"It's the most important thing I can think of to do," he says. And he's giving it his all.
After graduating from the University of California, San Diego, Dr. Young earned his Ph.D. in molecular, cellular and developmental biology at the University of Colorado, where he later graduated with honors from the School of Medicine. After residency, he took a fellowship in infectious diseases that focused on HIV.
"From the academic and scientific standpoint, HIV is one of the most fascinating diseases you could imagine," says Dr. Young. "But it was the patients that really drew me into HIV medicine. The opportunity to care for people that others won't treat really drives me."
Today, after only six years in practice, Dr. Young is one of the foremost HIV clinicians, educators and advocates in America. In addition to caring for 250 HIV patients at the Rose Medical Center and Denver ID Consultants, Dr. Young instructs at the University of Colorado Medical School, and is Principal Investigator for the Centers for Disease Control's HIV Outpatient Study (HOPS). He also travels the globe, providing treatment and medical training, and devotes considerable effort to advising government agencies on HIV issues.
And Dr. Young is an outspoken advocate for better HIV treatment -- even taking it to the streets when necessary. In 2002, when Abbott Pharmaceutical Company raised the price of the HIV treatment drug ritonavir (Norvir) by 400%, Dr. Young helped lead a protest, loudly complaining to the government, the press and the pharmaceutical industry.
"It was arrogant and they thought nobody would notice. And they thought if they did, so what?" Dr. Young says. Though Abbott refused to reduce the price of the drug, Young points out, "We raised awareness among the medical community to such price changes, and we sent a message to pharmaceutical companies. They've been more careful about making such price adjustments since."
"Still, domestic prices of HIV medications are rising and with costs of healthcare delivery also on the increase," Dr. Young says, "access to life-saving care and medications is being threatened in many communities."
So, he continues to plug away, in the clinics, in the labs, in classrooms, in the press, here and abroad; driven by the example of his hero Nelson Mandela, who helped turn the tide of apartheid.
"If the kind of positive social change that South Africa achieved could be duplicated in the global HIV environment," says Dr. Young, "the world would be a better place."
How long have you been practicing?
I've been in HIV care since 1994.
Can you describe how your work has changed since you first started?
I started HIV care in an era of programmed death -- we are now in an era of projected normal life expectancy.
What's the best thing about your job?
There's nothing better than restoring health and life to patients.
What's the worst thing about your job?
The worse thing about my job is the time away from my family, paperwork, litigation and struggles to preserve reimbursement. To do HIV care takes time. But you can't bill for that time like a lawyer does.
What have been your greatest successes in your work? Greatest failures?
Without doubt, my greatest successes have been seeing healthy individuals in 2005. In 1994 people with HIV had a terminal diagnosis. It's a really different story now, at least in the U.S. Also, it has been gratifying assisting with the development of new medications and new treatment strategies; plus I've had the opportunity to provide education for many HIV healthcare providers around the world. Greatest failures: The failure to achieve improved health for some patients, the failure to prevent new cases of HIV in our community and the failure to guarantee ADAP (AIDS Drug Assistance Program) funding for patients.
What is the biggest challenge you face as a clinician?
Finding the time and resources to educate patients about treatment options and adherence; protecting patient's access to care and medications; treatment for multi-drug resistant patients.
Would other clinicians give a similar answer?
I think so.
What do you think is the biggest problem people with HIV face today?
Apprehension about starting medications, choosing which medications to take and the risk of long-term toxicity. Other problems include basic access to healthcare and to HIV medications.
For the most part, what do you think is the biggest risk factor for HIV?
Ignorance and complacency on the part of the entire society. There are a lot of commonalities with HIV around the globe. There is a distinct absence of visible government, political and church leadership to make reminding people about the risk of HIV a priority. That's largely why the U.S. has maintained the same rate of new cases since the 1990s.
Do you think that the prevention efforts are sufficient? Anything you would change?
I absolutely do not think current prevention efforts are sufficient. We need public awareness, continued education about risk-prone behaviors and new prevention methods.
What single change would you like to see in HIV care?
I would like to see better tolerated, easier to take medications and guaranteed access to care for life. This would foster compliance and allow patients to live as normal and full lives as possible.
What do you provide in terms of education or counsel for a patient who is just diagnosed or about to begin treatment?
I provide time, time and more time to ask questions and comprehend. Print material, Web-based material, access to local AIDS organizations.
Can someone who is illegally in the United States get HIV care?
This can be difficult, but we have some resources. We encourage enrollment in clinical studies. AIDS organizations can help with access to housing, care, etc.
What percentage of your clinic are immigrants?
Less than 5% of our clients are immigrants and they are mostly from Mexico.
What treatment regimen would you choose if you had to begin treatment today? Explain.
Newer boosted PI with two NRTIs. Long-term evidenced based data on durability and preservation of future treatment options.
What's the key to a great healthcare provider/patient relationship?
Judgment-free counseling and ease of communication.
How do you feel about patients who take a proactive role in their own treatment? Do you have many patients who are proactive? What do they do to take a more active role?
I certainly encourage and educate patients to do just that. In fact, it's a good thing to nurture. The better informed, more interested and more proactive people are in their care, the more likely they are to take better care of themselves.
Who was your all-time favorite patient and why?
I couldn't possibly choose just one.
What is the most important thing you have learned from your patients?
To listen to individual persons' needs -- not just treatment guidelines; to live life; cherish friendships and family.
If you weren't a clinician, what would you be? Why?
If I weren't a clinician, I would be an educator -- though in effect that's a large part of what I do now, traveling the country and the world educating people about HIV/AIDS and its treatment.
Who would you dedicate this award to if you could?
To my patients and my parents who never saw me finish my education.
Where did you grow up?
New York and San Diego. My dad worked at the Brooklyn Navy Yard and when that kind of went bust, after I was in grade school, we moved to San Diego.
What did you want to be when you were a kid?
Marine biologist or professional bicycle racer. Actually, in high school and college, I raced bikes extensively. I had Olympic dreams and I almost made it. But then came the Olympic boycott in Moscow in 1980. And that was kind of the end of that.
What kind of work did your parents do?
Father: electrical engineer; Mother: computer systems analyst.
When did you decide on medical school?
Junior year of college.
What was your major in college?
Biochemistry (minor in film, history). I struggled to decide between clinical medicine and research. In the end, I got to do both.
What made you decide to go into HIV care?
From the academic and scientific standpoint, HIV is one of the most fascinating diseases you could imagine. But it was the patients who really drew me into HIV medicine. The opportunity to care for people who others won't treat really drives me and the whole community of HIV caregivers. There's a shared sense of mission.
Who were the most influential people in your life, both professionally and personally? Why?
My graduate and medical school mentors: Jerry Hurwitz/Tom Cech and Steve Mostow/Chip Schooley/David Cohn. Collectively, they taught me the value of independent, critical thinking and caring for education and patients.
What do you do in your spare time?
Ski, sports photography (mostly skiing-related) and travel. I started skiing as an adult and really fell in love with it in Colorado. My wife, who was a molecular biologist, and I began skiing a lot together. She's now a ski instructor and my two daughters are national champion skiers. I often take my skis with me on my travels. I was in India recently teaching, and my only regret was that I didn't have time to get to the Himalayas. But I will someday.
Tell us about your wife. Do you have kids? Pets?
I'm married to Louisa Morrissey (she's a ski instructor). Our daughters are ages 18, 20 and they are both college students (one is studying political science, the other engineering; both are champion skiers). Our house has had a 1:1 human to dog ratio for years.
Where do you live? What kind of community is it?
Summit county, Colorado. Small mountain community of 5,000 people at 8,500 ft, 65 miles from Denver.
If you had anyplace to live besides where you live now, where would you live?
Pacific coast of Costa Rica, South Island of New Zealand or British Columbia.
What's the biggest adventure you ever had?
Solo, 14-day trip around the world teaching about HIV. In Africa, I went on an elephant tracking safari. That was wild. Heard lions roaring in the night. An amazing experience.
What's currently on your bedside table for reading? What book would you say has had the most impact on you?
A biography of Nelson Mandela. It's a story of humility. It's also a story about dramatic, peaceful social change. If the kind of positive social change that South Africa achieved could be duplicated in the global HIV environment, the world would be a better place.
What kind of music do you like to listen to? What's album do you listen to the most?
Jazz or blues.