Letters: Dear Doctor - Dear Parent

The Thinking Moms' Revolution blog (not to be confused with the very useful Thinking Person's Guide to Autism) is written by a number of mothers who strongly believe in "healing" their children's (vaccine-induced) autism. Overall, they seem to be very angry, which is beautifully reflected in a recent post - "The letter I wish I could send to my old pediatrician". There is, of course, no reason why the poster could not send that letter, although her chances of the pediatrician actually reading it might go up, if she find another address than "Dear Dr. Asshat". Orac does a good job in taking the fallacies in the letter down, however, as often the case, one of the commentators takes the cake with a response letter, which deserved to be showcased:

Dear Ignorant Parent:

We are well aware that you pulled your child out of our practice, since we've seen a marked decrease in the volume of ignorant questions that our nurses have had to answer as of late. Trust us, you won't be missed.

Will we lose an ounce of sleep over you deciding the vaccines are wrong for your child? No. However, if your young, and unvaccinated little one comes down with measles, mumps, whooping cough, polio, or rubella then we would wager that you will. We've treated all of them in our tenure as doctors and be assured, while modern medicine can reduce the risk to your child after infection, the results can still be daunting.

Blindness, paralysis, deafness, and even death are some of the results of not vaccinating your child from diseases that once killed millions around the world. By not allowing us to vaccinate you are saddling your child with plenty of risks, none of which he should or need bear.

We all understand that the internet is a treasure trove of information. The problem with that is that not all the information is correct. Certainly you can find information claiming vaccines cause autism and a host of other developmental problems. Guess what else you can find? People that believe the earth is flat and that nobody has ever been to the moon. You claim there's evidence to support your claim? How nice. So do the people that believe the earth is flat. A cursory internet search on vaccines being bad does not make you an expert. Years upon years of medical training does, and that learning process is ongoing.

If you thought we were curt with you when you started asking these questions then it's most likely because we've been inundated by questions from you. Asking the same thing a hundred times but slightly changing the wording isn't going to get you a different answer. You decided long ago that vaccines were evil and now you simply want to try to get us to go along with you. We aren't going to. When we rolled our eyes at you for citing a study that was twenty years old it was because there was twenty years of newer information that supported our point of view.

Your claims that we broke your child are ludicrous. When you showed us an outdated study that linked autism with vaccination we showed you a dozen that did not. Our data was somehow tainted in your mind because you believe that we're all in the pocket of some shadowy conspiracy group. We aren't. Your claims that we're running a business and that we make money off vaccinations are also completely unfounded. Be assured that treating a child who has contracted the mumps is going to be a lot more lucrative than simply vaccinating against it. Yet, that's what we do. The Hippocratic Oath says do no harm, you like to say that, but there is another important part of that oath you missed, where is states that prevention is preferable to cure. In our tenure as medical professionals we have come to believe in that statement after treating scores of children permanently harmed by diseases the should never have been stricken with but for their parent's misguided good intentions.

We wish you the best of luck with your family and hope only for the best for you all. We also hope nothing bad comes of your decision.

I am not sure that time could mend the communication breakdown between mothers who think of their doctors as "asshat" and doctors who think of their patients' mothers as "ignorant", but lack of communication is one of the main reasons why parents take their children (or adult patients themselves) to charlatans. We know that time with the patient/parent influences continuity in care (i.e. how long the patient will stay with a health care provider), there are good recommendations in the literature how to address the concerns of parents who refuse vaccination, which also have time as an essential component to build trust and establish and maintain communication channels. More and more physicians dismiss non-vaccinating parents from their practices. They perceive the risk for their other patients as too high. This does mean though that the children of these parents are likely to end up in suboptimal medical care reinforcing their unrealistic views of vaccine dangers. Do you think an insurance-reimbursed hour per new child in a pediatrician's practise would be a solution?