In almost 50 years of practice, I've never fired a patient, but during the COVID-19 pandemic one nearly pushed me over the edge.

Mary was not the only patient in my panel who espoused anti-vaccine views. I have more than a few, and we generally get along just fine. But due to my compromised immunity, I wasn't accepting new patients who weren't vaccinated against COVID at the time (we've since changed our policy to require masks rather than the vaccine). I knew that vaccinated people could still spread the virus, but I wanted to take what precautions I could for myself and my patients while the virus was raging. Mary was established to the practice, however, and I wasn't going to fire her just because she refused the vaccine. But then she asked me to lie for her.

“Doctor,” she said via email, “Mike and I want to go to Bali on vacation, but there is a COVID vaccination requirement to go there, so we need you to say that we can't take the vaccine for medical reasons.”

I was agog. Mary had some medical issues, but none were a contraindication for the vaccine. As far as I knew, her partner also had no medical problems that would preclude vaccination, but he hadn't seen me as a patient for more than 10 years.