Doctors "firing" patients refusing to vaccinate their kids

[iheartscience]

Re: Doctors "firing" patients refusing to vaccinate their ki

I think they should "fire" patients who smoke and eat high cholesterol foods too. Those behaviors are risky as well, right?

Two major differences Laila.

One, having high cholesterol and smoking is something most commonly an issue with adults whose risky behaviors are affecting themselves. A doctor in this case can only advise. You can take a horse to water but you cannot make him drink it. But by not vaccinating when necessary you are putting your child (and so many others) at risk.

Secondly, this type of behavior (except for secondhand smoke but that's a different topic for another day) doesn't affect the whole population. It affects the adult who is engaging in the poor eating, lifestyle and exercise habits.

You are looking at 2 ends of the spectrum in any case. You cannot logically compare one to the other. Not vaccinating your helpless to decide for themselves children is not the same as your decision to engage in poor lifestyle habits that affects primarily you.

Galateia, I'm sorry for what you went through...how awful!

Ditto missy.

Laila, an adult with high cholesterol vs. an adult choosing not to vaccinate their children based on no scientifically sound evidence whatsoever are not even close to analogous.

 

[dragonfly411]

Re: Doctors "firing" patients refusing to vaccinate their ki

First let me say I am NOT Trying to compare children to dogs. BUT

Where I am from, you are required BY LAW to vaccinate your dogs/cats and have proof of such. I agree 100% with the doctors offices. Why should they run risks for your refusal? Why should they be held responsible as the office that treats the child if YOU refuse to take precautions. I think it should be required BY LAW to vaccinate children. It is beneficial to them in the long run. I am here. I do not have autism or anything else. I was fully vaccinated.
Many places here will not see an animal that hasn't been vaccinated, such as shows, doggy daycares, groomers. It'd be interesting if schools, sitters and other services would do the same for children.

 

[kenny]

Re: Doctors "firing" patients refusing to vaccinate their ki

I've spent hour researching vaccines, the different types, the ages, the benefits and potential harms that they could cause a child. When they first came out they weren't even given to pregnant women and young babies-but now that's a very common practice.

Due to the nature of this topic I don't feel comfortable sharing my beliefs on this since so many people have IMO very aggressive view points and stands and making claims that those who chose to not vaccinate are horrible and ignorant parents. While many of the studies that support vaccines are done by the companies themselves or off shots of the companies. Another thing to consider is that many of these things that have experienced a decrease in activity also has to do with more of the awareness of over all general hygiene and having clean water and a water treatment plan. Back in the day people just threw their crap out the window and onto the streets below spreading disease like wild-fire-which is now no longer a common practice.

If people chose to vaccinate their children should be safe-although recent outbreaks in Cali showed that out of the children who got it (I believe it was mumps or something like that) half had been vaccinated and the other half had not.

Many people chose to wait and space out the vaccinations. But claiming that the parents are ignorant and bad parents is just plain foolish. Everyone has the right to chose. We can't say a woman has a right to chose and then say parents have no right to chose for their children. My husband wasn't fully vaccinated and he is just fine and went to public school (although those laws may have changed since then). Many people for religious purposes chose not to vaccinate and I for one don't believe anyone should be forced to do anything that they don't agree with. Many studies have come out on different medication (not speaking of vaccines here) and other things and then you see all these law suites done with since they did damage to a huge number of people and now the lawyers are suing the company. Many girls who have gotten the gardasil vaccination (which btw I also got but had I done my research I wouldn't have) have had clots-nerve damage and quite a few have even died after receiving them. Now they are pushing for boys to also get the vaccine. I just did a quick google search and didn't verify the facts of the articles but I thought I'd link them for interesting reading.
http://abcnews.go.com/Health/CancerPreventionAndTreatment/gardasil-hpv-vaccine-faces-safety-questions/story?id=8356717

http://pediatrics.about.com/od/immunizations/a/0307_hpv_cntvsy.htm

http://www.topsecretwriters.com/2011/12/proven-dangers-and-side-effects-of-gardasil-from-merck/

I myself was vaccinated as a child but that was because I was in the foster care system. Many parents have spent hours reading study after study-eating healthy and making sure their children aren't exposed to to much TV, sugars, get the proper amount of protein, and also chose not to vaccinate. Some chose to do so-I think every parent has a right to make an informed decision and every doctor has a right to chose to refuse the patient if that is what they feel is what is best for their practice.

I respect everyone opinions and choices, but this topic is about putting OTHERS in danger.
Some freedoms must be curtailed for the good of society.
Red lights and stop signs also impinge on your freedom.

 

[wildcat03]

Re: Doctors "firing" patients refusing to vaccinate their ki

http://abcnews.go.com/Health/CancerPreventionAndTreatment/gardasil-hpv-vaccine-faces-safety-questions/story?id=8356717

http://pediatrics.about.com/od/immunizations/a/0307_hpv_cntvsy.htm

http://www.topsecretwriters.com/2011/12/proven-dangers-and-side-effects-of-gardasil-from-merck/

If you consider abcnews.com, about.com, and "topsecretwriters.com" valid medical literature sources, then there's not much anyone can say to change your mind.

 

[vintagelover229]

Re: Doctors "firing" patients refusing to vaccinate their ki

Wildcat-you didn't read my post. I said I did a quick google search and pulled up 3 results and didn't verify the information I just said it was interesting reading.

And Kenny-comparing red lights to this isn't the same. But those who get vaccinated should be safe from those who haven't based on the fact they've received it. The argument is if they should be allowed in schools and or refused care at a doctors office for those who have yet to be vaccinated and could potentially be exposed. Doctors have every right to refuse who they want-there are alternative forms of care such as holistic medicine for those who can't find a provider and as for the schools that's up to the government to decide. Parents can always chose to home school if they decide not to vaccinate and the system changes the laws requiring it for daycare and schooling purposes.

 

[Circe]

Re: Doctors "firing" patients refusing to vaccinate their ki

Wildcat-you didn't read my post. I said I did a quick google search and pulled up 3 results and didn't verify the information I just said it was interesting reading.

And Kenny-comparing red lights to this isn't the same. But those who get vaccinated should be safe from those who haven't based on the fact they've received it. The argument is if they should be allowed in schools and or refused care at a doctors office for those who have yet to be vaccinated and could potentially be exposed. Doctors have every right to refuse who they want-there are alternative forms of care such as holistic medicine for those who can't find a provider and as for the schools that's up to the government to decide. Parents can always chose to home school if they decide not to vaccinate and the system changes the laws requiring it for daycare and schooling purposes.

Er ... actually, this isn't true. A child who's gotten the vaccine has increased resistance to the live virus, but if a bunch of kids in close proximity to him haven't been vaccinated spread the virus in his vicinity, there's a chance he can get it. There's also a greater chance of viruses mutating and our current vaccines becoming inefficient.

The way I look at it ... I read a lot of history. Back in the day, it wasn't uncommon for people to lose a sibling or three to common childhood diseases - and, no, mumps and polio weren't affected by changes in hygiene (they're airborne), but by dedicated researchers and a concentrated effort on the part of society. Me, I'd rather not go back to a time where you have to ask, "Oh, you have two siblings? And how many dead ones?"

As for the parallel between a woman's right to choose and parents right to choose for their children - bad analogy, and right up there with high cholesterol. People have every right to choose what happens to them - it's when their decisions endanger others that the government needs to step in.

 

[Octavia]

Re: Doctors "firing" patients refusing to vaccinate their ki

I have a severe allergy to tetanus, which was discovered through vaccinations. After I got my initial DPT vaccination, my parents had to rush me to the ER. The doctors thought it was a reaction to the pertussis part, so the next time I just got DT and reacted again. After that, they finally figured out what it was. Unfortunately, this means I cannot be vaccinated against pertussis (whooping cough) because the vaccination ONLY comes in combination with tetanus, which scares me. It's definitely something I will discuss with my doctors prior to TTC.

Even so, I would never consider not vaccinating my children. I might just be hyper-vigilant about talking to the doctors about my history, any potential issues, and procedures if a reaction occurs. But as long as I'm comfortable with my doctor, I generally trust their recommendations. I don't stick with doctors who don't listen to me or don't give me a good feeling.

Personally, I don't know if I agree with "firing" families who are already patients, as I feel the doctor has already made a commitment to treat them. However, I see nothing wrong with encouraging those families to switch to a practice more in line with their beliefs, or screening new patients to ensure they intend to comply with the practice's recommendations. When I become a parent, it will be important to me that the practice we choose has a vast majority of vaccinated kids (making allowances for instances where an alternative might be medically necessary).

 

[packrat]

Re: Doctors "firing" patients refusing to vaccinate their ki

Even if you home school and your kids never go to daycare, at some point in their lives they'll have to go outside and be around other people. And being vaccinated doesn't guarantee you'll never get it..the less people are vaccinated the more the diseases will come around and the greater your chances of getting it, vaccinated or no. Are they even life long vaccinations anyway? I work at a Dr's office and had to get boosters last year, even tho I had all my shots as a kid..and yeah, I gave myself a damn sucker afterwards. Four injections and a TB test? Sucker time.

We had a course of measles come thru here a few years ago, and a lot of little kids got sick, and they traced it back to a town 45 minutes away from here and kids that hadn't been vaccinated. Meningitis swept thru here a year or two after that, and we had some High School kids die. A woman I used to work w/, her son ended up in intensive care and narrowly made it back out, b/c of it.

It just takes *one* person to get it, and the more people who aren't vaccinated who are in contact w/that person, the easier it's going to spread.

 

[Tacori E-ring]

Re: Doctors "firing" patients refusing to vaccinate their ki

If doctors feel like refusing vaccines is unethical than I think it is their right not to want patients who refuse them. I am confused why people refuse them after the autism link research was proven false.

 

[kenny]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have exploited this for eons.

 

[Porridge]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have used this for eons.

Sensationalism. "Vaccines Linked To Autism" sells more papers than "Everyone's Fine"

Also not many people can wade through the "information" that's out there. How many people do you think regularly peruse PubMed? Not as many as those who hang on Oprah's every word and are starstruck by ex-Playmates I'll bet. The amount of misinformation that is out there is terrifying.

ETA - after that study was proven false, retracted, and it was discovered that its author had an agenda to push his own pharmaceuticals in place of those he was "studying", did the Oprah/Jenny McCarthy's of the world discuss this at all? Was it widely publicised in the US?

 

[kenny]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have used this for eons.

Sensationalism. "Vaccines Linked To Autism" sells more papers than "Everyone's Fine"

Also not many people can wade through the "information" that's out there. How many people do you think regularly peruse PubMed? Not as many as those who hang on Oprah's every word and are starstruck by ex-Playmates I'll bet. The amount of misinformation that is out there is terrifying.

Are you saying people . . . have been . . . uhm . . . USA-Todayed?

 

[Porridge]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have used this for eons.

Sensationalism. "Vaccines Linked To Autism" sells more papers than "Everyone's Fine"

Also not many people can wade through the "information" that's out there. How many people do you think regularly peruse PubMed? Not as many as those who hang on Oprah's every word and are starstruck by ex-Playmates I'll bet. The amount of misinformation that is out there is terrifying.

Are you saying people . . . have been . . . uhm . . . USA-Todayed?

Haha...(googles USA Today)...yes I am!
As per my above ETA - did the USA Today's of the world discuss the retraction and subsequent discoveries at all?

 

[iheartscience]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have exploited this for eons.

YUP. This sums up, well, everything that makes no sense.

 

[Porridge]

Re: Doctors "firing" patients refusing to vaccinate their ki

In response to the original article, I can completely understand why doctors would not allow unvaccinated children in their clinic. They have a responsibility to their other patients.

Herd immunity is so vital, it's just staggering that people chose to deny their children such important protection and are willing to put others at risk. I'm fully in support of healthy skepticism, but there is no evidence to support not vaccinating children. The risks are so minimal compared to the possible consequences. Can people really forget history so quickly? The average life span is decades longer, child mortality is vastly reduced along with meningitis, mumps, measles... polio is all but eradicated, not to mention small pox... I mean for god's sake it's as plain as day!

 

[amc80]

Re: Doctors "firing" patients refusing to vaccinate their ki

I am confused why people refuse them after the autism link research was proven false.

Fear trumps reason.

Religions and politicians have exploited this for eons.

YUP. This sums up, well, everything that makes no sense.

You know, it's funny. I consider myself to be generally intelligent, logical, and reasonable. I never believed the autism link and was happy when that study was crushed. I plan on fully vaccinating my kids. At the end of the day I d believe vaccinations are safe...But a little itty bitty piece of my brain still wonders "what if?"

 

[diamondseeker2006]

Re: Doctors "firing" patients refusing to vaccinate their ki

I have lived my entire life with the side effects, and have a myriad of heath problems that made it a miracle I even made it to adulthood, due to vaccines. Despite having an immune system and overall physiology irreparably damaged by vaccinations, I am still in support of giving children vaccines, but not until they are at an age where their bodies can handle them.

People like to think that vaccinating infants is harmless, but I stayed sick for the first 18 years of my life (bedridden for many of them) thanks to this 'harmless' practice. Guess those few who are a 'statistic don''t even bear mentioning as a cause for pausing and making an educated decision fully aware of the risks before taking the leap.

Thank you for posting, Galateia. I see that there is some ignoring of the fact that some kids ARE harmed from vaccinations (forget autism!)! I think it is a parent's job to research the vaccines and determine which ones are worth the risk. We have seen time and again new meds or vaccines come on the market and after a certain number of people DIE, they pull the med or vaccine.

The fact is, babies today are given about double the number of vaccines my older kids had in the 80's. I under no circumstances would put that many toxins in my baby at one time today. We don't even know the long term effects of some of the newer ones.

Thankfully, my daughter is well educated and reads up on the vaccines, which have aluminum, etc., and with her outstanding pediatrician, they spread out the essential vaccines and delay others for her baby. For example, my kids got Hep B vaccines when they were around 12. The recommendations say that this is mainly for kids who will be sexually active and isn't likely to be "caught" in the waiting room. They don't need that one when they are newborn! My daughter eliminated pediatricians who seemed arrogant and who did not value parental input, so it can work both ways. She found a fantastic practice of young pediatricians who are open to and trained in alternative natural treatments and who are pro-vaccine but who work with parents to alter the schedule to allow the baby not to receive so many at one time. When they receive several at a time and have a reaction, then you have a serious problem figuring out which one caused the problem. Dr. Sears newly revised book on vaccines is excellent and something I plan to give as baby shower gifts. He is pro-vaccine but helps parents be educated about what they are giving their babies and offers alternative schedules.

I would be hard pressed to blindly trust the government on anything!

 

[Asu]

Re: Doctors "firing" patients refusing to vaccinate their ki

Wow.This is nuts to me.
where I am from,vaccinations are mandatory.You can't enroll your kids in school without it.But that's not the big problem,the point is that you risk troubles with the social workers if you don't.There is a list of all the kids born and living in every province,and for every age group there a few mandatory vaccinations,that are free,but that you can't refuse to have.
there are also a few that are optional (like the one for meningitis,because it only cover the less dangerous type of the disease anyway,and it's one of the few vaccines that caused the most problems afterward.),and for those you have to pay,but everything else is free,paid by national health care.I've heard of people not doing the optional vaccines,but everything else is mandatory,and no one would ever dream of not getting them!Talk about putting everyone else at risk

 

[wildcat03]

Re: Doctors "firing" patients refusing to vaccinate their ki

Wildcat-you didn't read my post. I said I did a quick google search and pulled up 3 results and didn't verify the information I just said it was interesting reading.

I did read your post. I was just perplexed/puzzled at the choices. Yes, a google search can turn up anything (example: Google "vaccines and autism). That doesn't necessarily make it true or worth posting.

 

[kenny]

Re: Doctors "firing" patients refusing to vaccinate their ki

Yes a tiny minority may be harmed by vaccinations.
But many more will be saved.

Should we opt to harm 1000 or save 1000 and harm 1?

(Numbers are made up and not relevant to the point.)

A couple unconscious people will also drown or burn because they could not unbuckle their seat belts after an accident - yet zillions are saved by them.

I'm very sorry if you are one of the burned or drowned ones, but overall seat belts are still a groovy thing by a huge margin.

 

[missy]

Re: Doctors "firing" patients refusing to vaccinate their ki

I don't know if you guys remember this story but it really struck a chord with me. So terribly sad.

http://danamccaffery.com/medicine.pdf

 

[wildcat03]

Re: Doctors "firing" patients refusing to vaccinate their ki

I have a severe allergy to tetanus, which was discovered through vaccinations. After I got my initial DPT vaccination, my parents had to rush me to the ER. The doctors thought it was a reaction to the pertussis part, so the next time I just got DT and reacted again. After that, they finally figured out what it was. Unfortunately, this means I cannot be vaccinated against pertussis (whooping cough) because the vaccination ONLY comes in combination with tetanus, which scares me. It's definitely something I will discuss with my doctors prior to TTC.

People like you, who have life threatening reactions to vaccines, are why the rest of us are morally obligated (although some people choose to dismiss/ignore that obligation) to be vaccinated. Our immunity protects you. But "herd immunity" only exists if a large percentage of the population (estimated to be >90% in some diseases) is immunized. Whooping cough is a really good example of a disease for which we are at risk of losing herd immunity, because the vaccine is pretty short-lived compared to others.

Public Service Announcement: Women of childbearing age should be vaccinated for pertussis prior to getting pregnant. Also, get Dad and any grandparents vaccinated, too! Pertussis can kill babies.

 

[Laila619]

Re: Doctors "firing" patients refusing to vaccinate their ki

I think they should "fire" patients who smoke and eat high cholesterol foods too. Those behaviors are risky as well, right?

Two major differences Laila.

One, having high cholesterol and smoking is something most commonly an issue with adults whose risky behaviors are affecting themselves. A doctor in this case can only advise. You can take a horse to water but you cannot make him drink it. But by not vaccinating when necessary you are putting your child (and so many others) at risk.

Secondly, this type of behavior (except for secondhand smoke but that's a different topic for another day) doesn't affect the whole population. It affects the adult who is engaging in the poor eating, lifestyle and exercise habits.

You are looking at 2 ends of the spectrum in any case. You cannot logically compare one to the other. Not vaccinating your helpless to decide for themselves children is not the same as your decision to engage in poor lifestyle habits that affects primarily you.

Galateia, I'm sorry for what you went through...how awful!

Ditto missy.

Laila, an adult with high cholesterol vs. an adult choosing not to vaccinate their children based on no scientifically sound evidence whatsoever are not even close to analogous.

But the smoking sure does affect others.

 

[missy]

Re: Doctors "firing" patients refusing to vaccinate their ki

I think they should "fire" patients who smoke and eat high cholesterol foods too. Those behaviors are risky as well, right?

Two major differences Laila.

One, having high cholesterol and smoking is something most commonly an issue with adults whose risky behaviors are affecting themselves. A doctor in this case can only advise. You can take a horse to water but you cannot make him drink it. But by not vaccinating when necessary you are putting your child (and so many others) at risk.

Secondly, this type of behavior (except for secondhand smoke but that's a different topic for another day) doesn't affect the whole population. It affects the adult who is engaging in the poor eating, lifestyle and exercise habits.

You are looking at 2 ends of the spectrum in any case. You cannot logically compare one to the other. Not vaccinating your helpless to decide for themselves children is not the same as your decision to engage in poor lifestyle habits that affects primarily you.

Galateia, I'm sorry for what you went through...how awful!

Ditto missy.

Laila, an adult with high cholesterol vs. an adult choosing not to vaccinate their children based on no scientifically sound evidence whatsoever are not even close to analogous.

But the smoking sure does affect others.

Laila, I acknowledged that fact if you had read my post. However, that still doesn't make your post a relevant analogy to the topic at hand.

 

[missy]

Re: Doctors "firing" patients refusing to vaccinate their ki

I have a severe allergy to tetanus, which was discovered through vaccinations. After I got my initial DPT vaccination, my parents had to rush me to the ER. The doctors thought it was a reaction to the pertussis part, so the next time I just got DT and reacted again. After that, they finally figured out what it was. Unfortunately, this means I cannot be vaccinated against pertussis (whooping cough) because the vaccination ONLY comes in combination with tetanus, which scares me. It's definitely something I will discuss with my doctors prior to TTC.

People like you, who have life threatening reactions to vaccines, are why the rest of us are morally obligated (although some people choose to dismiss/ignore that obligation) to be vaccinated. Our immunity protects you. But "herd immunity" only exists if a large percentage of the population (estimated to be >90% in some diseases) is immunized. Whooping cough is a really good example of a disease for which we are at risk of losing herd immunity, because the vaccine is pretty short-lived compared to others.

Public Service Announcement: Women of childbearing age should be vaccinated for pertussis prior to getting pregnant. Also, get Dad and any grandparents vaccinated, too! Pertussis can kill babies.

Huge ditto. We really are morally obligated IMO and to ignore that fact is just wrong.

 

[Laila619]

Re: Doctors "firing" patients refusing to vaccinate their ki

I know, Missy, I was replying to Thing. Sorry if I wasn't clear.

I'm just saying, why stop at firing anti-vaxers? Why not go all in? It's really a slippery slope IMO.

 

[amc80]

Re: Doctors "firing" patients refusing to vaccinate their ki

Public Service Announcement: Women of childbearing age should be vaccinated for pertussis prior to getting pregnant. Also, get Dad and any grandparents vaccinated, too! Pertussis can kill babies.

Yep! DH and I both got vaccinated a few months before we started TTC.

 

[Laila619]

Re: Doctors "firing" patients refusing to vaccinate their ki

Seriously though, I don't see what firing these patients will accomplish. Ultimately, it's the kid who will suffer, because the anti-vaxers are not going to change their minds. They have very strong convictions, so they'll either try to find a new doctor, OR they'll just stop taking their kid to any pediatrician. And then you have a child who is not receiving check-ups or medical care. Yikes. So I understand why doctors are doing it, but the end result probably won't be a good one.

 

[MakingTheGrade]

Re: Doctors "firing" patients refusing to vaccinate their ki

So as far as "firing" goes, maybe the better smoking analogy is the patient who insists on smoking while in the waiting room or in the exam room, despite the doctor having other patients who have to share that room who have lung issues. That patient, by refusing to be compliant to the doctor's practice guidelines, is putting those doctor's immediate patients at risk, and that's not something that the doctor has to tolerate since he has a duty to maintain the health of his other patients as well. Most pediatricians I know with this policy make it clear to the parents up front, and these are generally private practice pediatricians, not hospitals that provide emergency care, so it's not like you're refusing to give acutely live saving treatments in an emergency situation.

What I find more interesting and controversial is the Gardisil vaccination and whether teenagers should be allowed to get it without parental consent. Most vaccinations (with the exception of flu) we get when we're too young to have much opinion on the matter, but Gardisil currently is an option for many teenage girls, and it's a vaccination that potential curbs cancer (that's a pretty big benefit I'd say). However, parents sometimes feel strongly against it because it comes with the connotation that a girl is sexually active. Under most state law, minors can get testing and treating for STDs without parental consent because it can potentially be a public health issue if minors are too afraid of their parents to report and treat STDs. But this technically isn't treatment, it's prevention, yet isn't the public health benefit potentially even greater? Certainly you can argue both sides of this, but personally I'd be on board with teenagers being able to get this without parental consent. ideally, you could talk to parents and convince them about the importance of protecting their children from cervical cancer, but I know if I was a teen, there's no way my mom would ever have talked to me about Gardisil or let me get it, because she in her logic she would think that not having it would deter me from having sex. Brilliant...

Anyways, just thought I'd throw that out there since it's a current vaccination controversy.

 

[wildcat03]

Re: Doctors "firing" patients refusing to vaccinate their ki

Seriously though, I don't see what firing these patients will accomplish. Ultimately, it's the kid who will suffer, because the anti-vaxers are not going to change their minds. They have very strong convictions, so they'll either try to find a new doctor, OR they'll just stop taking their kid to any pediatrician. And then you have a child who is not receiving check-ups or medical care. Yikes. So I understand why doctors are doing it, but the end result probably won't be a good one.

I am a physician, albeit one with a unique perspective as an emergency medicine physician. Federal law prohibits me from "firing" or refusing to see any patient (EMTALA), but that does not apply to pediatricians. What does dismissing these patients from their practices accomplish for pediatricians? It allows them to sleep better at night. They can rest easier knowing that their patients aren't exposed to anything dangerous in their waiting rooms. They can look forward to their workday, knowing that they won't have to sign off on visits that directly oppose their moral beliefs and good public health. I had a long conversation with a few friends who are board certified pediatricians about this. One of them keeps all comers in his practice, the other dismisses non-vaccinating families after a few visits. The first visit is a discussion about why the parents are not vaccinating and what the physician's take on it is. The second visit is a chance for the parents to ask questions. He will accommodate alternate schedules as long as a certain number of the vaccines are given on or very close to schedule (Haemophilus, tetanus/diphtheria/pertussis, and MMR). On the third visit, the parent is presented with a copy of the child's medical record and a list of local physicians who might better serve that family. He will continue to see the child for visits for the next 30 days so that they can establish elsewhere. These children are not left without doctors (patient abandonment happens, but is also illegal). In/near almost EVERY city and in MANY small towns there is a local clinic that accepts all insurances including Medicaid/Medicare and essentially can not dismiss patients except under exceptional circumstances, so rarely will people be left without a pediatrician.