Blue Care Network Best Practices

Childhood immunizations

Making sure children are immunized is a priority at Wyoming practice

Dr. Tiffany Letts with patient Lincoln Lucas

Even though Tiffany Letts, M.D., has a high rate of immunizing children at her office, there’s always room for improvement. Increased efforts to track patients have resulted in some improvement in the past year.

Dr. Letts says her office now tracks patients more throughout the year and makes a concerted effort to immunize patients when they are in the office.

“Sometimes when I see a patient for a sick visit, I try to give them the immunizations they need if they haven’t been in for a well visit for some time,” says Dr. Letts. That’s important for families where transportation is sometimes an issue.

The staff also makes many efforts to get patients in. They make a lot of follow-up calls and send letters to those they can’t reach by phone. There are two other doctors in the practice and two nurse practitioners.

Dr. Letts says they all work together and use the same strategy to make sure children’s immunizations are up to date. “We discuss immunization in practice meetings,” says Dr. Letts. “Our entire practice is an integral part of keeping our population healthy and immunized.”

As with most pediatricians, Dr. Letts sees some patients in her office whose parents choose not to immunize. “We see that as an opportunity,” she said. Sometimes, after several conversations, parents change their minds. But other times, it takes a bit more effort.

Dr. Letts said she doesn’t want to alienate patients, so she isn’t judgmental. “With parents who are reluctant to immunize, I do not always approach immunizations at a first visit. I try to establish some rapport,” she said. “A lot of times, parents don’t initially divulge why they choose to refrain from immunizing their children. As I get to know them, I see where their reservations are, so I can address them.”

“It’s especially important to establish a good relationship with new families and get a sense of where they stand with immunizations,” continues Dr. Letts. “Some families may have been dismissed from other practices because they don’t immunize.”

Conversations with parents generally include research about vaccinations and sometimes the resurgence of some diseases.  

“I talk about diseases that were not as prevalent that we’re starting to see again,” says Dr. Letts. “I talk about my experience seeing those preventable illnesses, such as measles, pneumococcal disease and pertussis. Some families believe we don’t see these diseases anymore.”

“If I know what’s keeping them from immunizing their children, I try to confront that fear. I engage in discussion, but leave it open and I’ve had some pretty good success.”

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