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.

When my husband launched his private practice in July 2024, we faced this exact dilemma during flu season. Instead of avoiding the topic or making blanket announcements, we took a targeted approach that actually strengthened patient relationships. We created separate communication tracks based on patient behavior patterns from his previous six years in practice. Patients who historically got vaccinated received proactive reminders through our patient portal about convenient scheduling options. Those who hadn't previously vaccinated received general wellness check-in messages focused on seasonal health preparation--no mention of vaccines unless they brought it up. The result was remarkable: zero patient complaints about vaccination messaging, and our vaccination rates among willing patients increased 15% compared to typical practices. We also saw referring physicians appreciate that we weren't creating controversy in shared patient relationships. The key insight from building our $239K first-90-days practice was treating vaccination discussions like any sensitive medical topic--individualized, patient-driven, and focused on their established care patterns rather than broad public health campaigns.

Shamsa Kanwal, M.D., is a board-certified Dermatologist with over 10 years of clinical experience in medical and aesthetic dermatology. She currently practices as a Consultant Dermatologist at https://www.myhsteam.com Profile link: https://www.myhsteam.com/writers/6841af58b9dc999e3d0d99e7 Avoiding the subject of vaccines to prevent disagreement can seem like the easier route, but it often means missing a valuable opportunity for patient education and prevention. Even in the current environment, physicians remain among the most trusted sources of health information. When we approach vaccine discussions with empathy, respect, and evidence, we can address misconceptions and guide patients toward informed choices. The way the conversation is handled matters. I keep the focus on the patient's personal health risks and needs rather than issuing blanket statements. This helps patients feel heard and understood. With hesitant patients, I start by asking open-ended questions to learn about their concerns. I then respond clearly and respectfully, sharing reputable information without pressure. Sometimes the decision is not immediate, but leaving the door open for a future conversation is important. In the end, open and respectful dialogue about preventive care, including vaccines, strengthens trust, improves public health, and helps ensure decisions are based on sound medical guidance rather than misinformation.

In my experience, it's important for physicians to address vaccinations directly, even in a contentious climate. Avoiding the topic can inadvertently create confusion or give the impression that the practice isn't proactive about patient health. I recommend framing the conversation in a balanced way—emphasize the safety and benefits of getting vaccinated while acknowledging patients' concerns. For example, instead of pushing for vaccination outright, I suggest offering clear, evidence-based information, and providing an opportunity for patients to ask questions. This approach fosters trust and allows patients to make informed decisions. For those who are vaccine-positive, offering convenient in-office options can make the process easier and encourage higher participation. Ignoring the issue entirely could risk missing out on the opportunity to educate and support patients in a time when guidance is more crucial than ever.

From what I've seen working in public health messaging, it's important never to shy away from promoting vaccinations, even if the topic seems divisive. The role of a physician is to advocate for the health and wellbeing of their patients, and part of that is recommending and providing access to preventive measures like vaccinations. Communicating the benefits of vaccinations, especially as flu season hits, helps ensure that your patients have all the information they need to make informed health decisions. It's true that broaching vaccine topics requires sensitivity, given the diverse opinions on the matter. One effective approach is to provide educational materials that address common concerns and misconceptions in a factual yet understanding tone. This method respects patients' viewpoints while also gently correcting misinformation. Moreover, maintaining an open line of communication where patients feel comfortable discussing their worries can foster trust and possibly encourage more positive attitudes towards vaccinations. Always remember, your primary aim is to protect individual and public health, so it's worth the effort to engage on these crucial topics.

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.

Physician practices must navigate the complex landscape of vaccination communication, balancing public health advocacy with patient sentiments. Two main approaches exist: encouraging vaccinations through professional guidance to promote informed decisions, or adopting a hands-off stance to avoid alienating hesitant patients. Each method has its pros and cons, highlighting the challenges of addressing vaccine-related concerns in today's climate.