Should pediatricians/physicians who actively discourage vaccinations lose their license?

[MEN2C]

Not talking about the practice of allowing or disallowing patients who are vaccinated into your practice. I'm talking about physicians who regularly advice their patients not to vaccinate.

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[shepardsun]

As soon as there's a single example of morbidity in their patient population as a result of a vaccine preventable illness in which the parent's inclinations were to vaccinate but the physician talked them out of it, I think that would be a board reportable offense, if not a textbook definition of malpractice, given the standard of care. Certainly they should be challenged and if necessary ostracized by their colleagues well before that.

 

[SurfingDoctor]

Say you make it a ground for remediation by a licensing board, how would you prove it? Most physicians aren't going to document "I counseled patient's family not to get vaccinations". Alternatively, the families I've encountered as vaccine refusers don't need a doctor to convince them... they've got the internet for that. The burden of proof would be very hard I would imagine. I mean, I don't really care either way, but it doesn't seem like a practical solution to go after the rare idiot physician who thinks vaccines are bad. The California approach of mandated vaccination to enter school seems far more practical.

 

[BigRedBeta]

I can make the argument either way.
On a visceral level, I agree their should be consequences, probably in part because in the PICU, it's suddenly "modern medicine will save my baby" for 97% of the anti-vaxxers, and there are real consequences for PICU survivors.
On a practical level, is licensure the appropriate response? Fines? Getting tarred and feathered? I'm not sure what is likely to impact their decision making the most and also avoids making them a martyr for a deluded population.

 

[thetubes]

I bet these docs have don't tread on me plates

 

[NurWollen]

I bet these docs have don't tread on me plates

Honestly I'd say anti vaxxers in general probably have a bimodal distribution of political beliefs. Lots of HuffPo and Breitbart fans, not a lot of WaPo or WSJ fans.

In other words, they're the nuts on both sides.

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[MEN2C]

I guess my argument would be let's say when kids come in with septic shock, and you regularly advise herbal tea and advise against fluids and antibiotics, even if the kids don't end up dying, you'd lose your license eventually right? There is a certain level of standard of care that we all need to follow.....

 

[deleted480308]

I guess my argument would be let's say when kids come in with septic shock, and you regularly advise herbal tea and advise against fluids and antibiotics, even if the kids don't end up dying, you'd lose your license eventually right? There is a certain level of standard of care that we all need to follow.....

As the med board acts as de facto govt control, I’m really against the proposal

But if a specialty board wanted to revoke board certification as a symbolic measure? But thr person could still legally practice? That’s more tenable even if I don’t thunk it’s necessary

 

[BigRedBeta]

As the med board acts as de facto govt control, I’m really against the proposal

With regards to care of adults who are able to make their own decisions with informed consent, yes, I agree with your position.
Children as a vulnerable population are different legally and ethically and as such their care should be open to a greater level of scrutiny to protect them. It's one thing to be within a stone's throw of the standard of care, it's another to be actively running the other direction.

Honestly I'd say anti vaxxers in general probably have a bimodal distribution of political beliefs. Lots of HuffPo and Breitbart fans, not a lot of WaPo or WSJ fans.
In other words, they're the nuts on both sides.

Indeed. I find the hypocrisy when their kid is critically ill on the far left far more irritating. Probably has to do with the fact that they eventually come around to letting me do what I need to do, it just takes hours of discussion over every single decision...the right wing nuts just leave me dumbfounded when they start talking about government conspiracies and the like. Easier to just leave the room.

 

[SurfingDoctor]

I guess my argument would be let's say when kids come in with septic shock, and you regularly advise herbal tea and advise against fluids and antibiotics, even if the kids don't end up dying, you'd lose your license eventually right? There is a certain level of standard of care that we all need to follow.....

Well, not doing something when someone is ill is a different legal argument than doing something when someone is not ill yet.

 

[Stitch]

It's a tough question. I don't think it's the role of a licensing board in general. When I was in fellowship there was a local family doc who recommended against vitamin K shots for newborns. We saw a fair number of severe bleeds. We reported him to the medical board, but nothing came of it. Medical boards in general don't have the 'right' kind of teeth to deal with these issues. I do think professional organizations like the AAP have an obligation to call out these quacks, though the AAP has been pretty reluctant to do so. Paul Offit is pretty vocal as well in terms of how to deal with this situation. Removing the board certification also doesn't make sense to me, because that's just passing a test, which they can do.

And yes, there are anti vax crazies on the right and left. They are incredibly frustrating to deal with.

 

[Jojos]

absolutely, their actions directly lead to endangerment of other children (and sometimes) adults in addition to perpetrating an incorrect myth.