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Author Topic: Interesting Specialist Appointment  (Read 1207 times)

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Offline kentfrat1783

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Interesting Specialist Appointment
« on: January 08, 2023, 08:10:58 pm »
What's up everyone? I hope you're doing well.

I met with the Infectious Disease Specialist this week that I had while in the hospital.  It felt good that he wanted to see me and wanting to be my ID Specialist going forward.  I'm going to give him a chance as it seems like he spent time talking with me and going over some of my labs that he was a bit concerned about. 

I'm not cutting my CC Specialist off yet but I like having a good option for a local specialist. He also has connections at CC if I needed a reference up their so that is so cool.

Now onto the interesting part.  He mentioned that over time if I wanted that I could become my primary care doctor as well.  I also like that idea so I'm not hopping between doctors. 
What are your thoughts on having the same person as your Primary and ID Doctor?
04/15/22 - CD4 229 (19%) VL <20
11/14/22 - CD4 486 (24%) VL 73
10/12/22 - CD4 316 (19%) VL <20
06/20/22 - CD4 292 (21%) VL <20
01/25/22 - CD4 321 (22%) VL <20
09/22/21 - CD4 278 (19%) VL <20
02/02/21 - CD4 225 (19%) VL <20
06/08/20 - CD4 257 (20%) VL <20
03/17/20 - CD4 285 (19%) VL 101 (2.00)
12/17/19 - CD4 290 (20%) VL <20
09/17/19 - CD4 218 (16%)
06/18/19 - CD4 173 (16%) VL <20
03/13/19 - CD4 170 (16%) VL <20
January 2019 - Started Triumeq
12/05/08 - CD4 174 (18%) VL <20
08/28/18 - CD4 166 (15%) VL <20
05/08/18 - CD4 106 (11%) VL <20
03/05/18 - CD4   90 (10%) VL <20
12/11/17 - CD4   60 (8%)
09/07/17 - CD4   42 (6%) VL  54 (1.70)
May 2017 - Started Atripla
05/11/2017 - CD4     2 (1%) VL 169,969 (5.23)
Dx`d May 11, 2017
Location: USA

Offline leatherman

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Re: Interesting Specialist Appointment
« Reply #1 on: January 09, 2023, 12:25:33 pm »
What are your thoughts on having the same person as your Primary and ID Doctor?
I've always had doctors who filled both roles. In the early years, it was because all my ailments were all related to AIDS, symptoms or meds. Unfortunately years later, a different doctor wanted to drop the primary care duties, so I dropped that doctor. (ironically, that HIV clinic turned into a FQHC (federally qualified health center) and now that doctor does ID work AND primary care. LOL) These days, with no HIV-related issues but because I still vividly remember how bad my health used to be, I still have a doctor that plays both roles.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Loa111

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Re: Interesting Specialist Appointment
« Reply #2 on: January 09, 2023, 03:33:24 pm »
I think it is a great idea for your ID doctor also to double as your primary care doc (assuming he/she is qualified to do both roles properly).

Myself I would prefer to have this arrangement too. In fact my ID clinic & the boss ID doctor who runs it, is very good about providing a holistic service and they'll always have a look at other ailments that I may have, after all it could be related to HIV (i was Dx'ed with quite an advanced case a few years ago).

I find some primary care doctors, or GPs (General Practitioners) as we call them, just do not have a good grasp of what to do with a hiv poz person. My own local GP does not really know what to do with me, and nearly always bounces me back to my ID Clinic.

So I think it is a good call if you can get your doc to do both roles.

Offline J.R.E.

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Re: Interesting Specialist Appointment
« Reply #3 on: January 09, 2023, 06:46:01 pm »

I find some primary care doctors, or GPs (General Practitioners) as we call them, just do not have a good grasp of what to do with a hiv poz person. My own local GP does not really know what to do with me, and nearly always bounces me back to my ID Clinic.

So I think it is a good call if you can get your doc to do both roles.

I do agree with that. I see my primary care Doctor once a year. Now, if something happens within the year, It's not problem to make an appointment. If my ID doctor ( Nurse Practitioner),was my primary care that would be a 23 mile one way drive. My primary is 1 mile from where I live.

The first thing my primary care doctor does, is pull up on his computer my current HIV labs. We may have a 2 minute conversation on HIV. The second thing he does is go over the labs that he ordered, about one week prior..

Back in 2003, all I saw was my ID doctor at that time. My primary care at that time made the immediate referral to him, and I got to see my ID doctor the following day. But, I was pretty damn sick. All related to having my aids diagnosis at that time. I never saw that primary care doctor again.

When I got into the VA healthcare system, The first I did, was to choose a primary care doctor, immediately after that , an ID doctor was selected for me.

I have to chuckle a little bit. When I see my primary care doctor, he always looks so stressed out. That's probably not that uncommon in the VA healthcare system.

When I see my ID nurse practitioner, that I've had now for about 12 years, she always appears much less stressed out than my primary. She's always calm. cool, and collected. It's like night and day.

I really believe in the VA healthcare system, that the primary care doctors are overworked, as far as that goes so is my cardiologist, and definitely Dermatology could use some extra help.

But, to get back to the original post, I do believe in some instances, a combination of an ID and primary care could work out. there's a lot depending on that.

And as Leatherman stated, with me, I don't get sick because of HIV. that's is under great control.

With me, it's colds , flu, sinus infections, or even back in October, my bout with Covid.

I've gone through 2 primary care Doctors in the VA since 2009. I think My primary care is always glad to see me annually. Compared to many of his other patients, I think I am one of his more healthier patients, and he knows I take care of myself, and that my HIV is under control. So often, some of these primary care doctors, get very frustrated with some of their patients, because, they don't really listen to the doctors.

However, I am getting older (71), and going on to my 39th year with HIV,.. with age related issues coming on. I still have a heart valve that will need to be repaired or replaced someday. And, I am not looking forward to that. I see my cardiologist more than I see my primary care.  I see my ID twice a year, and my cardiologist twice a year. Echo cardiograms, are becoming more common, for me.

But, overall I am doing very well, Knock on wood !

Ray 8)

Current Meds ; Viramune / Epzicom , Eliquis, Diltiazem. Pravastatin 40mg UPDATED 4/26/23
 Tested positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of April 18th 2023, Viral load Undetectable. <20 (HIV log Copies <1.30)

CD 4 @661 /  CD4 % @ 18 %
Lymphocytes,absolute-3623 (within range)

CD8 Absolute- 2118 (H)
CD8 percentage-58 (H)
CD4/CD8 Ratio-0.37 (L)


Offline harleymc

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Re: Interesting Specialist Appointment
« Reply #4 on: January 10, 2023, 04:25:41 pm »
I don't have a primary care doctor. I use walk in group practices.  Previously I used the same doctor for my HIV needs, sexual health and general health but the delay in getting appointments was blowing out 6+  weeks.

My ID specialist can't do referrals, the funding model prevents that from occurring.

Once soon a time I thought Australia had a good.health care system, but these days I think it's rubbish.

Offline daveR

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Re: Interesting Specialist Appointment
« Reply #5 on: January 11, 2023, 08:16:40 am »
As I live in a country in which I am an expat and have to pay for private treatment I can walk into any hospital for care although I prefer to keep everything under the same roof and use just one hospital. My ID specialist is my GP most of the time and I like it that way. My issue comes if I go to the hospital for a non HIV issue and she is not there, the other GP's are not keen to see me. I usually get a consultation and they request me to come back another day to see my ID specialist. When I do that she always tells me I can see any doctor I like.


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