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Choosing the best doctor
Jun 4, 2004

I was diagnosed with HIV in January 2004. I started seeing the only doctor in my city that treats HIV. She is a great doctor but is really a family practicioner. I went to her for the first visit. Last month after talking to some other people I decided to get a second opinion from the University of Colorado Hospital. I left there feeling much more knowledgable. I came back to my doctor who recently started a title 3 clinic here. I received two different opinions of treatment. My second VL test went from 4785 to 14000. The doctor in Denver did not feel it necessary to start treatment yet since I had a cold, the other doctor said I needed to. My wife and I told her what the doctor at the University felt. She didn't look too happy. The doctor in Denver ran another test the VL is now 5050 and the CD4 is 475. I am crossed about what to do as far as treatment and doctors. Part says to see both, part says go to Denver for all the treatment. What is your opinion.

Response from Dr. Pierone

There are many family doctors that have chosen HIV medicine, learned it well, and provide care that is superior to ID trained academic doctors. There are other community based HIV doctors that offer mediocre advice (at best).

It may be too soon for you to make a decision about where to get your care until you have a few more interactions with the local doctor and the University medical team. Part of this is practical, how long of an out of town trip will this entail? It is not unreasonable to have both a local doctor and a regional expert participate in your medical care plan. Some local doctors get defensive and can't handle being second guessed by another provider. Some regional experts can exhibit imperious behavior (the "my way or the highway" syndrome). I suspect that after a few more medical visits, the best course of action will become clear to you. Good luck!



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