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The Changing Role of Pediatricians

pediatrician examining teddy bearStory Highlights
  • There are valid reasons for a specialty in pediatrics since the physiology of infants and children differs significantly from that of adults.
  • The role of the pediatrician has shifted over the years from a focus on treating illness to a focus on vaccination and producing electronic medical records tracking vaccinations.
  • The American Academy of Pediatrics does not have an official policy encouraging pediatricians to dismiss children from their practice if parents refuse to give their children every recommended vaccine on schedule, but HMO groups are financially rewarding doctors with high vaccination rates among patients.

As soon as they know a baby is on the way, one of the preparatory tasks most first-time parents go through is finding a pediatrician. Using a separate pediatrician for children instead of relying on the family doctor is actually a relatively new idea.

Apart from obstetrics, the concept of a specialty in children’s health was sporadic prior to the 1860s. It was only formalized with the introduction of the American Board of Pediatrics (ABP) in 1933, when it became clear there was a need for standardization in training. Prior to this period, all a medical doctor had to do was to declare a specialty in a chosen field.1

Definitions and vocational descriptors paint the pediatric specialist in noble terms, and many of the endorsements are valid and important: A baby is not just a small adult. “The smaller body of a neonate or an infant is significantly different physiologically from the one of a grown-up” and a pediatrician must be able to recognize normal “genetic variance, congenital defects, immunology, oncology and a group of other issues…”2

A Broader View of the Pediatric Role

The doctor considered to be the “founder of modern pediatrics,” Abraham Jacobi, MD, began giving lectures in 1860 on children’s health that went beyond the treatment of disease and considered the health of the whole child. Jacobi advocated strongly for breastfeeding and warned against feeding cow’s milk to infants.3 He believed that pediatricians should be involved in all areas of a child’s health and educate parents about healthy child-rearing customs, including feeding, hygiene and disease prevention as well as treating sick children.4 His goal was to encourage pediatricians to help “Americanize” immigrant children and he was an advocate for “children’s rights.”

Taking an authoritarian stance, Dr. Jacobi said:

Pediatricians monitor physical and mental growth development, perform routine evaluations, and dictate immunizations and vaccines to prevent illnesses, disorders, or even death.

Dictate? The implication is that parents should have no say in the matter of vaccinating their children, and that is exactly what is happening in pediatric practices today.

This same source goes on to remind us that pediatricians also “keep all examinations, tests, treatments, outcomes and medications on file in patient folders for evaluation or future use.”5 Certainly, that will promote continuity of care, but it also can be a double-edged sword wielded by someone who is dictating vaccines. That is especially true in these times, when such medical records are electronic and easily shared.

Enter the Well-Child Check-up

According to Vincent Iannelli, MD, the idea of the “well baby” visit was developed by American pediatrician Dr. Emily Partridge Bacon in the early 20th century at some point in her 50-year career as a pediatric specialist.3 Although well-baby visits at that time would have looked very different from those of the present, Dr. Bacon’s medical career only began in 1916, so her introduction of the well-baby clinic would have coincided with the smallpox, diphtheria and tetanus vaccination program.6

Today’s well-child visits are essentially synonymous with vaccination and are a minefield for parents who have concerns about vaccines. As more and more vaccines are added to the schedule, vaccination takes up more pediatric office time and accounts for more of the pediatric income.

The Vaccine Financial Incentive

According to William Sears, MD the problem goes beyond the simple arithmetic of “more vaccines+more office visits to provide them=more money.” He doesn’t believe physicians would be so concerned with vaccine income that they would push unwilling patients to vaccinate, or reject non-vaccinating families from their practice. What he has found, though, is that there are some HMOs that reward pediatricians for having a high percentage of fully vaccinated patients, essentially encouraging them to get rid of any non-vaccinating patients. HMO contracts in general reimburse practices at such a low rate, it might end up costing the doctor money to keep such families.7

Reportedly, Dr. Sears had assumed that doctors who refused to treat unvaccinated families simply believed so strongly in vaccines that they could not in good conscience keep them on, but now he fears that “some doctors, especially those large groups who rely heavily on large HMO contracts, may actually be doing this because of money.” He said:

The American Academy of Pediatrics Committee on Bioethics makes it very clear that the official AAP policy is that doctors NOT kick patients out of their office over this issue. But when money talks, some people don’t listen.


1 History of the ABP. American Board of Pediatrics 2016.
2 Nurse Universe. The Importance of Pediatrics. Medvotech.com and Vertical Alliance Group 2012.
3 Iannelli V.  Pediatrics—Pediatric Milestones. VeryWell.com June 23, 2016.
4 Connoly C. Growth and Development of a Specialty: The Professionalization of Child Health Care. Pediatric Nursing 2005.
5 The Importance of Pediatricians. Masters in Health Care 2016.
6 Immunization Action Coalition. Vaccine Timeline: Historic Dates and Events Related to Vaccines and Immunization. National Library of Medicine June 14, 2016.
7 Sears W. Financial Incentive for Doctors to fully vaccinate patients? AskDrSears.com Sept. 19, 2016.

7 Responses to The Changing Role of Pediatricians

  1. kevin bennett Reply

    October 7, 2016 at 6:43 am

    Some research group, not funded by pharmaceuticals. should take all the research. including those billions spent who proved in court that a vaccine caused ….. injuries. even the ones that could not prove. and come up w something. Even the contents of the vaccines should be scrutinized. spread the vaccines out so they don’t get too many at once. It should not be about money, but doing the right thing for the right reason.

    • Cynthia Reply

      October 12, 2016 at 3:08 pm

      Kevin you are so right. Being the mother of a vaccine injured child stinks! No one will do this though.

      Again money takes front seat to doing the right thing:(


  2. Cathy Wragg Reply

    October 8, 2016 at 6:48 am

    We just had a new grand baby. I was infuriated that the pediatrician in Roswell, GA told them he could not accept their baby as a new patient unless they got the hepatitis b shot? He also told them that it would put his other patients at risk because 1,000’s of babies are being diagnosed with hepatitis b. Really? Like the babies in his waiting room are shooting up and/or having sex…give me a break!

    It’s all about the money, period!

    • Cynthia Reply

      October 12, 2016 at 3:12 pm

      Number one this doctor straight out lied when he said 1000 of babies are getting Hep B. Red flag #1 to get new Ped. The amount of aluminum in the Hep B vaccine is 5xs the FDA recommended amt for a 2 month old but they can give to a newborn! It’s Russian roulette really. Hence the Vaccine INjury & Death court has been created for a reason. Tell this Pediatrician to look at the report.

  3. Ma Bear Reply

    October 9, 2016 at 9:02 pm

    Sure makes you want to avoid the medical doctor.
    Makes you want to avoid well child checks & just go to the chiropractors… who all seem to be leery of vaccinations!
    After a kid with a reaction, I don’t want to see a pediatrician unless they are a pediatric specialist.

  4. Race 2 Reply

    October 13, 2016 at 8:58 am

    The movie Vaxxed will be in town tonight but it is going to be a choir of the initiated because I called all my friends to see if anyone will see the movie with me and the only people willing to see the movie are those who already know this information. Mandatory vaccines, here we come.

  5. Vivian Reply

    October 22, 2016 at 2:35 pm

    We live in a world of fear as parents. It’s all about being scared. The medical profession has become an illness profession, a sickness factory and endless cycle of money making. It’s not just vaccines – Google cancer and all the money made from that (also exponential cancer rate linked to vaccines!) I have reached the conclusion that any sand parent who wants to protect their child has to get real and get away from
    The medical profession until it calms down. Get a good homeopath/naturopathic Doctor, but medical books (old second hand ones are best as the ones in your bookstore will be spouting the same stuff we are living with), do your research on the immune system and the microbiome and pray to God every day to watch over your family in this crazy time. It will settle – the evidence is becoming overwhelming now. I think governments are paralysed by the scale of what is happening but will eventually have to face up to it. In the meantime – why would you tell your doctor the truth? Forget it! If they ask if shots are up to date, nod eagerly and say “oh yes she has had all the shots she needs” ie: code for none!! We are really just the first wave to wake up and I think we are in a cultural, brainwashed trance right now.

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