At PCC, we perceive our supporting role in the independent pediatric space to include doing the dirty work of measuring the impact of threats to and opportunities for pediatricians and the children they serve - (like COVID [1, 2, 3], the Change Healthcare debacle [1, 2 - which is all but forgotten already], coding changes, etc.  One element of that service is to share the data we have with the public and not hoard it for our own benefit.  In fact, it's one of PCC's stated Values ("Share What We Know").

In today's installment of this effort, we're going to look at the potential impact of anti-vaccine propaganda on well visit volume and, shortly, vaccination itself.  I believe, in my heart, that much of the present federal (and some state) administrations' anti-vaccine policies are rooted in an inconsistent and intertwined combination of grifting and eugenics/racism.  So, when someone at the AAP asked us to look into the possibility of an increase in canceled or missed well visits as a result of RFKKK's behavior, we agreed.  One of PCC's mad wizards conjured up the scheduling data for just under 5 million well visits starting in 2024 to see what we can find.  The results are, fortunately, not depressing.

I'll start here with this simple chart.

Here, we're looking at the monthly missed and canceled rates for all PCC client well visits.  As you can see, missed visits stay consistently between roughly 5-6% and canceled appointments between 6.5-8%.  If you overlay each measure to look at the calendar cycle, there's also a perceived seasonal swing (small potential increase in 'lost' visits in Aug/Sep).  There is also some correlation between the two outcomes, as you can see here.

But what I don't see?  That patients are canceling or missing well visits because of anti-vax propaganda.  This is great news.  There is, of course, a little more to the story:

• This doesn't reflect the change in volume of scheduled visits (maybe families simply aren't making the same number of visits), but we're not seeing that impact yet.
• We haven't measured how many of the canceled visits are then re-scheduled and fulfilled.  That's a heavier lift.
• I was sure I'd see a difference regionally - and I didn't.  The state-level political divide does not appear to extend to how much patients rely on their pediatricians.  

• Parents may be sticking with well visits - yay! - but they may be refusing vaccines at a higher rate.  I hope to deliver that information to you shortly. 

• And the most important measure of all: what's happening to well visit coverage?  That data takes a little while to tease out because it moves in small increments (if your well visit coverage drops 10% in a month, that means only 10% of 1/12 of your patients become overdue this month if you think about it).  We will know more soon.
  

Thoughts?  Anyone feeling otherwise?  Thanks to the mad scientists at PCC and PCC clients for their data.