Revery Barnes1, Kimberly A Koester2, Jessica F Waldura3. 1. Department of Family and Community Medicine and. 2. Department of Medicine, University of California San Francisco, San Francisco, CA, USA. 3. Department of Family and Community Medicine and walduraj@fcm.ucsf.edu.
Abstract
BACKGROUND: As the enactment of health care reform becomes a reality in the USA, it has been widely predicted that HIV+ patients will increasingly be cared for by primary care physicians (PCPs), many of whom lack the experience to deliver full-spectrum HIV care. OBJECTIVE: To describe PCPs' preparedness for an influx of HIV+ patients. METHODS: This qualitative study included interviews with 20 PCPs from community health centres in California. We inquired about clinicians' experiences with HIV, their strategies for dealing with unfamiliar aspects of medicine and their management of complicated patients. We also identified the clinicians' preferred types of information and consultation resources. RESULTS: PCPs are not yet comfortable as providers of comprehensive HIV care; however, they are dedicated to delivering excellent care to all of their patients, regardless of disease process. Although they prefer to refer HIV+ patients to centres of excellence, they are willing to adopt full responsibility when necessary and believe they can deliver high-quality HIV care if provided with adequate consultation and informational resources. CONCLUSIONS: The Affordable Care Act will insure an estimated 20000 more HIV+ patients in California. With a dwindling supply of HIV specialists, many of these patients will be principally cared for by PCPs. PCPs will go to great lengths to ensure that HIV+ patients receive superior care, but they need the support of HIV specialists to expand their skills. Priority should be given to ensuring that expert consultation is widely available to PCPs who find themselves caring for HIV+ patients. Published by Oxford University Press 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
BACKGROUND: As the enactment of health care reform becomes a reality in the USA, it has been widely predicted that HIV+ patients will increasingly be cared for by primary care physicians (PCPs), many of whom lack the experience to deliver full-spectrum HIV care. OBJECTIVE: To describe PCPs' preparedness for an influx of HIV+ patients. METHODS: This qualitative study included interviews with 20 PCPs from community health centres in California. We inquired about clinicians' experiences with HIV, their strategies for dealing with unfamiliar aspects of medicine and their management of complicated patients. We also identified the clinicians' preferred types of information and consultation resources. RESULTS: PCPs are not yet comfortable as providers of comprehensive HIV care; however, they are dedicated to delivering excellent care to all of their patients, regardless of disease process. Although they prefer to refer HIV+ patients to centres of excellence, they are willing to adopt full responsibility when necessary and believe they can deliver high-quality HIV care if provided with adequate consultation and informational resources. CONCLUSIONS: The Affordable Care Act will insure an estimated 20000 more HIV+ patients in California. With a dwindling supply of HIV specialists, many of these patients will be principally cared for by PCPs. PCPs will go to great lengths to ensure that HIV+ patients receive superior care, but they need the support of HIV specialists to expand their skills. Priority should be given to ensuring that expert consultation is widely available to PCPs who find themselves caring for HIV+ patients. Published by Oxford University Press 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Entities:
Keywords:
Attitude; HIV; community health centres; physicians; primary care; qualitative research.
Authors: Nwora Lance Okeke; Allison R Webel; Hayden B Bosworth; Angela Aifah; Gerald S Bloomfield; Emily W Choi; Sarah Gonzales; Sarah Hale; Corrilynn O Hileman; Virginie Lopez-Kidwell; Charles Muiruri; Megan Oakes; Julie Schexnayder; Valerie Smith; Rajesh Vedanthan; Chris T Longenecker Journal: Am Heart J Date: 2019-07-18 Impact factor: 4.749