Your relationship with your GP

Choosing a GP

Questions you might ask as part of your selection of a GP

Working with your GP

How does the GP contribute to your care?

Principles of best practice

Your relationship with your GP

It’s important to get this relationship right. A good relationship with your GP can maximise your health and your ability to maintain your independence.

It’s up to you to some extent to def ine what sort of relationship you want. Some people with HIV/AIDS rely on their GP for expert advice and follow their advice to the letter. Others think of their relationship with their GP in terms of a partnership, preferring shared decision-making, with the GP bringing information to the relationship to assist the person with HIV in decisions about treatment and care.

GPs have different styles. Some prefer a relationship with their patients in which they give advice, whilst others prefer a collaborative relationship in which the patient takes an active role in decision-making. Some GPs treat you as a whole person, taking an interest in all aspects of your life. Others take a disease-specific approach, concentrating mostly on you in relation to your HIV disease.

You should shop around until you find a GP with the combination of skills and style that suits you. If you are living in rural or remote areas it may be harder to shop around as there may be few GPs with HIV/AIDS experience or interest. It’s OK to talk with your GP about how you would like your relationship with them to work and to expect that they will try to fulfil your needs.

Having one GP who monitors you over a long period of time can improve your quality of care because the GP gets to know about you and your particular path through HIV/AIDS. The GP builds up a good history of your illnesses and the treatments you have been on. Moving regularly between GPs can break this consistency of care and means that it’s harder for each new GP to get a clear understanding of what you need.

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Choosing a GP

It’s a good idea to think about what you want from your relationship with your GP. You may be relying on them for care and support for a number of years. You are the customer and you are purchasing a service from them, usually through your Medicare card. You do have some purchasing power and it’s OK to shop around until you find what you want.

Don’t be afraid to ‘interview’ your GP to find out how they work and what they think about caring for people with HIV. If they seem reluctant to have a discussion with you about how they work this might give you some indication about how other discussions you may want to have with them will go. Don’t forget that there are a lot of trained and dedicated GPs out there. Don’t be afraid to make a choice that suits your needs.

If you are in an isolated area or in a place where there aren’t many other people with HIV your choices might be more limited. Your state or territory AIDS council or PLWHA group might be able to help with some names.

Agencies are a bit reluctant sometimes about recommending GPs. They’ll give you a list but will not usually provide recommendations. Talk to other people with HIV/AIDS if you can. They might be able to tell you about their GPs. Don’t necessarily write a GP off if one person says that they have had a bad experience with them. It might still be worth checking them out.

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Questions you might ask as part of your selection of a GP

• How do you like to work with your patients?
• Have you had other people with HIV as patients?
• (For women with HIV/AIDS) Have you treated other women with
• HIV/AIDS?
• (For people who use recreational and/or injectable drugs) How do
• you work with people who use drugs?
• How do you keep up with the changes in treatments?
• Are you able to prescribe antiviral therapies? (Not all GPs will have done the necessary training to allow them to legally prescribe HIV
• If not, how do I access these therapies if I use your service?
• What do you think of complementary therapies?
• What arrangements do you have in place to protect my privacy?
  
  

(For people in rural and remote areas)

• What happens if I need to see you in a hurry?
• What happens if you are not available?
• Do you make house calls if I am unable to get out of bed?
• What happens after hours or when you go on leave — do you have a locum or after-hours service?
• (For parents) Can I bring my children along when I come to see you?
• Do you bulk bill? (That is can I just use my Medicare card or do I have to pay up front and claim back from Medicare? Is there a gap between what you charge and the Medicare rebate I will get back?)

It might be worth writing your list of questions down and even jotting down the answers you get back so that you can reflect on them later to help you make up your mind.

If all this seems too hard, there’s a simple way to choose a GP. Do you like them? Do you enjoy being with them, find them human, like their sense of humour, their hair colour? That, coupled with a bit of an interest in HIV/AIDS on their part might be the perfect combination you need!

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Working with your GP

Some people get nervous when they go into a doctor’s surgery. That is not surprising. They can be quite frightening places. Even if you have planned what you want to say or ask, you can forget really easily when you are in there and end up just sitting there nodding. It’s sometimes helpful to sit and think about what you want to know or discuss before you go in. Write down the things you are concerned about, the symptoms you have been having, the questions you want to ask. Take this list in with you and refer to it when you are with the GP.

Don’t be afraid to ask questions or to ask the GP to set out all the options for you so that you can make a choice. Use words like ‘choice’ so that they can see that you want to be in charge of making the decisions.

Treat the time you have with your GP as ‘your time’ and let them know if you don’t like the ser vice you are getting. For inst ance, if the GP takes three telephone calls while you are trying to decide on whether to change treatments, let them know that you would like their attention and that you find the inter ruptions distracting.

This is all sometimes hard as you may not want to cause a problem, but remember, you are the customer and they are selling a service. You have the right to comment on the quality of what you are purchasing.

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How does the GP contribute to your care?

The GP is often a central point of reference for your care and monitoring. They can: regularly monitor your HIV viral load, CD4 count and other indicators; prescribe drugs to stop you getting opportunistic infections; prescribe, monitor and change antiviral regimes; look after your general health; carry out regular sexual and reproductive health checks; pick up early changes in your health; make referrals to specialists if necessary and communicate with HIV/AIDS specialists to ensure that you are able to take advantage of any developments in HIV/AIDS treatments.

They also have a role in providing you with support and in referring you to other services like community nurses, counsellors, dietitians, dentists, physiotherapists, specialists like physicians, surgeons and obstetricians.

GPs also have a role in referring you to hospital for investigation and treatment if necessary and in providing your follow-up care after hospitalisation. If you are being hospitalised, the GP will usually give you a letter which summarises your history of HIV illness, current treatments, allergies and so on. The hospital will also generally give you a letter to take to your GP after hospitalisation, setting out what has happened to you in hospital and informing them of any changes in your treatments.

GPs can also provide home-based care for you if you are too sick to leave home. They can manage your pain relief and symptom control as well as contributing to the co-ordination of your care at home.

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Principles of best practice

• Up to date knowledge of HIV treatment options
• Systems for protection of patient privacy
• Bulk billing for long-term patients
• Relationship with HIV specialists/HIV treatment hospital
• Participation in on-going HIV education/training
• Non-judgemental attitude
• Arrangements for consistent care — locum, after hours
• Recognition of social and emotional issues and their impact on health