Physician practices often encourage their patients to get flu, COVID, and other vaccinations in the fall, whether at the office or at their pharmacy? But in the current environment, with vaccines themselves a contentious issue, is it better to let the subject alone, evade the risk of alienating some patients, and trust the vaccine-positive patients to make their own arrangements? Readers of our physician practice management weekly will be interested to hear from experts in physician practice and/or public health messaging about this.

One of the promises I've made to myself is that I'm always going to recommend what's best for my patients, even if they don't want to hear it. I'm lucky enough to be in a specialty practice where my clientele is a bit more self-selected and usually not focused on vaccines, but I'm not afraid to push back on misinformation in this area. I'm passionate about it because it's a choice that affects other people as well as yourself. If you want to have an increased risk of catching influenza, that's your business, but that choice will also increase the risks for those around you, and I can't accept that.

Avoiding the conversation about vaccines is a far greater risk than having it. Silence from a physician isn't neutral; it's a form of professional negligence that abandons the patient in a landscape of dangerous misinformation. When we evade the topic, we are implicitly telling our patients that their trusted doctor is not the place to discuss their most pressing health questions. The key is to relentlessly depoliticize the exam room. The conversation should never be about the news or social media debates; it must be about that specific patient's health. I make it a point to say, "Let's set aside all the outside noise. My only concern is your health and keeping you safe this fall. Can we talk about what that looks like?" This approach shifts the context from a public argument to a private, medical consultation. The patient may still decline the vaccine, but they will leave knowing their physician cared enough to provide personalized guidance respectfully. You may not win the argument, but you will preserve the trust that is the absolute foundation of our work.

Vaccines are a key part of medical practice, and they have a lot of benefits compared to side effects. Deciding on whether or not to tell a patient about vaccines shouldn't be the dilemma here; rather, there should be a better explanation of the vaccines and side effects. As physicians, we have a responsibility to promote evidence-based practices that protect individual and public health. Choosing not to discuss vaccines can also be non-beneficial in cases where people aren't well informed. Some patients have their doubts about vaccines, and there's a risk of alienating them, but this can be better avoided when the physician is more empathetic and doesn't bash them for their choice. Like it or not, every physician is indirectly a public health advocate, and these vaccines should be talked about more often, but also we should bear in mind that patients aren't robots and shouldn't have vaccines or opinions forced on them.