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May 28th, 2010

Six Tips for Choosing your HIV Doctor

“Doctor doctor, give me the news I got a bad case of loving you…”
— Robert Palmer

MarkDrMorrisGRABI had to say goodbye to my doctor recently. I was moving out of state, and Dr. David Morris of Pride Medical Group in Atlanta (pictured at right) had been nothing but a patient, supportive teacher to me. Over the years he’s seen me through Hepatitis C, a few crystal meth drug relapses and three boyfriends. I love him and what he’s done for me, and I hated the prospect of finding a replacement in Florida.

Fortunately, Dr. Morris agreed to give me some tips to make the process easier, and in this video episode you’ll see me take his advice. From medical records to being honest about my history, you can watch me use his advice during my very first appointment with Dr. Dominic Riganotti in Ft. Lauderdale.

That’s right. Dr. Riganotti (pictured, below) allowed me to film our very first meeting, and I appreciate his willingness to educate others through this process. And here’s the biggest lesson: don’t be afraid to ask questions about anything you think is important (several suggestions are provided in the video). It is perfectly customary for potential patients to question the doctor’s qualifications to treat them.

If there is anyone is our lives for whom nothing is “too much information,” it’s our doctor. As a patient I used to be more hesitant disclosing private issues like my sexual habits or drug abuse history, but I got over it when I realized my doctor wanted to help me, not put me in jail.

If you visit a doctor who doesn’t like the questions or gives you attitude, you can thank the jerk for their time and go find someone else (or request another provider at your HMO or community health center). This relationship is too important not to feel completely confident in his or her abilities.

I hope this video is helpful to you or someone you know. Thanks for watching, and please be well.

Mark

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4 Responses to “Six Tips for Choosing your HIV Doctor”

  1. Robert Meek Says:

    May 29th, 2010 at 2:11 pm

    Excellent, Mark. Thanks for the professional open sharing and educating you do for all of us. As you know, I had some issues with my past HIV doc. 99% of what you recommend here never happened. I have a new doc. She seems every bit as open and dedicated as this one for you is, and I am very pleased with her. They are not set up for full treatment, but that is okay.

    So my situation varies, slightly, but I have found one whom, for the first time, I feel I can really get what one should expect to get. It’s quite a nice thing to know, isn’t it?

    BTW, hoping you and your S.O. are doing fine down there in FL, and hoping that wretched BP oil mess doesn’t float your way.

    – Robert, and his Poodle FiFi, in Loris, South Carolina.

  2. Antron-Reshaud Says:

    May 29th, 2010 at 2:43 pm

    Thx Mark my friend for posting this. Definitely a God send. I am in the middle of switching doctors myself and these tips are going to be very helpful and needed.

  3. Terry Says:

    May 29th, 2010 at 4:17 pm

    Hello Mark. Thanks for the great work through your blog. I’ve enjoyed keeping up with you over the years through TheBody and your blog.

    I’m very surprised, and disappointed, actually, by your conclusion that you and Dr. Riganotti are “off to a good start.” I have to respectfully disagree with you. I wouldn’t be so inclined to challenge your personal choice of physicians, but because you’re putting it out there for many people to learn from, I feel I need to challenge some things here.

    Your first question for Dr. Morris was about how to approach a new doctor without offending him. Your question represents a concern that many patients, clients and other medical professionals (like myself) have expressed over the years. Therein lies the answer to the problem – most people have this fear of offending doctors, and those who don’t are probably of the generation that never questioned what their doctor had to say. You, the “patient” (the word itself implies a hierarchy), shouldn’t have to worry about anything but communicating your concerns to your doctor. You are paying him! He works for you! (And yet, until all patients feel differently, questioning a professional, whether a doctor or a plumber, will be uncomfortable and I appreciate Dr. Morris’ reassuring advice. — Mark)

    With regard to primary doctors “managing” your health care, again, I disagree with Dr. Morris. I work for the third largest Medicare Advantage plan in the country providing medical case management services that are intended to control costs. A lot of the hospital readmissions we see occur because a patient’s care is not being managed by the specialist who is more qualified to manage the condition – e.g., a cardiologist for congestive heart failure, an endocrinologist for diabetes, a nephrologist for renal problems, a psychiatrist for psychiatric problems. Dr. Morris and Dr. Rigonatti are contradicting themselves by conveying the message that you need someone (like them) with specialization in HIV/AIDS to manage your HIV, but you only need a primary care doctor to manage all other conditions. What??? A primary care doctor is better qualified to manage my psychiatric conditions than a psychiatrist? A primary care doctor is better qualified to manage my diabetes than a endocrinologist? You mention that “The best doctors admitted what they didn’t know” and that Dr. Riganotti’s Web site stated the he and prospective patients would be “…working as a team.” I couldn’t agree more with this approach – but, then look for a doctor who will admit that they probably don’t know as much as the specialist and then refer you to the specialist who will be better able to manage the condition. THAT is a sign of a good doctor! (Good point. I believe the casual references to diabetes or other conditions requiring specialists were not well served by my editing of hours of video here. Dr. Riganotti has already referred me to a hematologist for a rare blood disorder of mine. — Mark)

    Regarding Dr. Rigonatti’s lack of certification by the American Academy of HIV Medicine, I’m very surprised that you decided to go with him anyway. The AAHIV has been around for years and sets the standards for specialization in HIV care. If a doctor is certified by AAHIV you’ll know that a certain percentage of his practice is devoted specifically to HIV/AIDS issues. You’ll know that, as a requirement of that certification, he has attended a set amount of continuing education in HIV/AIDS on an annual basis where he will have learned the latest on HIV care. Why would you overlook this in your selection of a HIV doctor? (You are second-guessing my choice of doctor here, rather than the “tips for choosing” one. I stand by my ultimate choice and gave this lack of professional membership weight in my decision, which is all I’m suggesting for others. — Mark)

    You picked up on his discomfort when you called his attention to the “iParty” radio station he had playing in his office. Many people with HIV, myself included, have or have had challenges with substance use. (To your readers, I didn’t say “all” or “most”…I said “many.” By that I mean a significant number) Setting aside for a moment your own disclosure about a history of substance use and how the music may be a trigger for you, why would he be playing that kind of music in an exam room, anyway? If he were a specialist in psychiatry and/or an addictions specialist, I’m certain he would have been in a position to make better choices of the environment he created in which to treat his patients. (But he’s not an addiction specialist. He’s a physician willing to learn something; that music hasn’t played in his office since my first visit. It sounds like this young physician is teachable! ;] — Mark)

    I appreciate what you intended to do with this video; to empower people to make better selections of physicians when seeking HIV care and to encourage people with HIV to take a more proactive role in their care. Although most of what the video (Dr. Morris’s suggestions, in particular) suggests focuses on what the patient can do (which is empowering), it stops short of empowering people to demand more out of their doctors – for whom they are paying and trusting are providing the best care. Doctors need to do more.

    Lastly, I’d like to encourage anyone looking for a new HIV-specialist to visit the American Academy of HIV Medicine at http://www.aahivm.org to find that specialist. They can search for all certified specialists in their city/state, or they can search to see if a particular physician they want to see is certified.

    Thanks for the good work, Mark. I’m happy to see that you’re doing well…and welcome back to Florida.

    Best,
    Terry

    (I edited Terry’s very thoughtful remarks for space and readability, and appreciate the tough critique of my selection process. We both want the same thing: for people to demand the best care available to them. — Mark)

  4. Jonathan in SF Says:

    May 29th, 2010 at 10:04 pm

    My former physician in Dr. Rick Loftus, who needed to close his practice due to the economy and is taking some time off right now. Long story short. We are about to send in our applications and supporting video to be the first-ever Dr/Patient team on The Amazing Race! One never know where the gloved finger will lead you….

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