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Mar 18, 2008

Yes, Dr. Frascino, I was reading the question someone had about having trouble with their doc at the hiv clinic and how the clinic was concerned with the meds and the labs etc. I have had the same problem. They refuse to listen to anything as far as other complaints etc. They would not even give me anything for nausea. A side effect I directly related to hiv meds. They also refuse to blame anything on hiv or the meds. Its always something else. If my labs are good that is all they are concerned about. I have learned to lean on my PCP and my pain doctor. I continue to go there and I am not even sure why. But just wanted to comment on the other persons dilemma with his clinic--he is not alone. Just wanted to let you know that must not be as rare as it may seem or at least I thought it was crazy what I was dealing with at my clinic and I too become quite angry at times now I just go get my labs and really say nothing and unload my complaints etc to my PCP and pain doc and so far they don't seem to mind. Really they have done everything they can to help me. Thanks

Response from Dr. Frascino

Hello,

I'm disheartened to hear you too are having such problems with your HIV clinic. I'm worried some of this may be due to the high demand placed on HIV clinics and specialists, i.e. way too many patients for the number of experienced specialists. Consequently the specialists tend to focus on what they feel is the most critical component of your overall care your HIV plasma viral load, CD4 count and antiretroviral regimen. Other problems may be pushed aside or even shunted to other health care providers capable of handling issues related to discomfort, nausea, etc., which to the HIV specialist may seem trivial or at least less important. This clearly is not the optimal situation. Certainly an HIV specialist should work cooperatively with the other members of the health care team (primary care provider, etc.); however, a patient should never feel he is being reduced to merely a set of laboratory results or combination of medications. Quality of life must be factored into every treatment equation. I don't know if you have the option or flexibility to consider a private practice HIV specialist to replace your rather impersonal "clinic," but this might be one option to consider.

Good luck.

Dr. Bob


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