The doctor is in, but you need to go elsewhere - KAIT-Jonesboro, AR-News, weather, sports

Health your doctor?!

According to the American Academy of Pediatrics, about 18 percent of pediatricians admit to sometimes turning a parent away if they refuse to have their child immunized.

Patients and parents aren't only fired or terminated over differing opinions regarding childhood vaccines, however -- it can also involve disagreements over medical issues across the board.

If you refuse or demand a certain medical treatment or disagree with your doctor, you may be handed walking papers instead of a prescription.

According to the North Carolina Medical Board, patient termination is a growing issue and is primarily motivated by people feeling more empowered over their personal medical care.

Dr. Scott Kirby is the director of the North Carolina Medical Board. 

Patients have the right to challenge medical providers in an effort to seek the best care possible, but Kirby warned, "There are physicians who feel that the patient has to accept the consequences to their conscientious objection to whatever recommendations the physician may make."

Those consequences should be clearly outlined in a doctor's written policies.

Whether it's over a treatment plan or a prescription, if patients and physicians don't see eye-to-eye, the physician may make an ethical or professional decision to "divorce" the patient from the doctor's practice.

A doctor could also take such action against an aggressive patient seeking a prescription drug they don't really need, or if the patient refuses to pay their bill or repeatedly misses their scheduled appointments.

According to the American Medical Association Guidelines, however, doctors should give sufficient notice to the patient to find another doctor.

In general, physicians must document the reason for the termination, and they should ensure the patient's medical records are appropriately transferred to another medical provider.

The physician should never just tell a patient to take a hike.

Cherie Minette is a naturopathic physician and she had concerns over whether or not to vaccinate her little boy.

When she discussed these concerns with her physician, Minette says, "She folded her arms and said, ‘If you can't trust us, we can't help you,' and I thought, you're right, you can't help me, but it shook me as a new mother."

Minette said she then wondered what she would do next, and if other doctors might react in a similar manner if she also voiced these same concerns to them.

"It's been said over and over, vaccines are a victim of their own success and people just don't understand how devastating these illnesses can be," Kirby pointed out.

Experts say the best defense against a doctor/patient "break-up" is for both to understand each other by thoroughly addressing all questions and concerns.

"If pediatricians don't take that time and opportunity to explain to parents the importance of vaccinations, or even just the other side of it, then they risk losing that parent and maybe that child to getting the care they need," Minette said.

Whether it's over vaccines or any other medical treatment, more terminated patients are now turning to naturopathic doctors like Minette for care.

An alternative to the traditional medical model, naturopathic doctors utilize natural therapies, diet and exercise to treat everything from allergies to heart disease for both individuals and families.

Naturopathic doctors, however, do not perform major surgery, and not all states legally license them to practice medicine.

Minette says naturopathic medicine is not a substitute for routine physicals or surgery, and patients need to communicate their homeopathic care to their physician to avoid any complications.

Regardless of whether you chose a medical or naturopathic physician, the doctor/patient relationship should be a partnership.

If there is ever a disagreement between you and your physician regarding your medical care, experts say the best prescription may be better communication. 

Additional Information:

  • The American Academy of Pediatrics strongly endorses universal immunization. Click to read more.
  • According to a periodic survey of fellows of the American Academy of Pediatrics (AAP) on immunization-administration practices, 7 of 10 pediatricians reported that they had a parent refuse an immunization on behalf of a child in the 12 months preceding the survey. (Source:;115/5/1428)
  • Measles-mumps-rubella vaccine was refused most frequently, followed by varicella vaccine, pneumococcal conjugate vaccine, hepatitis B vaccine, and diphtheria and tetanus toxoids and pertussis vaccines.
  • Four percent of pediatricians had refused permission for an immunization for their own children younger than 11 years.
  • A small number of pediatricians reported that they always (4.8%) or sometimes (18.1%) tell parents that they will no longer serve as the child's physician if, after educational efforts, the parents continue to refuse permission for an immunization. (Source:;115/5/1428)
  • The role of the physician in these situations is to provide parents with the risk and benefit information necessary to make an informed decision and to attempt to correct any misinformation or misperceptions that may exist.
  • Parents who choose not to immunize their own children increase the potential for harm to other persons in 4 important ways: (Source:;115/5/1428)
    a.) That child poses a potential threat to other unimmunized children.
    b.) Even in a fully immunized population, a small percentage of immunized individuals will either remain or become susceptible to disease.
    c.) Some children cannot be immunized because of underlying medical conditions. These individuals derive important benefit from herd immunity and may be harmed by contracting disease from those who remain unimmunized.
    d.) Immunized individuals are harmed by the cost of medical care for those who choose not to immunize their children and whose children then contract vaccine-preventable disease.
  • If a patient refuses, the pediatrician should listen carefully and respectfully to the parent's concerns, recognizing that some parents may not use the same decision criteria as the physician and may weigh evidence very differently than the physician does. (Source:;115/5/1428)
  • Vaccines are very safe, but they are not risk free; nor are they 100% effective. Source:;115/5/1428
  • Physicians should also explore the possibility that cost is a reason for refusing immunization. In such cases, the physician should work with the family to help them obtain appropriate immunizations for the child.
  • Continued refusal after adequate discussion should be respected unless the child is put at significant risk of serious harm (as, for example, might be the case during an epidemic).
  • Physician concerns about liability should be addressed by good documentation of the discussion of the benefits of immunization and the risks associated with remaining unimmunized. Physicians also may wish to consider having the parents sign a refusal waiver.
  • In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice. Although pediatricians have the option of terminating the physician-patient relationship, they cannot do so without giving sufficient advance notice to the patient or custodial parent or legal guardian to permit another health care professional to be secured. <;115/5/1428> Such decisions should be unusual and generally made only after attempts have been made to work with the family. Families with doubts about immunization should still have access to good medical care, and maintaining the relationship in the face of disagreement conveys respect and at the same time allows the child access to medical care. Furthermore, a continuing relationship allows additional opportunity to discuss the issue of immunization over time.

The following information is from an article published in The Wall Street Journal entitled "The Doctor will never see you again."

  • Chronically abusive, disruptive or drug-seeking patients may be asked to leave.
  • Habitually missing appointments, refusing to pay reasonable bills, failing to heed medical advice.
  • Some pediatricians refuse care for children whose parents won't let them be vaccinated due to autism concerns.
  • A 2006 survey by the American Academy of Pediatrics found that 74% of members who participated had one or more parents refuse at least one vaccination in the past year; 32% of those parents changed their minds after education efforts from the doctor. Only about 16% of pediatricians said they sometimes discharge families if the parents won't relent.
  • Most doctors just agree to disagree.
  • Doctors can close practice to new patients, refuse to accept some insurance plans or limit Medicare or Medicaid patients but they cannot discriminate on race, gender, age or religion.
  • American Medical Association guidelines state that a doctor may withdraw from a case only after giving the patient enough notice to find another physician. State rules vary, but doctors generally must document the behavior, inform the patient what the problem is, give him or her a chance to change, then send a certified letter stating the relationship is over, while still agreeing to provide treatment as needed for another 30 days.
  • The right of doctors to refuse to treat some patients was upheld by the Fifth Circuit Court of Appeals in the 1987 case, Brown vs. Bower.

The following information is from an ABC News report entitled "Doctors may ‘fire' parents who don't vaccinate children."

  • Despite adamant statements from the American Academy of Pediatrics and the U.S. Centers of Disease Control that vaccines have no link to autism, an anti-vaccination movement is growing online, from parent to parent. Click here to read more.
  • Some parents find help with a naturopath (a person who studied holistic medicine), but they do not have a legal license to practice medicine in most states.

The following notes are from Dr. Scott Kirby, director of the North Carolina Medical Board:

  • The term "fired" implies an employee/employer relationship. Kirby says a more appropriate term to describe the separation of a doctor and patient is "termination".
  • Physicians have a responsibility to individual patients, to other patients (i.e. in the waiting room), and to society at-large. They have to make decisions based on all three.
  • Fear of termination often causes patients to not tell their doctor about other treatments. In the end, that doesn't help anyone.
  • State medical boards issue position statements to their physicians giving guidelines on how to handle this situation.

Click here for more information about naturopathic medicine.

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