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The Case for Primary Care Clinicians in HIV Care

The Case for Primary Care Clinicians in HIV Care. Should we be PMDs to HIV patients? Can we or will we have to? Better and more efficient utilization of Specialists. Division of Care. HIV physicians have had focused medical practices

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The Case for Primary Care Clinicians in HIV Care

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  1. The Case for Primary Care Clinicians in HIV Care

  2. Should we be PMDs to HIV patients? • Can we or will we have to? • Better and more efficient utilization of Specialists

  3. Division of Care • HIV physicians have had focused medical practices • As medical conditions in the elderly accumulate who will manage the care • Multiple clinicians / difficulty with coordination of care / drug treatments and interactions • Will first generation HIV clinicians retire leaving a care gap? Oh, and this piece of information – many newly diagnosed HIV patients already have primary care clinicians

  4. Too many patients

  5. Unlike us, they are aging • 27% of people living with AIDS in the US are older than 50 • Numbers of cases expected to increase with increasing survival under treatment National Association on HIV Over Fifty

  6. Our Patients Are Aging

  7. Leading Causes of Death in Elderly US CDC

  8. Cultural Competency of Current Clinicians

  9. Can Our Specialists Afford to Deliver Primary HIV Care?

  10. Additional funding flat and moving

  11. Funding • Public funding drives HIV care from specialists • Public funding rises from 37 to 50 to 62% from asymptomatic to symptomatic to AIDS Schur, C.L., and Berk, M.L.: Health Insurance Coverage of Persons With HIV-Related Illness: Data From the ACSUS Screener

  12. Practice Set-up of AAHIVM dues Paying Members

  13. Complexity of HIV Care • Regimens and potency • Technology

  14. One pill daily Regimen Complexity?HIV

  15. Two pills daily

  16. Three pills daily Three pills daily

  17. Type II Diabetes Aspirin Insulin Glitizone Sulfonylurea ACE Statin Metformin

  18. Technology • Better medications • Communications technology • Working with patients / HIV specialists • Resolving drug interactions • Regulating visits and labs • Electronic medical records

  19. Cooperative Care of Patients

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