Pediatricians subsidize vaccines to keep children healthy and prevent pandemics. They don't have to

When he told me one of the biggest challenges as a pediatrician, my uncle looked exhausted and it had nothing to do with medical issues. “I spent about a million vaccines a year,” he explained. “After all, I said and done, I’m not even sure I even broke them.” After 25 years of providing care for children in Virginia, my uncle described a financial trap that undermined our country’s pediatricians.

These days, vaccines have been headlines. But this broken financial model, where the huge cost and incredible risk of pediatricians is merely a silent threat to children’s vaccination programs throughout the United States, and all children, families and communities that benefit from it.

Impossible burden

The cost of vaccines is high. They represent the second largest expense for children’s habits after employees’ salaries. Let's start from scratch: buy vaccines. The price of each vaccine is not transparent: it depends on many factors such as the loyalty of manufacturers and distributors, your size as a practice, your ability to get the right contract first and the time of year. These prices are constantly changing, so you are always adjusting.

Then, as a small independent routine, you need to buy $50,000 to $100,000 in a month for vaccine stocks. You have to take too much risk, take too much cash flow and inventory risk, or very little, have to keep patients out. When maintaining inventory, you need to track manufacturer batches, expiration dates and temperatures in real time to ensure patients receive safe, high-quality immunizations.

Always you have to compete with the time-consuming documentation process. Different vaccines are provided to different patients, and it is sometimes difficult to determine who is who. In some cases, patients with the same precision insurance company will need additional vaccines, depending on their plan. Once sorted, you must record the entire process (including the inventory used) in your own records while also reporting the information to the state. These key records as proof of vaccination are not usually transferred between states or even between cities in one state. So if the patient recently moved, you have to find and enter everything from scratch.

Finally, you have to get the insurance company to pay you off. Different insurance companies and different plans have different rules on how to file a claim. Any secondary question can make you refuse, delaying the entire process for up to three months, and the worst is writing off the vaccine you have already paid for. This is just the beginning. Barriers are everywhere: newborns who have not yet legally owned insurance, families with multiple insurance plans, recent job changes that affect insurance status, you can name them. Even if everything goes well, insurance reimbursements may be lower than the vaccine you will pay for first.

Each doctor rinses and repeats every day, more than 15 times a day.

But, most notably, when you realize that any part of this unpopular system is related to medicine or science. It is supply chain optimization, not pediatric medicine.

That way, it is no surprise that 36% of pediatricians have stopped or are considering providing a vaccine completely. Academic Pediatrics. This is a particularly shocking number given the list of major challenges that have been suppressed by pediatricians. They form one of the lowest-paid physician categories in the country. According to Medscape's annual physician compensation report, their time is increasingly spent on administrative work – an average of 15 hours per week, compared to nine hours per week in 2012. Pediatricians pour hundreds of hours of care base a week to prevent our healthcare system from collapsing under the weight of preventable diseases.

Ridiculously, we ask doctors responsible for preventing measles outbreaks and polio resuscitation to subsidize these efforts from their own pockets. A childhood vaccine program was developed in 1994 to address this problem for Medicaid and uninsured patients, but the process there is more complex and profitable.

Dangerous chain reaction

This unsustainable model is particularly harmful considering the disturbing national trends. The vaccination rate is declining, and the rate of vaccine hesitation is rising. When I talked to pediatricians about how to address the increase in vaccine preservation for parents, I heard the same thing in general: They need more time to educate, consult and take care of their patients. However, spending every other minute with the parents involved can make the habit pay the debt deeper. This is a vicious cycle, and everyone is lost.

It is worth mentioning: People now have more problems with vaccines than ever before, because there is indeed more uncertainty than before? Or is it because the experts they ask for simply don’t have time to give thoughtful and careful answers?

What I learn every day with pediatricians across the country is that most people in medicine naturally don’t consider the economic impact. Why do they want it? Pediatricians have spent more than a decade studying to provide excellent care rather than researching cash flow management or insurance reimbursement optimization.

A new way to move forward

No need to do this. I've seen what might be when we do this. Pediatricians are less hardworking, parents are better consulted, children are better cared for, and communities remain protected. The technology and expertise needed to solve this problem already exists – we just need to implement solutions that address the status quo and put children’s health first.

We can continue to ask pediatricians to subsidize disease prevention from their own pockets and observe the number of doctors specializing in caring for children continues to decline, while those who continue to practice financially. Or we can build a system that does the right thing for children’s health, which makes sense for their health care providers as well. The choice is ours. I know the future I am working on.

Photo: geber86, Getty Images

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