You Don’t Get Paid Enough for This

This is what poliomyelitis looks like.  Image courtesy of the WHO.

This is what poliomyelitis looks like. Image courtesy of the WHO.

from the American Academy of Pediatrics National Conference and Exhibition in Washington, D.C.

There’s no doubt that pediatricians have a lot of tasks to fit into a 10-minute healthy child visit.  Not only do they have to give vaccinations — for which they often lose money — but these days they also have to invest time in educating parents about the safety and importance of those vaccines.  You pediatricians out there certainly don’t get paid enough for this.  Actually, you don’t get paid for this at all.

This afternoon, I sat through Dr. Gary Marshall’s talk on how to address parents’ concerns about vaccines.  Dr. Marshall is the chief of the division of pediatric infectious diseases at the University of Louisville (Ky.).  He discussed a number of reasons why vaccination safety is on parental radar these days, ranging from misinformed celebrities providing medical information to a general lack of understanding of vaccinology and the safety measures that are built into the vaccine development/licensure/marketing process.

Fundamentally though, we suffer from our tremendous success in virtually eradicating some truly terrible diseases.  Without the specter of polio, tuberculosis, or measles in the news, the public has shifted from a fear of the diseases that these vaccines are intended to prevent to fear of the extremely rare side effects of the vaccines.  As a result, pediatricians have to expend time they do not have on discussing the benefits of vaccinations and addressing parents’ fears.  This is time that they could be devoting to more pressing and challenging health concerns for children, such as obesity, injury/violence prevention, and drug abuse.

This what measles look like. Image courtesy of NLM.

This is what measles looks like. Image courtesy of NLM.


In the question and answer session, Dr. Marshall noted that it is ethical and permissible to discharge patients from a practice if their parents refuse vaccination. While this might ease the burden on the practice, is doing so really the best thing for the child?  The implication is that, as long as a pediatrician is caring for the child, there is still the faint possibility that repeated discussion of vaccines with the parents might ultimately lead to the child being vaccinated.

You pediatricians sure don’t get paid enough for this.

—Kerri Wachter, @knwachter on Twitter

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Filed under Infectious Diseases, Pediatrics

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