No vaccination, no service: Some SC pediatricians turning away kids for parents’ decisions

A two-month-old baby was recently denied care at a Carolina Forest pediatrician’s office due to his parents’ stance on vaccines.

Christopher Evans, of Conway, said his wife took their newborn to CPG Pediatrics Monday for a checkup and was told the baby would need six vaccines. When Evans’ wife refused to have all the immunizations done at once, the pediatrician said they don’t see patients whose parents refuse immunizations and left, according to Evans.

That decision stems from a policy adopted by recommendation of the American Academy of Pediatrics, according to Brian Argo, chief financial officer of Conway Medical Center, which operates CPG Pediatrics.

Argo said the company adopted the policy within the past two years, and his understanding is that there is some flexibility on the timeline for vaccinations, but there are some manufacturer recommendations that must be met. The policy does not apply to their emergency rooms, he said.

Tidelands Health does not have a policy prohibiting physicians from treating unvaccinated patients, according to spokesman Carl Lindquist, but they take precautions to isolate any patient who comes in exhibiting symptoms of a communicable disease.

Evans, who moved to Conway from upstate New York with his wife and three other children about a year ago, said he would’ve allowed the pediatrician to administer at least the polio vaccine but he believes, based on his independent research, that injecting so many vaccines at once could harm his child.

Pediatricians caring for his other children in the past have been willing to space out the injections, he noted.

Dr. Martha Edwards, immunization liaison for the SC chapter of the American Academy of Pediatrics, said the immunization schedule exists to immunize children when they’re most prone to those diseases.

“If we delay, it’s not as effective,” she said. “Breaking up (the vaccines) has no basis in science.”

Edwards, who works as a pediatrician in Rock Hill, said the decision to not see children whose parents refuse immunizations was difficult, but needed to protect other children in the office that might be unable to get certain vaccinations for medical reasons.

“We really wrestled with this for a long time: protecting kids from their parents’ decisions versus protecting other patients,” she said. “You can argue we’ve given less choice, but we think this is the most important issue in healthcare, and this is our way of saying it strongly.”

Evans argues that what he calls this “all-or-nothing” approach to immunizations is putting the community at greater risk. He said his oldest child is getting ready to enter the Horry County Schools system and still needs additional immunizations, but without a pediatrician, he’ll instead consider getting an exemption from the SC Department of Health and Environmental Control.

Exemptions on the rise

South Carolina allows medical and religious exemptions to vaccinations for children entering school and day care, according to DHEC’s website. Evans indicated his aversion to vaccines is related to his religion, but he declined to disclose his religion. The religious exemption form also does not require disclosure of the parents’ religion.

Religious exemptions have been rising in South Carolina, according to DHEC data, which shows that the number of students with exemptions has nearly doubled since the 2014-15 school year — with 5,826, about 0.75 percent of all students — to the 2018-19 school year — with 11,154, about 1.4 percent of all students.

Horry County is below state average, with 1.17 percent of all students, but has still seen an increase of more than 200 students with exemptions during the past five years.

Edwards said she’s very bothered by religious exemptions — which every state except California, Mississippi and West Virginia allows — because she believes parents are using it falsely to avoid vaccines based on social media fear campaigns.

“(Pediatricians) are watching in despair while parents get misinformation,” she said. “Practitioners trained for years, but (parents) don’t want to hear it. … Instead they’re trusting some person that could end up being a Russian bot.”

Edwards admitted there are risks associated with vaccinations, but she explains to parents that the act of driving the child to the doctor puts them at greater risk, and the risk of death or severe illness from not getting vaccinated is much higher.

She pointed to the recent national outbreak of measles — a disease the medical community thought it eradicated with a vaccine — as an effect of the rise in misinformation.

Measles was last reported in South Carolina in November, when six cases were identified in Spartanburg County, which happens to be the county with the largest percentage of students who have religious exemptions, according to DHEC data.

Patient abandonment

Beyond the issue of choice for parents, Evans is now arguing that the pediatrician’s treatment of his infant constitutes a form of medical malpractice known as patient abandonment.

The South Carolina Medical Association advises physicians wishing to terminate a patient relationship should give patients written notice explaining the reason for the termination and agreeing to continue providing treatment for a reasonable period of time, about 30 days, to allow the patient to find another provider.

Evans said the pediatrician didn’t provide adequate notice and wouldn’t even check his baby’s heartbeat. He confronted hospital administration about the issue, posting video of his interactions to YouTube, and there was an initial disagreement about whether a physician-patient relationship was ever established.

Evans was later handed a letter terminating the relationship, but the letter states that the pediatrician will only provide care in an emergency situation during the next 30 days.

Argo said Conway Medical Center believes it is in compliance with all applicable state rules and regulations.

Harold Christian, a Greenville-based attorney at Christian and Davis LLC, said that, generally, medical practitioners have a right to end a relationship with a patient as long as it doesn’t endanger the patient and they give adequate notice to obtain other care.

He’s litigated medical malpractice cases involving patient abandonment issues, but they most commonly involve doctors terminating relationships due to alleged opioid misuse, he said.

Christian advises that the best way to avoid conflict is for physicians to clearly explain their policies and patients to explain their philosophies in advance of an initial appointment.

Evans said he was already planning on suing Conway Medical Center for an unrelated issue involving his son’s birth at the hospital, and he believes this latest issue may be because they know about those plans.

In another video he’s since deleted, a hospital administrator told him their company would no longer accept anyone in his family as patients due to his interactions with staff, and he was then escorted off the property.

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