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What Happens When An OD Opts Out of Getting Vaccinated?

Patients assume he has been; how should staff handle inquiries?

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IT WAS AN early Wednesday morning, and the front desk team at Willowbrook Optometry were gathered in reception for an emergency department meeting. Practice owner Dr. Yi passed coffee and danishes to the seven staff members.

“Thank you all for coming in,” Dr. Yi began. “We have some COVID-related items to review.

ABOUT REAL DEAL

Real Deal scenarios are inspired by true stories but are changed to sharpen the dilemmas involved and should not be confused with real people or places. Responses are peer-sourced opinions and are not a substitute for professional legal advice. Please contact your attorney if you have any questions about an employee or customer situation in your own business.

ABOUT THE AUTHOR

NATALIE TAYLOR is owner of Artisan Eyewear in Meredith, NH. She offers regional private practice consulting and ABO/COPE approved presentations. Email her at [email protected]

“First, some good news: as of last week, all 27 staff members have received both vaccine shots!”

The group offered up a round of applause. “Thanks for the two paid days off!” chuckled Ann.

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“Does that mean we can chill out with the PPE?” asked Paige.

“We still need to wear masks and be careful, but a big upside is we won’t struggle with the staffing issues of quarantining and having 10 percent of the team constantly out sick,” Dr. Yi replied.

Christine raised her hand. “You said staff members … did Dr. Clayton get his shot?”

Dr. Yi shook his head. “No, and this is the reason for today’s meeting.”

Just then Dr. Clayton knocked at the locked front door. As Dr. Yi walked over to let him in, the group put down their coffees and pulled up their masks.

“Sorry I’m late, guys,” said Dr. Clayton, taking a seat in the far corner.

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“It’s fine, we were only getting started,” Dr. Yi said, turning to address the group. “Last week Dr. Clayton wasn’t feeling well, so as a precaution I asked him to not come in to work. He had a negative COVID test on Friday and had another yesterday afternoon, so he is seeing patients today.”

“It was a 24-hour stomach bug,” Dr. Clayton chimed in reassuringly. “I really could have come back Monday.”

Dr. Yi ignored his comment. “However, when some of you called Dr. Clayton’s patients to reschedule appointments, you shared with them that he isn’t vaccinated.”

“Why is that a problem?” Christine asked defensively. “I made probably half of those calls. Patients asked why they were being rescheduled; I said he was sick, they asked if it was COVID and I said we don’t know; he’s getting tested.”

“It’s private health information, Christine,” Dr. Yi said.

“Really?! That he’s sick?” she said skeptically.

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Dr. Clayton stood up, fidgeting with his N95 mask. “Patients don’t need to know the exact reason you’re rescheduling. Simply saying that I had a personal emergency is sufficient.”

“What has happened is many patients have rescheduled with a different doctor,” Dr. Yi continued.

Paige raised her hand. “Shouldn’t patients be informed if their doctor isn’t vaccinated?” she asked. “I mean, at this point most patients are assuming you are.”

Christine nodded along, adding, “It feels like we’re lying. No, worse, it feels like we’re putting people in danger. I mean, one of those patients I moved was 98 years old!”

“I hear what you’re saying,” said Dr. Clayton. “However, I plan to continue wearing PPE, which as we’ve seen over the last year is quite effective. Keep in mind, we are going to have patients who are unvaccinated too.”

Dr. Yi walked around the room handing out paperwork. “I’ve typed up scripts to use when rescheduling, so Dr. Clayton doesn’t lose patients,” he said.

The team looked at each other silently, frowning under their masks.

The Big Questions

  • If the department ultimately refuses to gloss over or give vague replies to patient questions, what should Dr. Yi do?
  • Do patients have a right to know if their healthcare providers have not (and will not) get COVID-19 vaccination?
  • What can be done with Dr. Clayton’s schedule to reduce the negative impact of future multi-day quarantines? Is a quarantine after an illness necessary if the rest of the staff is vaccinated?
Stewart G.
San Francisco, CA

There was no reason given as to exactly why the doctor has not been vaccinated. Does he have predisposing conditions that prevent him? If not, I frankly think it is totally irresponsible on the practitioner’s part. If I knew that he refused to be vaccinated for no reason, then I personally would be very ill at ease even working with him, let alone being his patient. I’ve been vaccinated and I’m proud I am. I’ve even pasted a copy of my vaccination card in the waiting room and wear a pin letting patients know.

Pam P.
Downers Grove, IL

It is not necessary or HIPAA-compliant to give a detailed review of staff illnesses. Simply stating there was a family emergency/personal emergency is sufficient. If a staff member or doctor is questioned by the patient directly, I think they should be truthful. Most of us are already vaccinated but no one is authorized to share who has or has not had the vaccine, though they can let patients know about themselves if they would like. Our office is not mandating the vaccine, but questions can be alleviated by saying something like “We are fortunate to have this available to us as healthcare workers.” I believe the CDC recommendations still call for quarantining if exposed to COVID, vaccinated or not.

Timothy K.
Jamaica Plain, MA

Fire the doctor who refuses to be vaccinated and give him severance or send him on unemployment. If he is afraid to be vaccinated because a percentage of people get side-effects, too bad. Find another job. If the doctor who refuses the vaccine is forced to get it (by the office) and develops serious complications, the office may be responsible. I am not sure why the main doctor did not talk to the deviant doctor privately. Involving everybody looks like communal punishment. Talk to a lawyer first, this will hopefully protect everybody.

Martha D.
Wheatfield, IN

First of all, they should never have told patients the details of the doctor being sick. That was irresponsible. As long as the doctor is taking the normal precautions then his COVID status should not be an issue. The doctor has a right to privacy just like the patients. I am not sure how the staff can redeem his good name. Maybe the practice can schedule some of the new patients for the doctor so he can build his practice back up.

Cheri J.
Madison Heights, MI

Patients should not make assumptions. They should each make their own best decision. It’s the personal decision of each individual what medical care they choose to have.

Rebecca B.
Brewer, ME

If you’re refusing to be vaccinated but uncomfortable with people knowing that, you should reflect on your reasoning. Still, it shouldn’t be offered information to patients. If a patient asks, it also shouldn’t be a problem to tell them the truth, and if the doctor is choosing to make that decision they should expect to lose some patients.

Barbara M.
Venice, CA

Eyecare examinations place the patient and doctor in very close proximity. I would not seek an exam from a doctor who has not been vaccinated, and I would leave the practice if I later found out the doctor refused a vaccination and hid that information from me. I believe that honesty is a part of qualifications. This virus has played havoc for a full year. How would the doctor feel if a patient already had the virus and gave it to the doctor but kept that information from him. It goes both ways. I think doctors are wrong not to get the vaccine yet insist on seeing patients and not informing them. Wrong.

What’s the Brain Squad?

If you’re the owner or top manager of a U.S. eyecare business serving the public, you’re invited to join the INVISION Brain Squad. By taking one five-minute quiz a month, you can get a free t-shirt, be featured prominently in this magazine, and make your voice heard on key issues affecting eyecare professionals. Good deal, right? Sign up here.

Natalie Taylor is an experienced optometry practice manager for Advanced Care Vision Network and a consultant with Taylor Vision. Learn more at tayloreye.com.

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