Beth C. Natt, MD, MPH, MBA, Medical Director of Pediatrics at Atlantic Health

Summary

Podcast Summary: Vaccine Hesitancy & Equipping Healthcare Leaders

Podcast: Becker’s Healthcare Podcast
Date: May 23, 2026
Guest: Dr. Beth C. Natt, MD, MPH, MBA, Medical Director of Pediatrics, Atlantic Health
Host: Chris Sosa

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Episode Overview

This episode of Becker’s Healthcare Podcast features Dr. Beth C. Natt discussing the increasingly pressing issue of vaccine hesitancy, particularly how healthcare leaders can better support physicians in engaging with hesitant parents. Dr. Natt shares practical strategies, challenges faced in the field, and insights into measurement and operational impacts, all within the framework of her leadership work at Atlantic Health.

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Key Discussion Points and Insights

Dr. Beth Natt’s Background

• Pediatric hospitalist for ~20 years with increasing responsibility in administrative and operational leadership ([00:28]).
• Currently system medical director of the pediatric service line at Atlantic Health.

Understanding Vaccine Hesitancy in Pediatrics

• Vaccine hesitancy and refusal—including for other preventive interventions like vitamin K—have become more frequent ([01:05]).
• Encounters often occur in emotionally charged environments (new parents, exhaustion, stress).
• Clinicians see recommendations (e.g., hepatitis B, erythromycin, vitamin K) as evidence-based, but parents may approach with different information and concerns.

Quote:
“All of our vaccine hesitant parents have something in common. Just like us as physicians, they are simply trying to do what's best for their child.”
— Dr. Beth Natt [01:40]

Aligning on Shared Goals: Empathy and Reframing

• Both clinicians and parents want the same outcome—child health—but approach with different information and anxieties ([02:13]).
• Reframing hesitancy as a difference in information, not intent, helps clinicians approach conversations more constructively.

Quote:
“The disagreement's really not about the goal… We actually just come in with a different deck of information and that reframe really helps our clinicians think about how they're going to approach the conversation.”
— Dr. Beth Natt [02:13]

Tools and Strategies for Equipping Clinicians

• Support clinicians emotionally before focusing on skill-building ([03:05]).
  • Validating their frustrations and providing peer support reduces burnout and increases empathy and effectiveness.
• Partnership with Concern (Employee Assistance Program) implements peer discussions, combining emotional support with motivational interviewing training.

Quote:
“Before clinicians can really effectively listen to hesitant families, they actually need to have a space where their own frustrations and concerns are acknowledged.”
— Dr. Beth Natt [03:08]

• Group sessions normalize challenges, encourage value-based messaging aligned with parental priorities, and shift away from confrontation toward guidance ([04:27]).

Measurement and Evaluation of Efforts

• The impact of communication interventions is difficult to isolate due to multifactorial nature of vaccine decisions ([05:33]).
  • Influences include media, social networks, culture, personal experiences, and politics.
• Primary metrics:
  • Clinician well-being and confidence.
  • Vaccination rates tracked at nursery/practice levels over time.
  • Practice dismissal rates (being dropped as patients for refusing vaccines).
    • Notable stat: Dismissal by pediatricians rose from 6% (2006) to 37% (2019); no evidence this increases vaccine uptake ([06:20]).

Quote:
“There's actually no evidence that dismissal improves destination uptake. And we really want to make sure that we are supporting our families and giving them the information that they need to be able to make evidence based decisions.”
— Dr. Beth Natt [06:45]

• Early days for their program; significant, sustained results will take time ([07:20]).

Operational Payoffs: The Value of Listening

• High-quality clinician-patient interactions are among the most modifiable and impactful levers in vaccine decision-making ([07:46]).
• Key payoffs:
  • Families remain in care—greater chance to maintain influence and support broader child health.
  • Increased vaccine uptake through relationship-building and shared decision making.
  • Reduced conflict and enhanced decision confidence.
  • Improved clinician well-being and decreased burnout, especially critical amid heightened politicization of medical care ([08:50]).

Quote:
“Every family kept in care is a family that still has a trusted clinician at the table. And that's important for vaccination, but actually all of the child's health, not just whether or not they're getting all their vaccines up to date.”
— Dr. Beth Natt [08:03]

• Burnout is significant: “About 90% of physicians are reporting some stress right now due to the politicization of medical care.” ([09:14])

Advice to Peer Leaders

• Listen to clinicians and include their perspectives in designing interventions ([09:44]).
• Emotional and operational sustainability are key, especially in pediatrics where workforce challenges are acute.
• Engaged clinicians are willing and eager to address vaccine hesitancy, but need institutional support.

Quote:
“Listen to your clinicians. We're really very excited about the work we're doing with our Concerned Employee Assistance Program in terms of helping our clinicians through these difficult conversations… We want to make sure that our clinicians are feeling supported because they're going to be doing this for a career.”
— Dr. Beth Natt [09:44]

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Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote | |-----------|---------------|-------| | 01:40 | Dr. Natt | “All of our vaccine hesitant parents have something in common… they are simply trying to do what's best for their child.” | | 02:13 | Dr. Natt | “The disagreement's really not about the goal… We actually just come in with a different deck of information and that reframe really helps…” | | 03:08 | Dr. Natt | “Before clinicians can really effectively listen to hesitant families, they actually need to have a space where their own frustrations and concerns are acknowledged.” | | 06:45 | Dr. Natt | “There's actually no evidence that dismissal improves destination uptake. And we really want to make sure that we are supporting our families and giving them the information that they need…” | | 08:03 | Dr. Natt | “Every family kept in care is a family that still has a trusted clinician at the table. And that's important for vaccination, but actually all of the child's health…” | | 09:14 | Dr. Natt | “About 90% of physicians are reporting some stress right now due to the politicization of medical care.” | | 09:44 | Dr. Natt | “Listen to your clinicians… We want to make sure that our clinicians are feeling supported because they're going to be doing this for a career.” |

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Timestamps for Important Segments

• [00:28] – Dr. Natt’s professional background
• [01:05] – Rise in vaccine hesitancy and its challenge in pediatric hospital settings
• [02:13] – Reframing vaccine conversations and aligning on shared goals
• [03:05] – Supporting and equipping clinicians emotionally and with practical tools
• [05:33] – Measurement strategies for evaluating intervention impact
• [07:46] – Operational payoffs: care retention, vaccine uptake, and reduced clinician burnout
• [09:44] – Key advice for healthcare leaders looking to address vaccine hesitancy

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Conclusion / Takeaways

This episode offers a practical, empathetic examination of vaccine hesitancy through the lens of clinical leadership. Dr. Natt emphasizes the importance of reframing conversations, supporting clinicians emotionally, and building long-term relationships with families. The episode underscores the pivotal role of supportive, community-oriented leadership and the need for structured measurement, while reminding listeners of the far-reaching impact of clinician well-being on both vaccine uptake and broader child health.

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Transcript

[A]

Welcome to the Becker's Healthcare Podcast. I'm Chris Sosa, your host and I'm thrilled today to be joined by Dr. Beth Natt, she assistant Medical Director of Pediatrics at Atlantic Health. Beth, thank you for joining us today.

[B]

Thank you so much, Chris. Really happy to be here.

[A]

Fantastic. So, Beth, before we get into our topic today, which is vaccine hesitancy and how we can how healthcare leaders such as yourself can move that process along with your peers and those who you lead, could you just please introduce yourself and give us a bit about your background?

[B]

Yeah, so I'm a pediatric hospitalist by training and I've been in pediatric hospitals now for about 20 years and over the years have been getting more and more involved with administrative and operational tests and I'm currently the system medical director of the pediatric service line at Atlantic Health.

[A]

Thank you so much for laying out your background for us, Beth. So as I mentioned off the top, we're talking today about vaccine hesitancy and specifically how it relates to how healthcare leaders can equip their physicians and other leaders to deal with that as far as parents are concerned. So from your point of view as a hospitalist, what would you say is a starting point?

[B]

So, you know, as a pediatric hospitalist, one of my key roles is that I have to take care of babies in the, well, baby nursery. And one of the things that we've seen over the years is that vaccine hesitancy as well as refusal of other common preventative medicines like vitamin K have become increasingly common. As a pediatric hospitalist, this is pretty challenging. It's the first time this family has met me. Baby's here, they're exhausted, they're overwhelmed and they're really thinking about the health of their child primarily. And we're going in and we're having these conversations about hepatitis B, erythromycin, vitamin K, which we look at as being very clear cut, evidence based guideline recommendations. I think one of the things that we've really come to realize is that all of our vaccine hesitant parents have something in common. Just like us as physicians, they are simply trying to do what's best for their child.

[A]

Beth, I'm glad you mentioned that. The commonality of empathy. Right. Both you and as a physician and the parent, you both want the same thing. Right. So how do you get yourselves and even the parents sometimes in that mindset of pulling in the same direction?

[B]

Yeah. So, you know, as you said, the disagreement's really not about the goal. Right. It's both sides actually want to do no harm. They want to ensure the health and well being of the child. We actually just come in with a different deck of information and that reframe really helps our clinicians think about how they're going to approach the conversation. So when hesitancy is seen as an opposition, we get frustrated as clinicians and we default to lecturing or debating with families. And if we see it as a parent drawing upon a different information set to be able to get to the same goal, we get to be able to be more of a persuader or a guide to help the parent navigate towards a well informed decision.

[A]

Beth, thank you for mentioning reframing. I think that's a really good point to get into my next question here. And that's specifically what sort of tools you have as a leader to train and equip clinicians to have these conversations around vaccine hesitancy?

[B]

Yeah, so part of this work really starts with supporting the clinician, not just trying to skill them up. Before clinicians can really effectively listen to hesitant families, they actually need to have a space where their own frustrations and concerns are acknowledged. And we know that because clinicians that are getting exhaustion or frustration due to these hard communication styles that they're using and they're being not as effective as they want to be, and those are feelings supportive, are actually able to demonstrate some more empathy and connection. One of the things that we've done here at Atlantic Health is actually partner with Concern, which is our employee assistance program to start to facilitate peer discussions with our primary care pediatricians and other interested faculty to allow us to both combine emotional support with actually some practical motivational interviewing skill building.

[A]

Beth, you find that you must find, I would imagine that it's very helpful to give clinicians just sort of a reset. And not only that, but an outlet to say, you know what, this whole thing is frustrating. And, you know, one, I think you have to just simply listen to them and to work with them to figure out, okay, I hear you and here's how we move forward. I mean, is this something that's become of more importance over the last decade or so, or is it something you've always known as someone, as a leader of clinicians?

[B]

So I think that having our primary care pediatricians feel heard and recognize that their concerns are not just their own and it's part of a full community is really helpful for them. And they recognize that other people are having the same struggles as them in a day to day basis. That really helps have them feel supported, but it also is allowing them to start to Work through things like value based messaging. So helping to get the vaccination message out there with the parental priorities, like, you know, protecting their child's health, making informed decision rather to then just position these vaccines in an oppositional way to their values.

[A]

Gotcha. So looking at the next step, the next phase of this whole operation that you've been working on, Ned, Beth, it's a very clinical and, you know, formal way of putting it, but I think you understand what I'm getting at. So basically how do you, how do you assess whether your efforts are working, whether it's just with the clinicians? Well, not only with the clinicians, but with the community and those who your targets of this message.

[B]

Yeah, this is hard. Right. So vaccination decisions are multifactorial. They're shaped by media exposure, social networks, cultural values, personal experiences and the broader political climates. But no single initiative is going to have sole credit for moving the needle. And really because of that, isolating the impact of just one communication intervention is also going to be inherently difficult. But there's some signals that we can use that will help us know if we're moving the right direction, you know, so first of all, we're looking at our clinician well being and our confidence. This is where we're really hoping that our concern, facilitated discussions is going to be most impactful. And then we're also hoping to see increased vaccination rates. We do know with work done on influenza as well as HPV vaccination that motivational interviewing strategies have really increased the uptake there. And we're currently practice tracking our nursery and our practice level vaccination rates over time. And although it's not perfect, it is a clinically meaningful outcome. We're also looking at the dismissal rates of dismissal from practices. This is a critical and really overlooked metric. We know by looking at some AAP data that the dismissal rates from pediatricians have been rising sharply. It was about 6% back in 2006 and in 2019 it was 37% of pediatricians reported that they were dismissing vaccine refusing families for some at some points. And the hard part is that there's actually no evidence that dismissal improves destination uptake. And we really want to make sure that we are supporting our families and giving them the information that they need to be able to make evidence based decisions.

[A]

So Beth, are you able to give us a little insight on how those measurements are progressing at the moment?

[B]

So we're in our infancy now, so it's going to take a long time for us to see A systematic impact. So far, nothing to report, but hopeful that we're on the right path here.

[A]

Understood. Hopefully you'll be able to check in with us at some point and let us know how all this is going. That would be great. So the next and maybe the last question I want to get in front of you is what is the operational payoff when families feel heard rather than lectured? I know you were describing the difference between those two early in the conversation. So what would you say is the payoff there?

[B]

Yeah, so the same complexity that makes measurement hard makes payoff hard to attribute as well. Vaccinations decisions are shaped by forces far beyond the exam room. But the evidence clear that the quality of the clinician patient interaction is one of the most modifiable levers that we have. And then if that interaction is built on the shared goal foundation, the downstream effects are real. So, number one, we want to make sure families stay in care. This is maybe the most single important operational outcome because every family kept in care is a family that still has a trusted clinician at the table. And that's important for vaccination, but actually all of the child's health, not just whether or not they're getting all their vaccines. Up to date, we're also hopeful to see that vaccines families are more likely to vaccinate. And one of the lessons we've learned from our clinicians who have historically accepted families who choose not to vaccinate is that the decision changes over time as they built a trusted and therapeutic relationship, and that shared decision making interventions significantly increase vaccine uptake while decreasing conflict and increasing decision confidence. These aren't small effects. They represent the difference between a conversation that ends in refusal and one that opens a door. And then last, particularly in pediatrics, right now, we want to make sure that we're addressing burnout. Making sure that our clinicians feel supported is an operational payoff that doesn't really make the headlines, but it's incredibly important because about 90% of physicians are reporting some stress right now due to the politicalization of medical care. And moral distress is really associated with burnout.

[A]

Beth, lastly, I know you said earlier that a lot of these efforts are in the infancy, so the measurements aren't quite there yet, but I'm sure they will be at some point. But I do want to ask you, so if you say there's another peer of yours from another hospital health systems who said to you, beth, I see this problem, I want to tackle it too, what advice would you give them?

[B]

So I think first of all, listen to your clinicians. We're really very excited about the work we're doing with our Concerned Employee Assistance Program in terms of helping our clinicians through these difficult conversations. I was surprised to hear how actively engaged our pediatricians wanted to be in this type of discussion on a day to day basis. And then also recognizing that we want to make sure that our clinicians are feeling supported because they're going to be doing this for a career. We want to make sure that we are able to have them have the sustainability, especially in pediatrics where we know we have workforce issues every single day.

[A]

Beth, thank you so much for coming on to the podcast today and discussing this very important topic with us. And we can't wait till our paths cross again.

[B]

Wonderful. Thank you so much. Chris.