Member Profile: Edwin DeJesus, M.D., F.A.C.P.
Florida Physician Is Working to Develop Resources for All HIV Practitioners
Edwin DeJesus runs both an HIV practice and a busy clinical research operation. And he thanks the American Academy of HIV Medicine for its role in helping to validate the work he does -- and its role in helping him stay on top of the onslaught of new information the field generates.
DeJesus is an infectious disease Specialist with Infectious Disease Consultants (IDC) in Altamonte Springs, Florida, and is principle investigator with the affiliated IDC Research Initiatives. "We have very large research office," he tells The Nexus, "and we're fortunate to have access to a lot of clinical trials, new therapies, new medications and new drugs -- all of which benefit our patients." But, he notes, "I'm trying to keep a practice busy and still offer my patients the time that everybody deserves -- and at the same time I'm trying to go to all the meetings and keep up with all the data. Keeping all those things together without losing my sanity is a little bit much."
That's one of the reasons he calls the Academy's work to date "very, very helpful" -- and even "incredible." DeJesus lauds the Academy for "defining the boundaries of HIV medicine." In the beginning of the epidemic, he explains, "providers were lost. We were lost on the battlefield of this new disease that was killing thousands of people. There were treatment uncertainties, insurance company rules and restrictions, government regulations, patient advocacy groups, and the pharmaceutical industry to deal with. There were so many people pulling from so many different sides that we got lost in the middle." The Academy, he continues, "has defined the boundaries of the battlefield by defining what a specialist is and what our role should be. And now it's helping to provide us with the tools we need to fight the battle even better."
DeJesus is one of the experts tapped by the Academy to develop the Self-Directed Study Guide that accompanies its Core Curriculum of the basic knowledge an HIV Specialist should possess. "For me," he says, "it's an honor to be participating. We've made a very ambitious commitment -- and we're all putting our hearts in it." The guide, he points out, "will help providers capture what we believe is the most recent and most factual clinical data that we have." The study guide developers are "trying not to introduce any bias into the guide," he emphasizes. "Some of the topics are controversial," he concedes, "but we're staying with facts that are strongly referenced by important studies or by experts in the field. The guide is going to be a very important tool for many clinicians -- even those who don't have a lot of experience, but who care for HIV-infected patients."
Indeed, he adds, the Academy has already exceeded his expectations. "It has gone farther than I expected it to at this point," he comments. "I give a lot of credit to everyone there. They've done a lot more than I thought would be possible by 2002." In the future, he adds, he'd like to see the Academy "organize more subgroups that will look at specific populations and the relationships between their providers and HIV." He thinks the Academy can play an important role in "relating better to Hispanic populations, their risk factors, their educational needs, etc."
DeJesus emphasizes that the Academy's work to date is right on target, stressing that its "most immediate need is to continue to pressure key governmental agencies and the managed care companies to ensure access to HIV Specialists." California has taken a big step in that direction, largely as a result of the Academy's work, he notes, and Florida is looking at similar regulations directing plans with HIV-infected members to provide access to Academy-credentialed HIV Specialists. "We've come a long way," he says. "We need to continue to convey the message that a specialist is needed to treat these patients."
Interestingly, he notes that even though the Academy's focus is not yet on subgroups, it has already provided indirect assistance in that area. "I can't tell you how many times I've had a Hispanic patient who wants to be seen by a Hispanic physician tell me he or she is moving to a new city and wants a recommendation for a new doctor," he says. "I just go to the Academy's Web page and I know that I can have a certain level of comfort that any name I see there will take good care of my patient. I like just knowing that source is there."
Academy work aside, DeJesus says he's most proud of his practice's emphasis on treating patients regardless of their ability to pay. "We have a system that has allowed us to even provide medications in some cases," he reports. "That's mostly thanks to pharmaceutical industry support. No one is turned down." His clinic, he points out, doesn't have federal government funds, Ryan White grants, or ADAP resources. "Many of my patients are covered by Medicaid," he says, "and many have no insurance at all. We see them regardless."
This article was provided by American Academy of HIV Medicine. It is a part of the publication The Nexus. Visit AAHIVM's website to find out more about their activities and publications.