Doctor refuses to treat the unvaccinated

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An Alabama doctor announced he would not treat patients who refused to get vaccinated against COVID-19 ...

Alabama Doctor Refuses to Treat Unvaccinated COVID Patients

Specializes in NICU, PICU, Transport, L&D, Hospice.
12 hours ago, jive turkey said:

Can't answer 

That's what I thought 

I'm always down to agree to disagree.

peace.

The doc answered your question himself.  You either didn't read the article, didn't comprehend what you read, or you simply want to disagree with his reasoning or other reasoning offered in response.  Your pattern of commenting in these threads provides some clues and reflects a pattern, don't you think?

From the article: 

Quote

"If they asked why, I told them covid is a miserable way to die and I can't watch them die like that," Valentine wrote in his post.

 

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14 hours ago, jive turkey said:

Yea, and as mentioned above if that's the reason I'd call bull on that.  Sick people go to doctors offices and hospitals.  One disease is being picked on.  Just because someone isn't vaccinated doesn't mean they're infectious.  

What I see is people side stepping the question.  

I do think he means to make a statement and I don't know how I feel about that. But, I also don't believe he has an obligation to develop or attempt to maintain professional relationships with persons whom he recognizes will present a barrier to his personal ability to therapeutically provide care. A healthcare provider might decide this about any similar patient situation so long as it is not based upon discrimination against a protected class/population and is not illegal for other reasons. And sometimes they do. The fact that it isn't completely common helps us understand that most providers really do try to work with people to the extent that they can, to the extent that those people are gaining something from the relationship, to the extent that they are not fundamentally opposed to what the provider has to offer and to the extent that they are not endangering others. But they absolutely terminate relationships with abusive patients or others who won't take measures to keep office staff safe; this is not a new thing. I think you're underestimating what it means that we are currently in the middle of a pandemic. Grandma's laissez-faire attitude about the pneumonia vaccine doesn't have anything to do with this and is in fact mostly her problem. That is not the same as large numbers of people who want to participate in society but not do anything in anyone else's best interest.

A separate aspect, which I'm sure can be debated but many in the provider role might confirm, is that those who are distrustful of something like a basic public health recommendation during a pandemic often come with other attitudes and beliefs that make the relationships particularly cumbersome and stressful to maintain. For instance, aside from covid, those who believe MMR causes autism and all sorts of other things often make inappropriate requests and tend to be skeptical of recommendations in a way that is beyond both simple ignorance and healthy skepticism. I do not mean to generalize to all people who have some qualm about some recommendation, but the group I am referring to in particular tends to be argumentative and distrust a lot of things from the word go. In the end, if such patients frequently distrust their clinicians' advice, that is rough on everybody and it is valid to assert that they are indeed best served by a provider whom they can trust.

The hard thing about wanting to always make the exact choices one wants to make is that lots of other people have that same freedom, too.

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Specializes in Customer service.

The covid patients are taking spaces in hospitals. People who need surgery are on hold. This wasn't the situation in the past. 

If you're a nurse in metropolitan areas, you'd know the pain. I'm not a nurse. I'm a CNA. I used to work in a subacute and post hospitals. Early phase of the pandemic, patients were discharged to us prematurely. Some nurses weren't ready for those categories of patients. We hardly had an RN. Thank goodness someone experienced in ED, ICU, and etc came to us. She turned out to be a retired nurse. I learned some tricks from her when it was a code blue. I've seen enough. I don't need to see everyone suffers to convince me that this COVID-19 is an insidious infection.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
17 hours ago, jive turkey said:

 

I notice none of you has a good reason  why a doctor should discriminate against one population but not the other.

Wait a minute...I thought you were very open minded about reasons not to do something.  Now all of a sudden you need better reasoning for something that doesn't even put other people at risk...while you are perfectly comfortable with invalid and poorly sourced reasons to remain unvaccinated.  Doesn't that seem inconsistent to you? What makes the decision to not vaccinate valid but not the decision to discharge unvaccinated patients from a practice?

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On 8/21/2021 at 12:32 PM, jive turkey said:

That's illogical.  COVID is not the only infectious disease out there.  Denying care for children because they're a danger to others would mean no kids seeking treatment for an infectious disease can be seen.

Little Timmy has itchy bumps all over? Get out!

Susie has a runny nose and a fever? That could be a variety of infectious diseases. Get out!

You also made a statement that's alarming.  The doctor refuses the CHILD because the PARENT is anti-vax.  The child gets denied for a choice it had no control over.  Sure maybe they can "go somewhere else" but imagine if this idea of refusing treatment for people gained popularity. There would be fewer places to go with care being delayed.  

Are you serious? I take your response to suggest you condone that behavior. Do you?

 

LOL...children cannot decide for their care, parents or guardians do. If the kids get ill from the diseases that are preventable with vaccines, I think that the police should be called to pick up their parents. If they die, their parents go to the jail. Their punishment should be according to the severity of their children's condition. 

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19 hours ago, jive turkey said:

How about refusing the drug user because he might attack

In my country, they call cops for those drug addicts after medical treatments. In the US, I heard that they don't call cops after the drug addicts are stable and safe to leave the hospitals but refer for the drug rehabilitation. 

 

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On 8/25/2021 at 8:59 AM, heron said:

No idea - she either resigned or was terminated. Not sorry - she was a lousy worker.

I was an anal when I was assigned to work in the non covid unit. The patients and residents who were admitted in our covid unit went ballistic when they saw me in their room. I asked them to help me advocate for them. We were spread thinner. The house supervisor really hated me for it. She sent me home the next day just like the other nurses and their assistants. I walked out without a fight. The administrator called me to work. The supervisor got fired for mixing the covid unit staffs without quarantine. ?  

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Specializes in Primary Care, Military.
On 8/21/2021 at 4:17 AM, jive turkey said:

Be that as it may, do we use that as a reason to exclude people from care? I don't want to put words in your mouth so pardon me if I misunderstood. 

I do see many use the fact that COVID is contagious to justify some degree of a punitive response. 

If we want to not treat people because their choices harm themselves and/ or others:

How about the injured drunk driver that also injured someone else?

How about murderers in the infirmary?

How about the drug dealer with a gsw?

Just to name a few

 

EMTALA covers emergency treatment of emergency conditions. The rules regarding the provider-patient relationship are a bit different in the outpatient versus inpatient setting, or the incarcerated setting where the expectation is that you will be treating convicted criminals. There are specific legal/ethical procedures to follow for a provider who chooses to "fire" a patient from their primary care/outpatient practice to avoid liability. If they were never a patient, then there is no provider-patient relationship and thus no liability to start with. Many clinics exist that do not accept patients who refuse to vaccinate already - including pediatric clinics. In the city I live in, there are two main hospital-owned pediatric primary care clinics. One does not accept families who choose not to vaccinate, the other does. There is also the health department and a free clinic. There are more choices in the outpatient setting. Does it make it right? There are plenty of ethical arguments that can be made either way. In fact, this topic is often a part of a discussion in professional ethics courses.  

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Specializes in Travel Nurse, All ICU specialties and ED.
22 hours ago, jive turkey said:

 

I notice none of you has a good reason  why a doctor should discriminate against one population but not the other.

Many people have given reasons... the physician himself said he did not want to see anyone else in his care die from a preventable disease. Others included that the unvaccinated could unintentionally infect others in the waiting room or common areas. Just because you do not agree with the rationale does not make them "bad" reasons. Even if the rationale is considered reasonable it also does not mean that you or anyone else has to agree with it. 

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9 minutes ago, Charlcie said:

Many people have given reasons... the physician himself said he did not want to see anyone else in his care die from a preventable disease. Others included that the unvaccinated could unintentionally infect others in the waiting room or common areas. Just because you do not agree with the rationale does not make them "bad" reasons. Even if the rationale is considered reasonable it also does not mean that you or anyone else has to agree with it. 

Thank you for pointing that out allow me to clarify:

The responses I got sounded more like speculating why the doctor did it vs saying what they considered a good reason to adopt the practice of discriminating against unvaccinated pts.

As it relates to opinions of good vs bad reasons I concur it is a debate of opinion not fact.  Even if I say I don't think their reason is good, my opinion doesn't make it factually bad. 

I've offered my opinion about the vaccine, people disagreed, and thought they were bad reasons.  I can accept that.  

In retrospect I would remove the word good from the statement as to not give the impression people needed an answer that agreed with my opinion. 

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Specializes in Primary Care, Military.
On 8/25/2021 at 9:35 AM, veganista13 said:

I’ve heard of this happening, doctors walking out in protest because of the unvaccinated. WOW!? Do your job and treat the sick. You took an oath. You treat the homeless guy who refuses to get a job and doesn’t have insurance, you treat the smoker for lung cancer, the obese heart patient…why is this any different? Those patients made choices as well. I don’t approve of transgenderism but I still treat those patients just as I would anyone else.  People in medicine have become heartless and forget that people have a choice as to what they put in their body. The comments people leave In Regards to one choosing not to get vaccinated are so cruel and heartless. Makes me lose faith in humanity. Personally I’d rather care for an unvaccinated patient sick with COVID than one who was vaccinated and then hospitalized with COVID.  

What you're discussing is the inpatient environment. Not the outpatient environment that is being referenced here. In the inpatient setting, the patient doesn't have much choice as the provider that is attending/on is likely all that is going to be available to them. There is already an established provider-patient relationship by accepting the assigned patient load for whatever position that is.

In the outpatient setting, by declining to accept these patients into your clinic, you are not beginning a provider-patient relationship at all, and thus there is no responsibility nor liability. The patient is still able to select another PCP in the community and there is no breach, no abandonment, no "protest," and no "walking out." They merely are treated by another clinic. "Firing" patients from a clinic they currently have a provider-patient relationship in must be done following specific procedures to ensure there is no liability, the patient has continuing coverage for their care, and that no breach occurs. There are pediatric clinics that operate in this way already. Those parents who disagree with the clinic's values seek care from other pediatric clinics. Many times, reasons for "firing" a patient actually include no-showing appointments, failure to pay bills to the practice, and violence/aggression towards staff. You have to remember that the outpatient world is a little different. 

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Specializes in Primary Care, Military.
23 hours ago, jive turkey said:

 

Unvaccinated doesn't even mean infectious. Maybe if the doctor had the visit he/she could sit down for a good long time and educate them !! but nope ain't got time for that, can't spend more than 5 minutes with the patient because the fewer its they see in a day the less they can bill for.

 

Your quote, in bold, caused me to absolutely bust out laughing. Yes, sit down for a "good long while" to educate them. Within that pre-determined 10-15 minute time slot for the entire visit where you also need to perform all the required pre-screening questions, medication reconciliation, obtain the chief complaint and expand upon it along with the history, complete the physical exam, develop and start the treatment plan, and provide that education for what their actual visit is for. Along with the other screenings and box-checking for that visit. Yes. A "good long while." Reimbursement will totally support that. The other patients waiting will be on board with waiting well in excess beyond their scheduled appointment times for you to get through to this patient, as well. ?

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