New Twist on the Immunization Issue

Today was the day I interviewed a new family physician. No easy feat in Ontario, given the ongoing shortage, but I had heard that a local family health team was currently accepting new patients.

I went in, however, with hesitation. You see, I’m one of those parents. The ones physicians dread. I am a parent with children who have not been immunized. My reasons are mine, and based on extensive family medical history that I won’t get into in this post, but in my mind, it  was a no-brainer: the risks of bombarding their immature immune systems felt, when they were babies, higher than the risks of contracting the diseases the vaccines would prevent. The autism thing? Not even on the radar (yes, the irony is obvious).

I’d never had any issues with our family physician in Ottawa.  I felt lucky compared to some families I knew who’d been “fired” by their doctors for not following the standard immunization schedule – who’d been refused treatment because their physicians didn’t support their choices. My physician didn’t applaud my choice, but she also didn’t prevent us from accessing care because of it.

So. The new doctor. She did the intake on the kids, and then, finally, asked if their immunizations were up to date. I took a deep breath, let it out, and told her. And I told her why. And she didn’t blink. What she did say shocked me, though. According to this physician, doctors are given financial disincentives when they have children on their caseloads who are not fully immunized.  She said she’d keep us on her roster nonetheless, which is good (because I get a really good vibe from her, and having a doc you like is important), but I’m still ruminating over this new piece of news.

It couldn’t be true, could it? If it is, then it would directly contravene the Health Care Consent Act. It feels like doctors are being pushed via blackmail to deliver care that may be good for the public as a whole. Which I get, really. I totally understand that vaccines have made the general population healthier overall. That doesn’t mean, however, that immunization is the right (or safest) choice for each individual.

Because it didn’t sound right, I decided to see how good my Google-fu is. While I couldn’t find any statement that clearly explains that money would be held back for lack of treatment, I did find this document.

Under Comprehensive Care, it states that [a]ll Family Health Team physicians must provide comprehensive care services listed in Attachment A.

Here’s Attachment A:
Family Health Team physicians must provide the following core services:
Patient Education and Preventative Care
Use evidence-based guidelines to screen patients at risk for disease, to attempt early detection and institute early intervention and counselling to reduce risk or development of harm from disease, including appropriate immunizations and periodic health assessments.

So… maybe? It’s not totally clear in this document whether physicians wouldn’t get paid for not immunizing, but I also found something else that piqued my interest: doctors are given financial incentives based on the percentage of patients under 2 years are fully vaccinated according to the schedule. A physician can get up to $2200 on top of their other income, based on the numbers of vaccinated infants and toddlers.

I like my new doctor. She’s young, and progressive, and seems like she’ll be a good fit for the long term. So far, even though we may not be philosophically on the same page, we’re both still willing to read the other’s book with an open mind.

I’d still like to get more information about the Ministry of Health’s policy around immunization incentives, because it’s still not sitting well with me. At all.


1 Comment

  1. berta said,

    January 18, 2010 at 9:24 am

    That is just wrong! And even though you couldn’t find anything conclusive I don’t doubt it. I couldn’t find a pediatrician who would take us so Murm has my family Dr. Who I feel is awesome anyway so I’m glad. He even helped me figure out a good delayed vax schedule so she’d have to get as few as possible of the ones we did do. I’m glad you found someone willing to listen to you.

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