that one in 25 to 30 parents in Ontario refuse immunizations for their child, or place their child on a modified vaccine schedule. He adds that one in eight to 10 parents express concerns over how vaccines may affect their child.
?It?s a big problem because?you?re leading to more and more unimmunized children,? Yamashiro said. ?If this movement is allowed to fester, it?s like a wound. If you allow it to sort of grow, then you?re going to start affecting everybody?s health.?
As recently as 10 years ago, pediatricians rarely dealt with worried parents fretting over vaccines, Yamashiro said, but the increasing wealth of online medical information has resulted in misinformation.
?If there?s a secret hypochondriac living inside you, it?s going to feed that pretty quickly,? he said.
Yamashiro said parental fears over immunization have increased since 1998 when The Lancet, a prestigious U.K.-based medical journal, published a study linking autism with the measles-mumps-rubella (MMR) vaccine. In 2010, the journal retracted the study, led by Andrew Wakefield, who has since been stripped of his medical licence.
But there are those who are still wary of vaccines, such as Edda West, a B.C.-based grandmother and co-ordinator of the Vaccine Risk Awareness Network, a non-profit organization that provides information on the risks associated with vaccines.
West became an advocate of ?vaccine awareness? 35 years ago, after her then 15-month-old daughter became sick with a high fever and developed an ?atypical? case of measles. The incident led her to connect with parents who had had similar experiences.
?We believe most parents try very hard to make healthcare decisions that are in the best interest of their children,? she said. ?Well-informed parents know that there is a big gap in scientific knowledge about the impact of multiple vaccines on the health of their children.?
?They are concerned because doctors are unable or unwilling to discuss these concerns rationally and without prejudice.?
Oakville mother Erika Klein, who has a 15-year-old daughter, says doctors shouldn?t discharge patients over a disagreement of treatment or immunization.
?I just think it?s wrong that just because the parents have opted out of the vaccination ? why should they be denied care?? she said. ?It?s a (doctor-patient) relationship based on trust, and there?s a history there.?
Klein?s daughter Morgan received all of the required vaccines, but they opted out of the voluntary ones against meningitis and human papillomavirus. Klein says her doctor, with whom she has a good relationship, recommended the shots, but ?he didn?t force it on me.?
While he?s heard of other doctors turning patients away, Toronto-based pediatrician Marvin Gans says it?s best to deal with vaccine-averse parents diplomatically. He offers a delayed schedule, with the goal of eventually getting something into the child. Currently, less than 1 per cent of his patients are unvaccinated.
?If you turn them off, they may feel that nobody cares and medicine doesn?t listen,? Gans said. ?And there?s no hope of them coming back.?
Interesting.
Re: Pediatricians in Canada discharging unvaccinated children
Like parents with medical degrees who know WTF they're talking about?
My only concern with this is that it can be difficult to find another doctor, especially in smaller areas because there is a doctor shortage. So then you've got these kids with no GP. They can certainly use walk-in clinics (which I've found to have consistently good care) or the ER.
Though, perhaps those who don't vaccinate use the doc less anyway? I could see them using homeopathic or naturopathic doctors.
Our previous pediatrician, when we first met with them, told us they are pro vaccine and if we were to decide to not vaccinate our child, that they would have to ask us to find another practice. They didnt want unvaccinated coming into their offices.
So, this doesn't surprise me.
~Benjamin Franklin
DS dx with celiac disease 5/28/10
The bolded is the primary reason we chose our pediatrician. It came down to two practices that were pretty much equal (pro-BFing, evening hours, separate sick waiting room, etc.). One would see unvax'ed kids, the other wouldn't.
I think this is likely.
I groaned yesterday when the pediatrician was shocked (and pleased) that my 3 year old was up to date on his shots. I didn't realize this was a rare thing. Oh, and this was my son's first appt with this office (I switched to this practice when my daughter was born). I kid you not, at the last practice we went to, they were always out of vaccines. Not once while going there did he receive all of his shots at once. I had to call weekly to find out if they got more in (and was always treated like this was NBD). Then I'd get frustrated when they would tell me to just go on the Marine base to get it. I would then say they should suggest that to the military families, since they could actually go on base to get their kids immunized. They don't immunize civilian kids on base.
ETA:I realize this article is about Canadian practices, and apparently I have a lot of hostility towards my last pediatrician.
Ditto. I don't think our pedi practice outright refuses patients over it, but it was very strongly suggested at the open house we went to before DS was born that if you are not pro-vax you shoudl look elsewhere for a pedi.
DS1 born June 2008 | m/c at 9w March 2011 | DS2 born April 2012
I have to sign a form at my doctor saying that I will follow treatment plans or the relationship is over. I don't know how often they invoke the form, but it's there.
I think the pediatricians are doing the right thing, if someone is going to fight you at every appointment or if you know you are going to fight with the doctor every time - why would you want to keep seeing each other?
Glad to hear it.
Big time.
Thats probably my only gripe about the Canadian health care system. We need more docs.
Although interestingly enough, the 'brain drain' of docs going to the US has slowed down a lot in recent years, so hopefully things will smooth out. That was only a small part of the problem though - we didn't have enough students graduating from med school as well. And we were making it really difficult (and expensive) for foreign-trained docs to get their Canadian license.
Most of the parents I know who've been put in this situation (in the US) honestly DON'T want to keep seeing a doc who has a "my way or the highway" attitude. They'd ideally like to have an established relationship with a doctor they can talk openly with about their concerns, who treats them like people and not morons because they don't have "MD" after their name. Unfortunately, because of geographic and insurance concerns, not everyone has a lot of options when it comes to selecting doctors.
Frankly many of the non-vaccinating parents I know only take their child to the doctor if the child is truly ill. They generally don't do a lot of well baby visits, and they're not the type to freak out and run to the doctor when their baby has a sniffle. Generally the non-vaccinating parents are less work for a doc than the high maintenance new parents who freak out over everything and are constantly demanding an appointment for every runny nose, cough, or remotely elevated temp.
Meredith, 6-1-06 and Alex, 11-5-09
I don't understand this. "I don't trust my doctor and I think modern medicine is just the drug companies trying to kill my children, but if my child is REALLY sick then yeah, I'll take him to the doctor." Wouldn't that be the *last* time you would want to take your child to the doctor? When they're very sick and vulnerable? Why would you suddenly trust your doctor to make your child well?
I don't have an MD after my name and I've never been treated like a moron by a doctor. I don't think that doctors treat non-vaccinating parents like morons because they don't have an MD after their name. I think they might treat them like morons because they are willingly putting their children and other children at risk for preventable, debilitating, lethal diseases because of something they read on the Internet.
+1.
<a href="http://www.thenest.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Home D
Exactly this.
That is a paediatrician, so she will have more patients on file that a regular GP. My kids go to a GP and only see a paediatrician if I feel or my GP feels that the referral is necessary.
main reason i left my last practice..... i noticed it was only happening to certain patients and i think there was some shady insurance billing practices going on. you are not putting my kid at risk or on some wonky a$$ schedule to make an extra $50/visit. eff off biatches.