Survey Findings: For Doctors Treating HIV/AIDS, Experience Tops Specialty Training

Study of the impact of medical workforce composition and organization on the care of people with HIV

From 1996 to 1999, researchers at Harvard Medical School conducted a study of how the organization, financing and characteristics of medical providers affect the quality and the costs of care received by people with HIV/AIDS.

The study supplemented a detailed 1996 federally funded survey of 2,864 HIV patients by obtaining data from the patients' physicians, other health care providers, and treating organizations.

This study consisted of surveys of clinicians and health care sites where patients in the larger study had been treated.

Key Findings

  • Physicians' HIV-specific knowledge was more strongly associated with their experience with HIV patients (i.e., caseload) than with any specialty training in infectious disease. This suggests that generalist physicians can develop specialized knowledge in HIV care through clinical experience and self-education, the investigators say.

  • Most physicians say they would prescribe protease inhibitors only if they judged that the patient was likely to adhere to a complicated medication regime or schedule. Investigators said this practice raises concerns, given the difficulty physicians have in accurately predicting a patient's future adherence to a medication regime.

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