The state legislature in Florida decided it is legal and appropriate for pharmacists and pharmacies to begin administering vaccines against multiple diseases. Their list of adult vaccines includes seasonal flu shots, Pneumovax (pneumonia vaccine) and Zostavax (vaccine to prevent shingles). The rationale of the legislature is that access to doctors to receive these preventive vaccines is limited and difficult.
By refusing to administer vaccines in their office because it is time consuming and not profitable enough, my colleagues in primary care have not made my argument against permitting this any stronger. I thought prevention and administering vaccines was part of the job description in primary care. I am not asking my colleagues to lose money, but I do believe there is a distinct difference between not making a large profit and losing money. Isn’t it our professional and ethical responsibility to provide preventive services?
Over the years, the fall season and start of the school year have always provided an opportunity to remind patients that they were due for an annual checkup and to make positive suggestions on what other opportunities were available for them to try and prevent infectious or chronic disease. School-age children have been required to receive immunizations before entering school for obvious public health reasons. This provides an opportunity to benchmark their growth and age goals and discuss healthy living as well. The visits came towards the end of the calendar year when most individuals had met their annual medical deductible so the out of pocket costs were not great.
As I walk into my local CVS I am confronted by ads for vaccines and same-day clinics. They remind me that physicians have lost this encounter to enhance the doctor/patient relationship and provide sound health advice for the future because administering vaccines isn’t very profitable. Pharmacies often use vaccinations as a loss-leader to draw you in and get you to purchase other, more profitable, items.
I will continue to provide vaccines in my internal medicine office as I believe it is the professional and responsible thing to do.
Steven Reznick is an internal medicine physician and can be reached at Boca Raton Concierge Doctor.
