Do Pediatricians Profit from Vaccines? A Doctor Explains the Facts

If I had to pick the piece of misinformation circulating around social media that drives me nuts, it’s that pediatricians are making “big bucks” from giving vaccines. That could not be further from the truth.

Like most misinformation, it starts with a kernel of fact that then grows, and becomes exaggerated and twisted to imply something completely different than that small truth. There are a few (not many) insurance companies that will reimburse slightly higher if physicians meet certain metrics. Those metrics can include patients coming in on time for their yearly visits, blood tests improving, and yes, even vaccines.

This stems from the fact that the current insurance-based system does not really reward great medical care over mediocre medical care. Seeing 50 patients per day quickly, and providing average care reimburses much more than seeing 25 patients per day, and providing extraordinary care – even if the physician is spending the exact same amount of time working. This is opposite of most industries, where a higher performing product or service generally has higher financial reward. If a company makes a really good widget, they will sell more and can charge a higher price than a company that makes an average widget.

People are not widgets though, so it’s difficult to quantify “better” care. These metrics related to reimbursement are an attempt to reward better care in a quantifiable way, knowing it’s difficult to quantify patients’ health.

Pediatricians give the most vaccines and we are the lowest paid medical specialty. That right there should tell you that vaccines are not highly profitable for pediatricians. We have to purchase vaccine refrigerators and freezers (much more expensive than home models) and high-tech thermometers to make sure the temperatures are always in range. Most practices pay a staff to give them and record them in the medical record and the immunization registry. We have to purchase different sized needles, alcohol wipes, bandaids and pay to dispose of sharps in a special container. Immunizations range from ~$20 a piece to almost $500 for one dose. Practices often have a large up-front investment and hope that insurance will reimburse enough to break even.

The riskiest part is mistakes or waste. If a vaccine is drawn up and not used, it must be disposed of properly, and the practice is responsible for the cost. If there are too many vaccines that have expired, often companies will only let a certain percentage be returned. Recently, I made just ONE mistake – thinking the company I use for vaccines was contracted with ONE patient’s insurance and it wasn’t – and I lost $150.

While it’s impossible for me to look at every pediatric practice’s financial records, I firmly believe that most pediatric practices would save money (and time) by not carrying vaccines. Most do though, despite the financial risk, because we care about your child and their health.