It strikes me, a nonphysician but a parent who benefited from magnificent pediatricians, that the strongest argument a doctor can make when a parent balks at vaccination is that a pediatrician owes a duty to all his or her patients as individuals, not just to each individual in a vacuum.
A parent who refuses to vaccinate a child is endangering the rest of the, OK, herd. That's a good reason for separating the potential agent of infection from the others, just as children with communicable diseases are usually not invited to sit in the common waiting room.
There are all kinds of arguments for vaccination, even though it means accepting a small individual risk. Making the arguments convincing probably does come down to the manner and power of persuasion of the pediatrician.
No doubt some parents will prove intransigent. Although the question remains as to what happens to the children who are excluded from the practice for this reason, it seems to me that "firing" is justifiable.
More to the point, couched in terms of the danger an unvaccinated child poses to the other children in the physician's practice, not to mention to schoolmates and society, it might just be a threat, delivered as an explanation rather than a retaliatory measure, that could win compliance.
David Ollier Weber
The Kila Springs Group