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Report Pediatricians Receive Bonuses For Administering Vaccinations


Image Credits: public domain (CC0) / pixnio.

Most American families use pediatricians—rather than generalist family doctors—as their frontline children’s health care provider.

With the backing of its trade organization, the American Academy of Pediatrics (AAP), the field of pediatrics has been booming for some years, ensuring current and future demand for the many doctors-in-training who are choosing pediatrics as their specialty.

Pediatricians’ average annual salary (roughly $200,000) may not be competitive with some of the more specialized medical domains, but pediatrics appears to offer high career satisfaction and inducements such as flexibility and part-time work opportunities.

In addition, the 11 well-child visits recommended by the AAP over a child’s first 30 months (with annual visits thereafter through age 21) ensure a steady stream of repeat customers and revenue for pediatricians.

In accordance with the Centers for Disease Control and Prevention’s (CDC’s) vaccine schedule, pediatric practices are expected to administer vaccines (often as many as six at a time) at about half of well-child visits through the adolescent years, making vaccination a foundational bread-and-butter component of pediatricians’ job description.

The one problem with this rosy pediatric picture is that some parents do not want to go passively along for the ride.

It is quite common for pediatricians (and family doctors) to encounter parents who refuse one or more infant vaccines, most often due to safety concerns.

These concerns also mean that pediatricians frequently get requests to modify or delay the vaccine schedule—nearly three-fifths (58%) of pediatricians reported such requests in a 2014 AAP survey.

One-size-fits-all vaccine proponents argue that families who question any aspect of the CDC party line are confronting pediatricians with an “alarmingly untenable dilemma” between either “continu[ing] to provide substandard care by foregoing many or most of the infant’s highly recommended protective vaccines” or “dismiss[ing] from the practice the family who refuses vaccines.”

Rather than recognize the validity of parents’ safety concerns or admit to their own ambivalence about some of the newer vaccines, many pediatricians—nearly two in five according to some estimates—choose to boot uncooperative families out of their practice.

A recent Medscape survey indicates that one of the main things that pediatricians dislike about their job  is “dealing with difficult patients.”

However, when pediatricians dismiss families whose only crime is the desire to make informed and individualized health care decisions on behalf of their children, the doctors are doing more than just unprofessionally dumping “difficult” patients—they also are protecting their bottom line. Increasingly, insurers and provider organizations are collaborating in a “value-based” approach whereby insurers give bonus payments to doctors and other providers who achieve specified quality of care targets.

A widely reported example of this type of pay-for-performance model is the Blue Cross Blue Shield of Michigan “Performance Recognition Program,” which uses “meaningful” payments to reward Blue Care Network (BCN) health maintenance organization (HMO) providers “who encourage their patients to get preventive screenings and procedures.”


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