When you take a stand about something, it’s nice to look around and realize you’re not standing by yourself.

According to a study in the journal Pediatrics, about 20 percent of pediatric practices dismiss patients whose parents refuse one or more of the standard vaccines recommended during infancy. Mine would likely count as one of them. Though we don’t technically “fire” patients for not getting vaccinated, we don’t accept them to our practice in the first place, which is close enough.

As the authors of the study note, this puts my practice somewhat at odds with the American Academy of Pediatrics (AAP). In a set of guidelines issued in 2005 for dealing with the problem of vaccine refusal, the AAP advised that “pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child.” Though this was softened a couple of years ago to saying we should “endeavor not” to discharge such patients, the underlying message was pretty much the same.