"You're Fired!" - When Doctors Refuse to Treat Kids



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 I have personally dealt with being 'fired' from a pediatrician’s practice. Here is some background on the prevalence, my experience, what you should do when (if) it happens, and why it ultimately may be a good thing.

Prevalence and Background  

According to the American

Academy of Pediatrics, 70% of pediatricians in America will deal with vaccination refusals.[1]

Although the AAP does not recommend exclusion of patients for refusal of vaccinations, as vaccine refusal becomes increasingly more common, many pediatricians have begun releasing children from their care who are unvaccinated.

A more recommended approach focuses on addressing a parent’s concerns and reasons for refusal and providing parents with information about the risks vs benefits of vaccination. [1]

If you have concerns about vaccines or any medication your doctor suggests, it is important to find a pediatrician who is willing to take the time to discuss any issues. In general, parents should consider the information that is provided by the doctor and if you have concerns your doctor can not answer reschedule the appointment until all of your concerns have been alleviated.

Reasoning

In general, doctors can fire patients for the following:

            Consistently missing appointments

            Refuse to pay bill

            Patient is non-compliant (refuses the recommendations by doctor)

            Seeks drugs for recreational use

Pediatricians or family practitioners that fire patients for differences of opinion may seem a bit extreme, especially in the case of caring for children. The doctor-patient (-parent) relationship has the potential of being very powerful. However, I do think there can come a time when the doctor and the patient (or parent) should have a frank chat whether they are right for each other. Why let it escalate to “firing” someone?

Personally, I think I should have had this discussion with the first pediatrician my daughters had. Sometimes the attitudes and beliefs a doctor holds is not compatible, creating an insurmountable barrier to the doctor-patient relationship. There are many other doctors to choose from – might as well move on to someone who will be supportive (not dismissive) of your concerns.

My Experience

Not to go into too much detail, but I had concerns originally with vaccines when my first daughter was born. At the 2 month-well-baby visit, I had asked the doctor what she thought about a delay schedule. She never asked why I might be considering one or if I had any questions – instead, she said she didn’t recommend it because it would mean (1) I would have to make extra trips to the office and (2) the child may become more fearful.

That should have been first tip-off that our relationship might get a bit rocky.

I obediently agreed with her and got all of the injections.

However, since that time 4 years ago, I became more confident in my understanding of the immune system. We decided to decline vaccines completely after that first round at 2 months. The doctor would say at every single visit that “she is vaccinating against diseases that can kill our daughter”.

Never once did she provide any medical literature regarding vaccines, information on the diseases themselves or other ways to enhance a child’s immune function – it was vaccines or nothing. Period.

After getting a very abusive voice message and letter from an office assistant at the doctors office. I wrote them a certified letter. I was done being treated like a zealot.

See the actual letter - 

Although the AMA informs doctors to clearly communicate verbally to the patient in a compassionate and support way when dismissing them from their practice – that didn’t happen in my case…we did not receive that courtesy. 

What To Do Now?

If your doctor fires you – you have a 2 options:

Try to mend the relationship:

If you want to go back and attempt to repair the relationship with your doctor, you will need to know what reason you were dismissed (which may or may not be apparent). Schedule a time to talk or you could try to do this over the phone.

Move on:

Make sure to get copies from the doctor who fired you first.

Regarding vaccines - before scheduling any appointments with new doctors, try calling prior and asking them if they support parental choice with vaccinations.

What NOT to do

Don’t get overly argumentative or aggressive.

Don’t ask the doctor that dismissed you for a referral. Your best bet is to find another doctor on your own, someone completely independent from the practice that you were at.

Don’t complain about the old doctor. It does nothing to move you forward. You may very well find someone much better suited for you. A total blessing.

Conclusion

I eventually did find a very supportive doctor, by referral of a friend following a similar vaccine schedule. However, I think I’ve grown into a better patient (we’ll mom of the patient) as well. For example, if the doctor wants to write a prescription for antibiotics, I let them and never fill it – instead of asking for the reasons why they think it might help. I don’t ask (as many) questions anymore. If I do have concerns, I research it for myself. If I did these things with the first doctor, my daughters may still be in their care.

But I’m very glad it didn’t work out. Funny how things in life don’t work out – and that’s a good thing!

If your doctor can’t (or won’t) take the time to alleviate all of your concerns, find someone caring enough that will. Don’t let the relationship escalate to a letter in the mail stating ‘irreconcilable difference’.

In the sick room, ten cents worth of human understanding

equals ten dollars worth of medical science.  ~Martin H. Fischer

References:

[1] Rhonda Patt. Some pediatricians ‘fire’ unvaccinated patients. Charlotte

Observers. May 27 2012

[2] Steven Harris. “Take care when firing a patient”. American Medical News.  Feb 4 2008