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Working With Healthcare Providers

Winter 2004/2005

The following is adapted from the curriculum that ACRIA uses in workshops to discuss the often complicated relationship between individuals and their healthcare providers:

So -- What's the First Step?

Educate Yourself

Considerations When Choosing a Doctor or Other Healthcare Provider

Qualifications:

Location: How far do you have to travel? You may not have a choice.

Personality: Sensitivity to your particular issues -- drug use, gender, sexual orientation, religious or spiritual beliefs.

Relationship: What kind of relationship do you want to have with your healthcare provider? There are various possibilities:

Word of mouth: Ask other people who their healthcare provider is and how they like the service they get.

Finding the right setting: Depending on your circumstances (Medicaid, private insurance, uninsured), you may have different choices regarding where you can get your care -- a private physician, a private clinic, or a public clinic.

Making, Keeping, and Preparing for Appointments

It's Your First Visit -- Bring Your Medical History

Take Some Time Before Seeing the Provider

Make a Plan for Talking With Your Healthcare Provider

Don't Hesitate to Stop Your Provider the Moment You Don't Understand Something

Take Notes

Keep Copies of Your Lab Results

Ask About Your Medications

Get the Names of Other People Who Are Part of Your Medical Team

Waiting for the Visit

Bring Information to Your Healthcare Provider About Subjects You Want to Discuss

Missing an Appointment

Communication Skills/Conflict Resolution

Communicate Treatment Requests in a Spirit of Mutual Respect

Be Prepared for the Emotional Content of the Visit

Ask for Things in a Friendly but Firm Way

When You Find a Healthcare Provider Who's Good, Let Him or Her Know

Tell Friends That You've Found a Good Healthcare Provider

What to Do When Your Provider Isn't Available

Healthcare Providers Are Human

Firing a Doctor or (a Better Term) Switching

Special Issues

Getting a Second Opinion

This article evolved from a fact sheet originally created by Sally Cooper and the staff of the PWA Health Group. It has been expanded over time by ACRIA's treatment education staff with input from ACRIA's Community Advisory Board and the clients with whom we work.

Healthcare Providers Don't Receive Any More Training Than the Rest of Us in How to Be Human Beings

  • Some are kind, some aren't so smart, some are malicious, and some are really great people.
  • They may be nervous and hate that they sometimes don't really know what to do.
  • They hate that they don't have a cure to offer you.
  • They rarely try to cause harm.
  • They're often overwhelmed, but rarely admit it. They carry their arrogance mostly to protect themselves, not to hurt you.
  • As in any other relationship, calling them on their stuff can sometimes help communication.
  • If it's not working, move on if you can!
  • Never forget that the healthcare provider works for you. It's your body, your health, your blood tests, your HIV. You are paying the provider's rent for him or her every time you walk in the door.

HIV Specialists

Some states have specific requirements in order for a healthcare provider to be designated a specialist in HIV care. In New York State, for example, providers must have the following experience and knowledge to qualify as HIV Specialists:
  • Direct care of at least 20 HIV-positive people during the past year, including managing antiretroviral therapy in those patients;
  • Ten hours of CME (Continuing Medical Education) each year that includes information on the use of antiretroviral therapy;
  • The latest information about HIV disease and treatments;
  • State-of-the-art diagnostic techniques, including viral load measures, resistance testing, and immune system monitoring;
  • Management of opportunistic infections and diseases;
  • Expertise in the management of HIV-positive patients with common co-morbid conditions, including tuberculosis, hepatitis B, hepatitis C, and syphilis;
  • Access and referral to clinical trials;
  • Proper referrals to other providers for specialty care (oral, ophthalmologic, obstetrics, gynecology, dermatology, nutrition, drug treatment, etc.);
  • Strategies to promote treatment adherence;
  • Patient education, including risk reduction/harm reduction counseling;
  • Post-exposure prophylaxis protocols and infection control issues;
  • An understanding of counseling for women of childbearing age, including knowledge of contraceptive methods and ways to prepare for a healthy pregnancy.


Back to the ACRIA Update Winter 2004/2005 contents page.




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