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You're a physician. Act like it.

May 26, 2017

A local pediatrician wrote a blog entry this past week where he referred to those that question if our current vaccine schedule is safe for all children as "yapping dogs urinating on the tree of immunization." 


Yes, you read that correctly. A physician referred to patients as urinating yapping dogs. 


How have we arrived at a place where it is publicly acceptable for physicians to act in this manner? He is not the first physician to have written in such an unprofessional manner on this subject and he is unlikely to be the last. It is excused and even applauded. Why? Because vaccines.


I am not going to discuss the safety of vaccines here, only the manner in which we debate it. Specifically, the way physicians discuss and write about the topic.


Our treatment of the topic begins-where else?- Facebook.


I’ll admit I spend a good amount of time on Facebook. I like to see what political/social justice type things my friends from college are up to. I like to post pictures of my kids for distant friends to see. Sometimes I’ll take one of those quizzes: Which Golden Girl are you? (I got Rose, in case you’re wondering. I was really hoping for Dorothy but I guess I haven’t matured to her level of sass and pith quite yet).


One thing that dominates my feed are posts from my fellow doctors and nurses bashing parents who don’t vaccinate their kids. And yes, I mean bashing. I don’t mean expressing concern for their children. I don’t mean seeking to find ways to turn the tide of increasing numbers of people not vaccinating their kids. I mean, bitching about them and how they’re screwing up herd immunity for the rest of us because they are bad people who ignore science.


I have issues with this.


Ironically, these people of science are not being scientific at all. The whole argument is that these crazed non-vaccinators are ignoring science. They’re irrational. They’re backwards (some even compare them to the Taliban). They’re stupid. They’re ignorant. The problem with this argument is that the accusers here are ignoring the fact that they themselves are not being scientific in the way they engage. Let’s look at the facts:


-By and large, non-vaccinating parents are highly educated with average to above average intelligence. That’s what the research shows us. Most of them have read everything their doctors have read and come to the decision that it’s not compelling evidence to them for one reason or another. So, calling them stupid or irrational simply isn’t accurate.


-Most parents who do not initially vaccinate will vaccinate their children within a few years. The vast majority of patients questioning vaccination cite their doctor as their most trusted source of information. But here’s the rub: the research shows that if their doctor comes at them with the attitude most doctors hold, these parents actually become *more* likely to not vaccinate. What has been shown to work, scientifically, is for physicians to engage in respectful, open minded dialogue with them and not engage in scare tactics or intimidation.


We have an obligation as physicians to pediatric patients of these parents and also to the greater community and society. Those physicians who feel universal vaccination is vital for the health of children thus have an obligation to work to convince non-vaccinating parents of our pediatric patients to change their mind. We’re tossing aside evidence based medicine and compromising our service to our patients and society with our attitudes towards these parents.


Why? Basically because this topic makes most doctors really really mad. And we allow really really mad to get in the way of our obligation to these kids. We find it emotionally comfortable to get angry and make it into a moral failing in these parents. Some of it is righteous anger in defense of community health. Some of it is control issues. We don’t like it when patients don’t do what we say. We got into medicine to help people and now they’re not letting us help them. Maybe it makes us sad to see them hurting themselves. Maybe it an