Doctor refuses to treat the unvaccinated

iNurs5, CNA · Aug 27, 2021

Another reason for outpatient clinical doctors avoid getting sued by unvaccinated patients for failing to protect them from their ill patients.

Litigious society.? ?

ladycody, BSN, RN · Aug 27, 2021

On 8/21/2021 at 5:20 PM, jive turkey said:

I hear you and agree with you on many things. Its all too common we see patients continue to disregard medical advice making life choices that lead to the need for immediate medical attention. What's interesting is the attitude and response we are seeing to one particular disease.

Most of us in health care have put ourselves in the position to be affected or infected by a patient making what we consider bad choices. We don't hear much discussion about denying care for them. We hear arguments like "diabetes isn't a VPD" or "smoking isn't contagious".

We don't deny care for HIV patients (preventable and contagious disease)

We don't deny care for hep A and B patients (VPDs and contagious)

We don't deny care for people with HSV (preventable and contagious)

People pick COVID as the special disease to have a different attitude about. ?

Cardiac, diabetic, hep, HIVsmokers...none of those patients shut down surgeries, impact patient care and critical care services, and fatigue healthcare workers like Covid does in a surge. They don't fill up hospitals in ways that incapacitate the facility's ability to offer care for patients. Yes...many hospitals will go on diversion when they are busy with a VARIETY of patients...but this one virus can single handedly shutter services. The response of many healthcare workers is not always rooted in judgement but has everything to do with the moral injury and fatigue of the PEOPLE...the humans...with all their complex emotions and stressors and pain...who have dealt with this disease. And not all of them have the stamina to do it all over again. They have my compassion.

ladycody, BSN, RN · Aug 27, 2021

On 8/21/2021 at 6:01 PM, jive turkey said:

He's refusing unvaccinated patients on the premise they will get it.

He said "and I can’t watch them die like that,”

How are they dying by not being unvaccinated?

This is about doctors discriminating against patients based on life choices related to one specific disease

OK TECHNICALLY you're correct so let me reword the analogies to fit for you

We don't deny care to patients who don't wear condoms

We don't deny care to people who choose to take illicit IV drugs

We don't deny care to patients that don't practice abstinence

We don't deny care to patients that travel to foreign countries without taking recommended vaccines.

"Dr. So n So if refusing patients not vaccinated against hepatitis because he/she can't watch people die like that"

?

This is a ridiculous comparison. It doesn't even qualify as a comparison.

turtlesRcool · Aug 30, 2021

The doctor-patient relationship is just that - a relationship. Patients have a choice regarding which practitioner to visit. Doctors in private practice also have a choice regarding which patients they take on. They're human, too. They should have the choice to work with patients they think will befit the most from their care. It's emotionally draining to see patients with a poor prognosis. It's even harder when those patients are people who ignore their doctor's advice. I don't think a doctor should have to keep on those patients, knowing they take the appointment slots that could go to people who trust what the doctor tells them.

Even the process of choosing their specialty is a form of doctors deciding which patients they will see. There are a lot of doctors who wouldn't touch oncology with a ten foot pole because it's so emotionally draining. This doesn't mean they're judging anyone for having cancer, just recognizing that they can't deal with losing patients on a regular basis. Other doctors dive right in and specialize in palliative care, knowing that most of their patients have very little time left. It sounds like this doctor isn't so much trying to punish patients for not getting vaccinated, but trying to protect his own mental health, and focus on the patients he thinks he can help. I feel like that's valid.

My kids' pediatrician doesn't accept kids of anti-vax parents as patients. This is not a COVID thing. My oldest is 13, and I remember asking about vaccines when we were interviewing pediatricians before his birth. The practice's stance is that they treat based on AAP guidelines, and that includes routine childhood immunizations. Their written statement explains that they cannot properly take care of patients who refuse to follow the medical advice they give. They also go through periods of not accepting new patients at all due to the size of the practice, so it makes sense for them to give their limited spots to people who will heed their medical advice rather than to those who aren't going to follow what they tell them. The parents who oppose vaccinations would be better off forging a medical relationship with a doctor whose philosophy aligns more closely with theirs.

subee, MSN, CRNA · Aug 30, 2021

On 8/25/2021 at 10:52 PM, jive turkey said:

That's the answer. Because they "can"?

That's the best we can do?

So doctors should start refusing care for ANYBODY that makes a choice that may present harmful to others?

So how about they refuse the 67 yo who didn't get vaccinated for pneumonia? pneumonia isn't infectious but the pathogens that cause it are

How about refusing the drug user because he might attack

How about refuse the 500lb patient, they may hurt somebody by falling

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.

I'm disappointed to see a bunch of nurses advocate for retaliating against people, selectively at that.

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

Again, speaking about something you don't know anything about. That doctor is a family practice guy. I seriously doubt that he is caring for hospitalized patients. He just doesn't want the unvaxxed in HIS OWN waiting room so that he, his staff and his patients can lessen the opportunity to make each other sick. Just because YOU are ANYONE else had a quick recovery doesn't mean that you didn't stpread it to someone else who wasn't as lucky as you. It's a big country. Even a very small percentage of people being hospitalized creates an enormous burden for all of us who have to pay for this - physically, financially or both. That's why I treat all unvaccinated persons as cesspools of disease.

~Shrek~ · Aug 30, 2021

I work with folks with all sorts of rough backgrounds. A number of them will not get vaccinated, no matter how hard you try to convince them due to their issues. A lot also suffer from mental health conditions, low self esteem, history of trauma, etc. It makes me sad to think that if they do develop the confidence to see a primary care doctor then they will face the wrath of “righteous indignation” and be scolded or kicked out of the provider’s office. I have worked with clients who are terrified of doctors due to a history of poor treatment and discrimination from docs in the past. I can’t imagine the re-trauma if they do someday decide to see a PCP only to have someone wag a finger at them over the shot and kick them out.

instead, docs should enforce strict masking for patients and staff, provide all staff with N95 masks, social distance, hand wash, have patients wait in the car as much as possible instead of using the waiting room (if they have a car), and have a fresh supply of vaccine on hand for anyone that comes in and decides they want it that day (believe it or not, some people will *only* get it if their PCP tells them to). Covid has been around for almost 2 years now, and docs need to be taking strict precautions in their offices-regardless of vaccine status. They know what to do. The general population won’t have 100% compliance, and they will continue to have health issues. Docs need to assume everyone is infectious, and to refuse primary care is wrong.

anewsns · Aug 30, 2021

1 hour ago, ~Shrek~ said:

I work with folks with all sorts of rough backgrounds. A number of them will not get vaccinated, no matter how hard you try to convince them due to their issues. A lot also suffer from mental health conditions, low self esteem, history of trauma, etc. It makes me sad to think that if they do develop the confidence to see a primary care doctor then they will face the wrath of “righteous indignation” and be scolded or kicked out of the provider’s office. I have worked with clients who are terrified of doctors due to a history of poor treatment and discrimination from docs in the past. I can’t imagine the re-trauma if they do someday decide to see a PCP only to have someone wag a finger at them over the shot and kick them out.

Yes. I've had experience with some of these people too. There are many people out there with poor health literacy and are not very political.They are just genuinely scared of the entire situation- both of covid and of the vaccine. They are the ones who I think about when I start to feel resentful of the unvaccinated. Close friends and family of mine. Im losing empathy for a lot of people in this country at this point and don't care what happens to them since I cant change people. (I was never in the big empathy contest people seem to get in nowadays anyway.) But my empathy for the group you are talking about is only growing. They are the real victims here, the ones paying the price for others selfishness. They are the ones I try to help educate because that could make an actual difference.

jive turkey · Aug 31, 2021

11 hours ago, turtlesRcool said:

The doctor-patient relationship is just that - a relationship. Patients have a choice regarding which practitioner to visit. Doctors in private practice also have a choice regarding which patients they take on. They're human, too. They should have the choice to work with patients they think will befit the most from their care. It's emotionally draining to see patients with a poor prognosis. It's even harder when those patients are people who ignore their doctor's advice. I don't think a doctor should have to keep on those patients, knowing they take the appointment slots that could go to people who trust what the doctor tells them.

Even the process of choosing their specialty is a form of doctors deciding which patients they will see. There are a lot of doctors who wouldn't touch oncology with a ten foot pole because it's so emotionally draining. This doesn't mean they're judging anyone for having cancer, just recognizing that they can't deal with losing patients on a regular basis. Other doctors dive right in and specialize in palliative care, knowing that most of their patients have very little time left. It sounds like this doctor isn't so much trying to punish patients for not getting vaccinated, but trying to protect his own mental health, and focus on the patients he thinks he can help. I feel like that's valid.

My kids' pediatrician doesn't accept kids of anti-vax parents as patients. This is not a COVID thing. My oldest is 13, and I remember asking about vaccines when we were interviewing pediatricians before his birth. The practice's stance is that they treat based on AAP guidelines, and that includes routine childhood immunizations. Their written statement explains that they cannot properly take care of patients who refuse to follow the medical advice they give. They also go through periods of not accepting new patients at all due to the size of the practice, so it makes sense for them to give their limited spots to people who will heed their medical advice rather than to those who aren't going to follow what they tell them. The parents who oppose vaccinations would be better off forging a medical relationship with a doctor whose philosophy aligns more closely with theirs.

I respect and appreciate your perspective. While I don't feel it's entirely wrong, in this situation, I call bull on those docs.

And I call bull on people who condone it.

The People most in need of the doc are the hesitant. Imagine if the doc accepted a visit, sat down and had a thorough discussion with the unvax patient. Not just telling them they're wrong, pointing to articles etc but actually taking time to get to know them, understand their background, their worries, fears, perceptions, sources of facts, show empathy, and establish trust. But of course that would take too much time and often aren't paid by the minute.

There will still be those that refuse. There will be those that will be receptive. But if they can't get through the door, there's no relationship as you mentioned. If anything if fuels contempt for the virus. People are not only hesitant but going from hesitant to more resistant thanks to the attitudes of medical professionals and portrayals of the public by the media.

"They can go to another doctor"

People don't realize how detrimental rejection and disdain is from a provider.

So if the goal is to increase vaccination, it won't be accomplished by refusing to help people.

THAT is actually selfish.

toomuchbaloney · Aug 31, 2021

5 hours ago, jive turkey said:

So if the goal is to increase vaccination, it won't be accomplished by refusing to help people.

THAT is actually selfish.

That doesn't sound very "open minded". You have told us all before that such an attitude isn't going to persuade anyone to change their minds. Why aren't you open minded about this stance? It certainly hurts fewer people than refusing to participate in the mitigation of a pandemic.

SmilingBluEyes · Aug 31, 2021

A primary care provider can discharge patients from his or her care, with adequate notice for pretty much anything. And not get in trouble for it, as long as documentation is complete.

On 8/25/2021 at 9:31 PM, jive turkey said:

I'm calling bull. All kinds of people with infectious diseases go to a doctors office at put others at risk.

COVID isn't respiratory illness out there.

I see everybody is avoiding the question and I presume to know why.

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.

Everybody that condones that is part of the problem.

I did not sidestep. I answered you.

jive turkey · Aug 31, 2021

4 hours ago, SmilingBluEyes said:

A primary care provider can discharge patients from his or her care, with adequate notice for pretty much anything. And not get in trouble for it, as long as documentation is complete.

I did not sidestep. I answered you.

You are correct. However, a discharge can't happen for a patient they refused to see in the first place.

I hear you, I wasn't saying you specifically didn't answer. There were other posters that did.

SmilingBluEyes · Aug 31, 2021

Well , you are right JT. A patient with whom a doctor has no relationship is not going to be discharged, clearly. But the phsician is to help to find alternative places for an established patient to go, where the values/behaviors more line up with their practices.

I see nothing at all wrong with that. I don't blame this doctor for doing what he is doing. He is limiting his practice to patients who do not refuse to adhere to his recommendations for avoiding disease/death/permanent disability. Thus, reducing risk to himself for malpractice and for other patients not to get sick. Makes perfect sense to me.

My own doctor has a similar relationship with me. If I refuse to follow his recommendations, he is going to: counsel me to do so. And failing that, he can elect to sever our relationship pending finding alternative arrangements.