New Doc?

[Grinch]

  Well my wife made my appointment to get bloods checked and to discuss maybe trying Atripla...traveling with Kaletra is difficult at times.
He wants me to see his new fellow as well.  This got me thinking,  I've only had one ID doc the 3 plus years I've been being treated.  I trust this Doc more than any Doc I've ever met.  Unfortunately I'm no longer interesting.  The CD4 is no longer 15.  The Cancer seems gone.  The Hep B and C seem completely gone.  To the point they've said I seem to have cleared it.  I didn't realize that was even possible, though considering how much chemo they dumped into my bloodstream and spinal fluid I guess anythings possible.  How attached does everyone get to their docs?  I can't even stand the thought of switching!

  Granted he didn't say he wanted me to switch.  He just wants his new fellow to be there as well, But that got this whole thought process rolling.

[appleboy]

Grinch,
It took me 3 Doctors to find the one I truly like.  She is awesome.  My suggestion is to shop around.  Yes, shopping around is a bitch but let me tell you it could end up making the difference. 
Bill

[allanq]

Grinch,
It's not clear to me what you meant when you said, "He wants me to see his new fellow as well."

Does that mean he wants you to see both him and this new fellow? Is he telling you that he can no longer be your doctor?

Maybe you just need to talk to him to ask him exactly what he meant and to let him know that you trust him and would like to continue being his patient.

Allan

[Ann]

Grinch,

Are you at a teaching hospital by chance? If you are, this "new fellow" is probably an underling who your regular doc is training. My clinic is in a teaching hospital and while my consultant remains the same, I often see doctors who are below him. After every clinic the consultants on duty get together with the learners on duty to make sure everyone is on the same page. It's worked well so far. The only time it hasn't for me is when I ended up having to see a different consultant, as opposed to a learner who was under my own consultant. The "learners" are qualified doctors who simply need more experience before they become consultants in their own right. They've got to get the experience somewhere!

Try to remember that it's not so much that you have become uninteresting, but that there are probably other patients who are having problems who need your experienced doctor's attention. If your clinic set-up is similar to mine, it means that if you do become "interesting" again, you can be sure that your regular doctor's time isn't being taken up by more routine cases and he will have time for you. It's the bigger picture.

Ann

[Grinch]

My post was confusing, I had a zillion thoughts running through my head, school, work etc.  Sorry.

I am at a teaching hospital and I'm sure he wants to introduce me to his new fellow.  It just struck me when I found out that the fellow would be tagging along, that this Doc, who I find to be one of the very best Doc's I've ever met, might not always be there for me.  He might move on.  The thought scares the crap out of me.  How does everyone handle such a thing?

The "not interesting" comment actually came from the Oncology doc that hand picked this ID doc.  The Onc, is one of the leading experts in Burkitts lymphoma, he mentioned one day, after his fellow became an attending, that I was no longer interesting, I didn't have active Lymphoma, I actually had CD4's , the whole hep clearing thing, the spontaneous sub-dural hematomas had quit, etc etc. and passed me on to the fellow newly promoted to attending.
That one actually felt like a graduation of sorts. The King of Oncology passed me on down because I was saved.

Bottom line, someday, some where I'll either fall over dead, or the ID Doc extraordinaire will move on.  The latter scares me more than the former!

edit to add:  For those that may be confused about the term "fellow"  Some docs attend a fellowship program in a specialty area.  This is after internship and residency.  I work with them in Heart Cath labs quite often.  They are full blown MD's that are serving a kind of apprenticeship under a very respected or experienced doc in their chosen specialty.  They work for up to 4 years like near slaves for very little pay.  More than residents to be sure but still not all that much.

[Ann]

Grinch,

As I suspected, your clinic system is very similar to mine - only the titles the various doctors in their various stages are different. The "fellows" or "registrars" or "learners" - whatever you wish to call them - are the ones who move on the most often at my clinic.

It does worry me sometimes that my consultant may decide to move on, especially in light of the negative experience I've had on occasion with some of the other consultants.

But, as my consultant seems to be staying put for an indefinite amount of time, I try to not dwell on the "whatiffs" the future may bring. I've got enough stress in my life without worrying about something that may never happen - in my lifetime. I just take each appointment as it comes and I keep learning all I can about hiv and its treatments so I can always be my own best advocate, no matter who my consultant might be someday.

Ann

[aztecan]

Hey Grinch,

Yes, I've been through this as well. I get the "do you mind if so-and-so sits in?" I don't mind. Sometimes they ask questions I forget to ask.

As for switching doctors, I have been forced to because of changes in insurance in the past. Hated it. I had a doc I really liked, my first.

Unfortunately, I had to switch because my new insurance company wouldn't cover anything or anyone at the hospital at which she worked. It sucked.

Nowadays, they don't have a choice, insurance companies I mean. There is only one doc in this area. The next closest is 200 miles away.

Of course, now this doc is taliking about retiring. So I could end up driving myself that 200 miles for each appointment anyway. Did that before and, in the winter, it isn't fun.

Anyway, enjoy your "fellow."

HUGS,

Mark

[Grinch]

Well...the "fellow" is a she... maybe she's Hawt!