There are several reasons why a health care practitioner may choose to bar unvaccinated patients from their practice. Some would argue that this decision breaks from the core of medical ethics. Here we bring to you the strategies you can use for treating unvaccinated patients.

Key takeaways

Building the case for discharging unvaccinated patients

Listed below are the reasons why a physician may choose to deny treatment to unvaccinated patients:

1. In an article published by the American Academy of Family Physicians, Ryan Neuhofel, DO, MPH mentions that practices that implement vaccine requirements may do so to spare immunocompromised patients from exposure to the deadly virus.
2. Doctors may also wish to keep their waiting rooms as COVID-free as possible, relying on vaccine mandates to do the job.

Practice-specific considerations

The nature of a physician’s practice may also be crucial in the decision to implement vaccine mandates, according to the American Medical Association. For example, if a doctor’s patient population is primarily composed of immunocompromised individuals who are medically unable to receive a vaccine, banning medically able patients who choose to remain unvaccinated could be a sound decision.

 According to Emily Largent, JD, PhD, RN:

“It’s always regrettable when patients don’t receive care, but when we have scarce resources like (donor organs), the decision not to list a patient is justified.”

Another factor to consider is the level of care a patient needs. Doctors are justified in asking a patient to get vaccinated prior to entry into the practice if the patient is looking to establish a primary care physician for long-term, routine checkups. They might be less justified if the patient required emergency care, in which case, it’s seldom ethical to turn someone away based on vaccine status. 

Sticking to a plan

The rebuttal and strategies for treating the unvaccinated

Perhaps the most evident argument against terminating treatment of patients based on vaccine status lies in the very foundations of doctorhood.

Doctors enter healthcare to serve. The decision is outlined by the commitment to care for patients whose medical circumstances could pose risks to physicians’ well-being and safety. The AMA reminds doctors that while there may be circumstances in which denying care to patients who lack certain vaccinations could be justified, it certainly isn’t recommended.

Exposure outside of the office

Terminating patients based on vaccine status may also prove ineffective. For example, while Neuhofel recognises the validity of some doctors’ decisions to protect other patients via office vaccine requirements, he also notes that such requirements don’t account for the potential exposure patients may face outside of the office. In essence, requiring vaccination to enter a practice can create an expectation that simply isn’t applicable to other environments like schools, libraries, or parks.

According to Emily Largent, JD, PhD, RN:

“I tend to favor the idea of more compassionate persuasion, rather than ending the treatment relationship.”

Not only do vaccine requirements promote a false sense of safety, but doctors who refuse unvaccinated patients may inadvertently contribute to lower vaccination rates in the long term.

Trust-building

If you’re a physician who feels frustrated with unvaccinated patients but doesn't wish to discharge them, there’s still hope. In our conversation, Largent mentioned that patients who have longstanding trust with personal physicians may come around to the vaccine after a conversation or, more realistically, many conversations.

Terminating the treatment of patients who choose not to get vaccinated, on the other hand, could considerably harm the patient. Taking a more empathetic approach could be the more ethical and efficient option for many physicians.

This story is contributed by Jules Murtha and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.