You and your Doctor: How to choose or evaluate your medical doctor

If you're living with HIV, choosing a doctor is very important for your future. An open, honest working relationship with your doctor may help you live longer. This pamphlet divides up the process of choosing a doctor into three stages: Preparation, Interviews and The Decision.

Preparation


If you're unhappy with your current physician or they lack experience in treating those with HIV infection, they may be able to refer you to other doctors who specialize in HIV care.

Another excellent source of information would be your own friends or other people you know who are living with HIV. Ask who they see and what they like about them the most. You can also ask for a list of potential doctors from your local AIDS Service Organization.

Once you have a list of names to choose from, it's time for you to clarify the kinds of things you would like to see in your doctor. You may also want to learn as much as you can about HIV infection and different treatment options, so that your choice of physician can be as informed as possible.

You need to decide for yourself what kind of relationship you want with your doctor. People may have different styles of relating to their physicians and those styles may vary at different times or for different illnesses. Some prefer that doctors be authoritative because it makes them feel secure. Others want a sense of partnership between equals where, together, they take the time to weigh the pros and cons of decisions.

Whichever you prefer, try to be clear with yourself and your doctor about your preferred style. You may also want to consider how much weight to give a sensitive bedside manner versus technical competence. Consider how important it is for you that your doctor be, for example, gay or a woman.

Try to narrow down the field to three or four and ask to be given a forty-five minute appointment. Have all your questions written down in advance so you don't forget anything. For your first meeting with a prospective doctor, you may want to take notes or bring along a clear-thinking relative or friend.


Interviews


Shop around for a doctor as you would for anything else. Here are some common issues you might want to ask about:
  • What is the doctor's knowledge and experience with HIV and AIDS?
  • Where do they have hospital admitting privileges? Is it a hospital known to give good care to those living with HIV? Is it located close to you?
  • What is the doctor's comfort level and sensitivity to gay or bisexual concerns? women's concerns? or IV drug user's concerns?
  • What is the doctor's approach to unapproved treatments, the "compassionate-release" of experimental drugs, and alternative or complementary therapies?
  • Does the doctor actively participate in research or clinical trials?
  • What kind of relationship does the doctor like to have with their patients? Does the doctor encourage patents' active participation in their health care?
  • Does the doctor make house calls? What system do they have in place for you to call at any time night or day?
  • What are the doctor's beliefs about quality of life issues, suicide for the terminally ill?
  • For those who do not speak English, or who cannot hear, is the doctor familiar with using an interpreter?

The Decision


Now that you have completed all the interviews, these are questions you have to answer for yourself in order to make your decision about which doctor to choose:
  • Did the doctor give you a chance to ask your questions and did you feel comfortable asking them?
  • Did the doctor answer in ways you could understand? Did they listen to what you had to say about you condition and respect your beliefs about treatment issues?
  • Do you have confidence in their knowledge and abilities regarding HIV care?

Keep in mind that your first point of contact with your doctor will be with the office staff, so think how comfortable you felt around them. Remember to consider issues of convenience too:
  • Is the office located close to you?
  • How long does it take to get to see the doctor when you need to?
You may want to give a prospective doctor a six month trial period before committing to her.

Be a smart shopper and choose your doctor wisely and cautiously.

For further information on a variety of issues related to HIV and AIDS, please visit the Access Centre here at the AIDS Committee of Toronto (ACT), 399 Church St. (at Carlton), 4th floor.

You can also call:
  • ACT at 416-340-2437
  • Canadian AIDS Treatment Information Exchange (CATIE) at 416-944-1916 or 1-800-263-1638
  • Toronto People with AIDS Foundation at 416-506-1400.

Text: David Karnick, Abe Karrel and Frederick Freake