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Doctor conflict

Feb 24, 2008

I am an hiv+ male, 18 years. I have cd4 count of 400 and am undetectable. I am being treated at a large teaching hospital in the state where I live. They have a infectious disease unit that deals only with hiv. My problem is the staff wants to concentrate on hiv meds and thats it. They completely refuse to prescribe anything for weight loss and wasting syndrome and neuropathy and a host of others. I have went to see a family doctor and explaind the situation to him, he said because they are concentrating on controlling the hiv, the other things are not life threatening and do not have the precedence the hiv does. Since I have been on appetite stimulants I have gained 50 lbs and I have been taking the pain meds for the neuropathy, I feel so much better. It is like talking to a wall to get them to see this and I am increasingly angry with them at every visit. What should I do, stop going and find another hiv specialist or keep the 2 doctors. They are not happy that I went to see a family doctor to treat me besides them, but I dont care. They are not giving me the option, its a take it ot leave it attitude they have to anything other than hiv meds only.

Response from Dr. Frascino


Becoming increasingly angry with your HIV team with each visit is not a good situation. An effective doctor-patient relationship needs to be built on trust, cooperation and understanding. If this is not possible in your current arrangement, something needs to change. Sometimes large teaching hospitals may be impersonal due to their dual role of providing both teaching to the doctors in training and care to the patients who visit the facility. One option might be to find a private practice HIV specialist in your community with whom you feel comfortable. You could then use the teaching hospital medical center for a "second opinion" or on an as-needed basis. For instance if you need to change drug regimens or have a problem that is better evaluated or managed at a large medical center, you could use them for that if necessary. To find a certified HIV specialist in your area, check the American Academy of HIV Medicine's Web site at There you will find a list of HIV specialist listed by locale.

Good luck.

Dr. Bob

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