Interesting Article on Vaccinations

[shawnandangel]

http://news.yahoo.com/s/ap/20081201/ap_on_bi_ge/med_vaccines_cost

What it says is that some doctors are looking into not giving vaccinations to insured children because it can actually cost some doctors up to $30 to give the vaccine. (depending on who they buy from ect.)

Now this was shocking to me. I thought of my pediatrician who's practice here in nashville has 7000 patients. Over time this would cost the practice $210,000. Holy cow!

I mean the doctors office is a business just like anywhere else. They should make at least a small profit on the service they provide.

My question is, how do some doctors make a profit off of vaccinations and then others lose so much? I realize they buy from different companies and such but there's a big difference between losing 30 and making 30.

eh, I thought it was interesting!

[wellyes]

I mean the doctors office is a business just like anywhere else. They should make at least a small profit on the service they provide.


It's a business, but NOT just like anywhere else. The hippocratic oath demands that they "keep the good of the patient as the highest priority". If they want to change the vaccine reimbursement policy, they should try to get the policy changed.... lobby the government or put collective pressure on the pharmaceutical companies.

I know a lot of people are anti-vaccine, but I don't know of any pediatricians who are. IMO vaccines are critical to public health and NOT giving them for $$ reasons is immoral.

[firsttimemama]

I just got kicked out of my ped office because we don't vax yet (DS is 1 yr old)

I assumed it was a money motivated decision

Some of my friends who are more antivax said to me "well I guess they weren't making enough $ off the healthy (nonvaxed) kids"

I don't know if that's the case, but my DS has never had a sick visit in his first year. No ear infections, no antibiotics, etc.

I realize this is a controversial topic. Not trying to start anything.

My ped office though not only is refusing nonvaxers, they're refusing alternate schedules and selective vaxers. I think that's just wrong. I believe parents should make the choices for their children. Not the ped, not the AAP, not the CDC...

[brittone2]

I just got kicked out of my ped office because we don't vax yet (DS is 1 yr old)

I assumed it was a money motivated decision

Some of my friends who are more antivax said to me "well I guess they weren't making enough $ off the healthy (nonvaxed) kids"

I don't know if that's the case, but my DS has never had a sick visit in his first year. No ear infections, no antibiotics, etc.

I realize this is a controversial topic. Not trying to start anything.

My ped office though not only is refusing nonvaxers, they're refusing alternate schedules and selective vaxers. I think that's just wrong. I believe parents should make the choices for their children. Not the ped, not the AAP, not the CDC...

The AAP in recent years even came out with a statement saying doctors should NOT reject patients who choose to not vax or use an alternative schedule. Of course, they still encourage doctors to pressure those parents, but their statement is that parents should not be rejected from a practice for their decision.

[o_mom]

Our peds office will refer you to the health department if your insurance doesn't pay a minimum amount for vaccines. Basically it is their wholesale cost, so the time and supplies are given free, but if they can't at least get the cost of the vaccine back they won't do it. The health department here has free vaccines for under age 2 and very low cost ($5?) for those over 2.

[egoldber]

The health department here has free vaccines for under age 2 and very low cost ($5?) for those over 2.

Our health department will not give your child vax if you have private insurance. So if you have crappy private insurance and your ped won't vax you I'm not sure what they will do.

[Tondi G]

thats interesting. I am pretty sure my peds office wouldn't be too keen on non vaxing parents... they are very pro vax. They have never made me feel bad about not wanting to give my kids a flu vax or wanting to hold off if my kiddo was sick.

My neighbor is wanting to do a delayed schedule and not give several vax and she had a really hard time finding a ped who would take her child as a patient! She is actually at the hospital as we speak delivering her baby (9 days late!).

[tnrnchick74]

My ped will allow an alternate schedule, but if you refuse (and do not plan to give) a vaccine 3 times, then they will release you from their practice. I understand parents wanting to not vax, but the peds also have to take responsibility for the fact that your child is not immunized and could possibly get a disease as well as pass it to those too young for a specific vax. I understand all point of view. For me, it's too great a risk to take - we are vaxing, but on a slightly alternate schedule as agreed upon with the ped.

[brittone2]

directly from the CDC:

Many of the concerns that providers have about caring for unimmunized children can be addressed.
“I don’t want to be held responsible if the child contracts a vaccine-preventable disease”
Liability to a provider in case of an occurrence of a vaccine-preventable disease in an unimmunized patient can be addressed by documenting in writing all immunization discussions and parent refusals in the patient’s record. The American Academy of Pediatrics offers a refusal to vaccinate form (exit).

“If a parent doesn’t trust my judgment about vaccines, they won’t heed my advice regarding other issues”
A parent’s reluctance to heed immunization advice does not necessarily mean that the parent will dismiss other medical advice.

“I don’t want to put my other patients at risk”
Doctors’ offices and clinics can manage the risks of transmission of vaccine-preventable diseases in their facilities by adopting the same methods used to control other communicable diseases

Also from the same page:
Excluding patients from your practice whose parents decline immunizations is not deemed the best public health strategy. Remember, unimmunized young children did not decide for themselves to forgo vaccination. If you don’t care for them, who will?


from:
http://www.cdc.gov/vaccines/pubs/providers-guide-parents-questioning-vacc.htm

[firsttimemama]

From the CDC article:

Remember, unimmunized young children did not decide for themselves to forgo vaccination. If you don’t care for them, who will?

wow.
just wow...

[brittone2]

Remember, unimmunized young children did not decide for themselves to forgo vaccination. If you don’t care for them, who will?

wow.
just wow...

well, I think that could be read two ways. I'm not a CDC fan ;) but they may mean if one physician dismisses a family for not vaccinating, how do they know another physician won't do the same? Why is it another physician's job to treat the child but not the physician who chose to dismiss the family for refusing to vaccinate?

At least, I think that's what they are suggesting, which actually makes sense to me. I don't think they mean the parent won't care for the child, etc.

[egoldber]

You know, the article the OP mentioned was about PEDs who refuse to vax. ;)

[mommy111]

It's a business, but NOT just like anywhere else. The hippocratic oath demands that they "keep the good of the patient as the highest priority". If they want to change the vaccine reimbursement policy, they should try to get the policy changed.... lobby the government or put collective pressure on the pharmaceutical companies.

Doctors have to feed their families and keep their doors open too. They cannot and should not be expected to pay for my child's vaccination out of their own pockets. Pediatricians are amongst the worst reimbursed docs around. And docs have been lobbying govt, only pharma companies and insurance companies have been doing it more effectively because they have more money and a better lobby.
I would throw it out that if we want better health care for our kids, that we lobby for it, and vote for it and insist that the govt do something about it.

And I completely agree that a doc has the right to recommend vax for my child but not to force them on me, and while they can refuse to care for my child if I refuse vaccinations, I am not sure I'd want to keep seeing such a doc anyway, who thinks he/she should have more say in my child's treatment than I should.

[o_mom]

CDC: "Remember, unimmunized young children did not decide for themselves to forgo vaccination. If you don’t care for them, who will?"

wow.
just wow...

I think in this context "care" means "provide medical care" - as in if you dismiss them from your practice there is a good chance they will go without any medical care.

[brittone2]

ack double post

[brittone2]

I think in this context "care" means "provide medical care" - as in if you dismiss them from your practice there is a good chance they will go without any medical care.

agreeing. For some reason the quotes got funky...just clarifying that I agree with you O_mom. For all of my lack of love for the CDC, I agree with their point here. eta: the one quote above makes it look like I said "wow, just wow" but that wasn't my quote. Then I tried to quote O_mom and it attributed her statement to firstimemama. Confusing!

[o_mom]

agreeing. For some reason the quotes got funky...just clarifying that I agree with you O_mom. For all of my lack of love for the CDC, I agree with their point here. eta: the one quote above makes it look like I said "wow, just wow" but that wasn't my quote. Then I tried to quote O_mom and it attributed her statement to firstimemama. Confusing!

Fixed that!

[brittone2]

Fixed that!

No problem! I was posting about how that quote was misattributed to me in the formatting, and then the same thing happened to me...one of your posts ended up attributed to firsttimemama in the formatting.
:duh:

[m448]

physicians are relieved of any injury to a child who is vaccinated so I don't understand why they worry about liability in the case of an unvaccinated child.

Also the public health issue is not merely one of unvaccinated children spreading diseases. Most outbreaks these days are happening in vaccinated populations. In fact, with many live vaccines taking a healthy child to a checkup in a pedi's office is a risk whether there are vaccinated OR unvaccinated children in the waiting room. Especially for those younger children too young to receive vaccines. All those live MMR and flumist recipients are a risk for others.