|health care provider with surgery
Aug 8, 2010
are you crazy spoken like a doctor ...you advised that person to change insurance or pay out of pocket for a surgery ...shame on you ...how about suggesting a john doe while in hospital ...i agree with changing health care people BUT within his insurance ....i am a HIV poz nurse
Response from Dr. Frascino
No, I'm not crazy. And if you read carefully, what I advised is that the questioner be honest with his health care providers regarding his HIV-positive status, as this information may be important in evaluating or treating a medical problem or complication. The questioner mentioned his wife works for the hospital system that his insurance would require him to use for his surgery and that other family members use the same orthopedic surgeon. He expressed concern that his confidential information would be made public if he utilized that doctor and hospital. Insurance companies and most hospitals would not allow someone to use a "john doe" designation for a hospital admission and surgical procedure. His options are limited. I suggested he find new health care providers with whom he could be honest, even if this meant changing health care plans or paying out of pocket. The message is that he definitely should not compromise his health out of fear his status might be revealed. This advice is very sound medically; not crazy at all in my opinion as an HIV-positive physician.
Disclosure to a health care provider Aug 4, 2010
I have seen several queries in this forum concerning the obligation to disclose (or not) but only one that was somewhat related. I am hiv+, on meds with an undetectable VL, and otherwise healthy. Other than for my wife, I have gone to great pains to conceal my status from my family, friends, and coworkers -- mostly for obvious reasons.
I am greatly in need of (yet another) surgery on an ailing knee but am very reticent to disclose my hiv status. This would be the first such procedure since becoming infected. Other family members use the same orthopedic surgeon, my wife works for the hospital system that our insurance would require me to use, and my last name is fairly recognizable. I know that HIPPA rules require confidentiality and all, but from a practical standpoint, the likelihood that it would not get around is virtually zero. The impact of that would be professionally and personally devastating, not only for me but perhaps for my wife as well.
You can probably see where this is heading. My predilection is to not disclose my status but I have misgivings about that as well. On the one hand, one could argue that if disclosure is not obligatory for sex, why should it be so in an environment where practitioners are supposed to use universal precautions. On the other hand, there is a much greater risk that one may come in contact with infected blood (even though the VL may be low). I don't believe that they routinely test orthopedic patients for hiv and have never been tested prior to my other surgeries, but, should they do so this time, that could prove equally embarrassing. I don't want to think of myself as a jerk if I don't disclose, but I also cannot risk the consequences of doing so. I'm not certain just what I'm asking here other than for your thoughts. Thanks.
Response from Dr. Frascino
It is not in your best interests to hide information from your doctors. This information may be crucial in evaluating or treating a medical problem or complication. If you feel you cannot be honest with your health care providers, including being upfront about your HIV-positive status, you should find new health care providers with whom you can work more closely and honestly, even if this means changing health care plans or paying out of pocket. Don't compromise your health. Being honest is never the wrong decision no matter what the immediate consequences may be.
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