We recently hosted a live discussion on Twitter (a TweetChat) as part of the #PWChat series, co-hosted by Ilan Shapiro, MD, MBA, FAAP, FACHE— Medical Director of Health Education & Wellness and Medical & Health Strategic Communications at AltaMed Health Services in Los Angeles, CA—with the intention of empowering physicians to discuss vaccination with their patients.

What advice can you give physicians on starting the conversation about vaccination with patients?

First, seek to understand where the patient is coming from. There is so much information out there, good and bad. Some people are still simply confused.

We are all in this boat together. Physicians are still human. We need to level the conversation human-to-human, validating fears and doubts, and most importantly, be vulnerable and share our own stories about why we were vaccinated. This opens hearts and minds. Your objective as a physician is to share information and help, with evidence-based data, explain what is real and what is not.

We’d say, be direct. Patients are people and deserve to be treated as anyone else.

Agreed. I always try to make sure my patients interact with me. I tell them I’m their waiter and will show them the menu and recommend best dishes, and that sometimes they will want something else. They are in charge.

This makes me nervous, and I worry that it can get too close to abandonment to be comfortable. While we certainly don’t want a return to medical paternalism, the physician has a subject matter expert role to play that goes beyond merely facilitative in my opinion.

The physician can still be the subject matter expert while balancing shared decision making.

I think investing a couple extra minutes when we have the patient in front of us MAKES A HUGE DIFFERENCE!Tweet Your Reply

What can/should physicians do to remain “neutral” during discussions about vaccination with patients, and why is that important?

Know the literature. Know the data. Understand biases and pro/con discussions. Understand where the patient is coming from.

Do not hesitate to mention the risks, as well as the benefits.Trust in the patients to do their own risk stratification with the full scope of information. When we promote paternalism, we sacrifice patient trust, and we all suffer.