Should I change doctors?

[smartbrotha]

I was diagnosed in January of this year and immediately started seeing a great doctor.  Soon after he started treating me, my great doctor moved away.  He referred me to another private practice.  I was assigned to a relatively inexperienced doctor (he is right out of his residency.)  Though he is a nice guy and I feel comfortable talking to him, I really believe he is not as proactive as he should be. For instance, shortly after I started Atripla, I had concern about my increased anxiety. He simply said I should workout to deal with the anxiety.   I have asked him a number of questions that he simply didn't know the answers to, nor did he try to find the answers. Luckily, I am really proactive and I continue to do as much research as I can about this virus.  Because he is also an internist, he is also my primary care physician and treats my diabetes.

   I set up an appointment with another doctor at a major teaching hospital in my state.  This doctor is extremely experienced and he is probably the leading HIV researcher in my state.  He was able to answer any question I had and I felt comfortable with him as well.  But, because he works at a teaching clinic, getting appointments and privacy might be an issue.  Also, he won't be my primary care doctor so I will have to find another doctor to treat the diabetes (he did offer to refer me to a doctor in the teaching clinic if I choose to continue to see him.)

   Thankfully, I have private insurance and my deductable/contributions will be the same regardless.  I am torn about what I should do.  Should I stay with the convenience of the private practice with the nice (and cute  ), but inexperienced doctor or should I go to the experienced, well researched doctor in the teaching hospital that will likely not be as convenient.  Advice would be welcomed.

[GSOgymrat]

I have asked him a number of questions that he simply didn't know the answers to, nor did he try to find the answers.

Deal breaker. My doctor may not know the answer to every question, in fact I respect him admitting he doesn't know rather than faking his way through it, but he WILL research and call me with the answer. I would find another doctor.

[Oceanbeach]

Deal breaker. My doctor may not know the answer to every question, in fact I respect him admitting he doesn't know rather than faking his way through it, but he WILL research and call me with the answer. I would find another doctor.

I have lived in 4 communities in 16 years.
1.  St. Mary's Care Clinic, Long Beach- Title I funded, the best in the state of California
2.  Lakeside Health Clinic, Lakeport Calif, Title II funded, the worst in the state of California.  Never met the doctor in 3 years treatment but he signed off on all files.
3.  The Center for HIV Prevention and Care, Santa Rosa Calif- Was Title I now Title II and recently closed
4.  UCSF, San Francisco Calif- Title I funded, trains the best doctors and uses the best technologies for 125 years- Bingo!

Where I am going with this is:  No matter who or where you payer of last resort is, when Title I funding is no longer available to the clinic, programs are cut for everyone, the patient ALWAYS loses including those with private insurance.

My #3 clinic in Santa Rosa had the best HIV specialist in the state, who is listed in the Top 100 people in Sonoma County of the 20th Century for his work with HIV.  When the final RWCA funding payments were terminated, the facility closed for all patients.

In training facilities such as St. Mary's, Long Beach or UCSF, San Francisco, they are learning, listening and will find the answer to any of your questions     Have the best day
Michael

[surf18]

this is your life and you cant mess with this. your dealing with a serious complicated issue. you need the dr that knows what the heck hes talking about. go with the more exp'd one,the one that answered your questions. and id take his referral for your other issue.
i was going to change too but we seem to be more on the same page lately but if i wasnt feeling the love with my dr id ditch him in a minute. this is my/our life and that is the most important thing here.

[WillyWump]

Yes.

You need to have 100% confidence in your doctor. If it were me I would switch.

-Will

[tednlou2]

I'm in the process of looking for a new doc.  Mine only works with HIV Monday afternoons--the rest he works with gereatrics at the VA hospital.  Like you, my doc has not known many common things or issues related to HIV.  He didn't have any interest in looking it up, so that he could learn as well.  He actually made me feel crazy saying, "Where are you reading all this?"  I was asking him about very common things like the new treatment guidelines, testosterone issues, etc.  He was still using the old treatment guidelines weeks after the new ones came out.  For all I know, he is still using the old guidelines. 

It is obvious to me that the HIV clinic needed a doctor on the cheap and got him.  He knows what a CD4 and viral load is, and that is all that matters to them.  Maybe that is just the way it has to be at HIV clinics where many patients don't pay anything, and we shouldn't complain about those kinds of places.  However, if I were a doctor working with HIV, I would read as much as I could so I would know as much as my patients.  So, I'm looking for a doc in private practice. 

[surf18]

I do feel that I'm more up on the latest news than my dr. That does piss me off.

[wolfter]

Just the fact that you're asking the question kinda tells the answer.  If you think there's an issue then there probably is.  Good luck.

[Ann]

Hi Brotha. One thing I'm wondering about is this - is it only the hiv aspect that he seems to not know much about or is it everything? Because if it is only the hiv, I would suggest that you go to the doctor at the teaching hospital for your hiv and stay with your current doctor for your general (primary) healthcare, since you seem to like him otherwise. It's important to feel comfortable with your doctor.

You expressed concerns that seeing the doctor at the teaching hospital may compromise your privacy, but this should not be the case. You are still protected under HIPAA.

You also expressed concerns about getting appointments, but scheduling ahead for your routine hiv check ups should take care of that problem. I always make my next appointment before I leave my clinic and they are always three months in advance. When it comes to hiv healthcare, it is better to have a little inconvenience and the best care available than to have convenience and a lower standard of care. I actually have to fly to get to my clinic and it is well worth the inconvenience of having to get up at 4am to make my flight and not get back home until around 8:30pm. It's a long day, but I'm getting the best care available.

If your non-hiv care with your current doctor is good, I would be inclined to stay with him as your primary care provider - because at least he probably knows more about hiv than most GPs - and get with the doctor at the teaching hospital for your hiv healthcare needs.

However, if you feel he is not knowledgeable enough about all aspects of your healthcare, forget the fact that he's cute and find another doctor. And politely let him know why you are leaving his practice.