October 15th, 2008

Back to School, Day 1

We offer two post-graduate courses each year, one entitled Infectious Diseases in Primary Care, and the other AIDS Medicine:  An Intensive Case-Based Course.  The Primary Care one started today, the AIDS course starts on Monday.

(Both are equally fascinating.  I am entirely unbiased.)

What is so striking is that the participants — and content — barely overlap at all.  Topics for primary care course:

  • Antibiotics
  • UTIs
  • Pneumonia
  • Sore throats/colds
  • Immunizations

You get the idea.  For the AIDS course?

  • Acute HIV infection
  • Management of treatment-naive patients
  • Interpretation of resistance testing
  • Metabolic complications of therapy
  • Legal and ethical considerations of HIV care

I suppose I should not find the lack of overlap surprising, given papers such as this one, citing that 62% of family practitioners refer their AIDS patients to specialists immediately — a big change from 1994, when only 18% did.  (Even 62% seems low …)

But the irony is that with improved antiretroviral therapy — the very thing that drove some generalists away from HIV care due to its complexity — HIV patients are living longer, and hence are in greater need of the kind of care delivered best by primary care clinicians.

So maybe what we really need is a primary care course for HIV specialists?

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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