Looks great on paper, but good luck implementing it:

The zoster vaccine is terribly expensive and fragile, and it requires strict temperature control. Heaven help the practice that suffers a power outage. Patients will argue that Medicare or their prescription plan will cover the vaccine. When patients call their benefit plans, they will hear, “Sure, it’s covered! Just have your doctor call us for prior authorization!” Anyone who has traveled that route knows that countless hours of staff time will be wasted.

Like it or not, my practice is a business with real expenses. At best, the cost of the vaccine will be covered but I will have to bear the initial outlay of $180 per dose. I still will also have invested significant staff time in storing, monitoring, and administering the vaccine, and doing the special paperwork.

At worst, I will be stiffed for the entire amount and have to fight the patient who believes she should not have to pay for the vaccine.

Primary care doctors are already being gouged for the dubious privilege of giving flu and pneumococcal vaccines at terrible rates of reimbursement.

Excuse me if I err on the side of not going bankrupt. I am not giving the zoster vaccine.