All About Your HIV Care
Primary Medical &
Advanced HIV Care
There are only a handful of doctors in the Detroit area specializing in providing HIV care and even fewer physicians who provide both primary medical and advanced HIV care. Dr. Paul Benson and the Be Well Medical Center are among this small, specialized group.
About Choosing a Physician….
The process of selecting a physician can be a difficult task, especially for someone afflicted with a chronic illness like HIV. Physicians who provide medical care for patients with HIV should have a compassionate demeanor, be dedicated to acquiring state of the art information about HIV, be accessible when needed in times of crisis, and be supported by a congenial office staff. Additionally, the challenging and masquerading spectrum of illnesses that HIV can cause, demands a physician with keen diagnostic abilities. The physician should also possess personable communication skills and project empathy with a genuine desire to comfort patients.
About My Approach….
My philosophy in caring for patients infected with HIV is based on primary care concepts that I, as a family doctor, have been trained to provide. I combine these concepts using a holistic approach developed during my Osteopathic training to provide high quality, friendly, and personalized care. I rely upon the wide scope of general medical knowledge acquired from my postdoctoral training, and combine it using the HIV experience as a family physician I have acquired since 1980.
About A New Diagnosis….
If you have just recently been diagnosed with HIV or an HIV-related condition, you may need to share your emotional turmoil with family, friends, a trained counselor, or us. If you need this support, please allow us to help you with managing this burden. Also, there are many excellent support organizations available in this community to help you, your significant other, spouse, or family. Additionally, we often have patient meetings in a relaxed unhurried atmosphere for questions, educating, and sharing experiences.
Remember, the majority of people infected with HIV are living well and working. There has been significant progress in treating HIV and it has pretty much become a chronic manageable disease. Normally, the initial anger, denial, and despair you may feel will be replaced by an ability to cope with the infection and its implications on your life.
It may be difficult for you to disclose to others (spouse, family members, significant others, friends, employers, etc.) that you are infected with HIV. If and when you elect to discuss these matters with others, assistance is available to help you develop strategies regarding your disclosure. There is a moral and legal obligation for previous intimate contacts to be notified. We can assist you in that endeavor, to the point of having them contacted so they do not know whom the contact was with. The same obligations exist for notification of future intimate partners.
Your close family members and/or significant others are welcome to accompany you during your office visit. We encourage this. You may want us to explain your condition to them and we will do so upon your request. In order to maintain confidentiality, I prefer to discuss these matters in your presence and preferably in person.
About Treatment Approaches
Your doctor and medical staff should act as your advocate and friend in dealing with this complex medical system we live in and provide you with the most up to date information needed to make informed decisions about your care. We also can assist you in obtaining a case manager to help guide you. Your involvement in the decision making process is a key element to a satisfactory clinical response, particularly in regards to utilizing and selecting antiretroviral medications. This control is what I call "patient empowerment" and is crucial in maintaining the best health possible.
Empowerment not only includes control of your medical team, but control of decisions affecting your health care from others, such as family and friends as well. In fact, the first step to building an effective strategy for living well and staying healthy is learning to make informed decisions and surround yourself with caring people who will be there for you without being overpowering. Becoming empowered about your health and life means developing a decision making process which encompasses how you feel about therapies. Personally, I appreciate well-informed patients who bring new information and ideas to my attention.
Individualization of care is most important.
• Some patients desire an aggressive medical approach to their care with therapies available through investigational new drugs. It is important to understand that entering studies of new drugs may limit some freedom of choice in regards to any additional treatments or regimens.
• Other patients may prefer a more traditional approach with the use of medications for approved indications only, or medication use guided by generally accepted treatment standards among the HIV medical community.
• Still, others wish to limit medication use to only that which is absolutely essential. Respect for different philosophies is essential. The health care provider should be flexible enough to the patient to provide variable approaches. What works for one person may not work for you. This is true for any disease and especially HIV. Similarly, a therapy that someone else may have had a bad experience may not cause problems for you and may actually prove helpful.
• Some patients, in addition to conventional pharmaceuticals, may wish to utilize alternative or complementary therapies available from Buyer's Clubs or Health Food Stores. If you decide to utilize these therapies, I ask that you to keep me informed of your regimen. You should realize that alternative therapies have not yet been validated by controlled clinical studies. Although they may have therapeutic benefit, they are outside the established approved standard of care. They may interfere with standard antiviral therapy. Also, it may not be possible to achieve the reported beneficial effects of some of these therapies at over-the-counter strengths. Harmful side effects or interactions with other medications may not yet be known. Your preferences in treatment will be discussed with you and incorporated into your medical care plan.
About the Media
You should be critical of news reports about HIV treatment "breakthroughs." Oftentimes, all the pertinent facts are not presented during "sound byte" announcements. Furthermore, usually the news stories are released prior to publication and distribution of the scientific paper upon which the story is based. The medical community at this point has not been afforded the opportunity to review the data and critique its conclusions.
HIV disease is one of the most complex medical problems our society has ever faced. There is much about the disease that is not fully understood and even the experts have differing opinions about many aspects of it. Because of this, most media coverage tend to oversimplify what they are reporting about and often give misleading impressions about new treatments.
You may also encounter "underground" reports that unfairly overemphasize the adverse effects of conventional medications relative to their benefits (if any are mentioned at all). This is a scare tactic, which distorts the risk to benefit ratio.
Remember, the intent of any program, entertainment or news, is to attract large audiences for better ratings and higher advertising revenues. Similarly, the print media may editorialize reports to grab headlines to increase readership and gain greater advertising revenues. Articles in the financial press may influence the stock value of publicly traded companies.
Please do not alter your treatment regimen without first discussing any concerns or reservations you might have with me. Your doctor should be your greatest resource in helping you to determine what is the best course of care for you.
About Why I Provide HIV Care
There are only a handful of doctors in the Detroit area specializing in providing HIV care and even fewer physicians who provide both primary medical and advanced HIV care.
Many patients expressed to me that they desire a doctor able to manage their HIV condition as well as their other medical needs. I have concentrated my efforts and time in providing that type of primary care the best I possibly can. HIV care is an intellectual challenge. The pathogenesis, or ways in which HIV disrupts the immune system, is much better understood. Treatment decisions may be very difficult to make as recommendations and guidelines continue to change due to newer published scientific data. There may also be an uncertain consensus of treatment options. Even though much more is known, there is still much that remains unknown.
Interpreting this information and integrating it into clinical usefulness for providing the best results demands the highest of intellectual cognitive skills from the practitioner.
Although the demands of HIV Medicine can be enormous on the physician, I derive great satisfaction from knowing that I have been able to comfort and help my patients. I maintain my respect and appreciation for my patient's dignity. The recognition of my efforts to preserve their ability to guide their own destiny, exemplifies in my mind all that is the best in a physician-patient relationship.
About Our Partnership In Your Care
I am committed to provide you with the highest quality HIV and general medical care. Working together in pursuit of this standard of excellence, we will at times discuss the benefits of a known or investigational drug therapy against the potential risks, side effects, or complications that could result from using these therapies. The consequences of not treating a condition will also be discussed at times. You may be provided with written information about medications prescribed that will tell you about its indications, side effects, toxicities, and how to take it.
Each person may respond somewhat differently to medications and we must always individualize treatment to your tolerance level. You should always inform me of any problems you think may be related to your medications.
A comprehensive team approach is utilized to provide optimum care. This sometimes requires that I orchestrate your care among physician specialists, home care agencies, nutritional counselors, and social service providers. The consultants and agencies I select to assist in your care are chosen on my knowledge and confidence in their abilities and caring attitudes, and not on any personal financial inducement. In the unlikely event a problem should arise with anyone providing your care, please discuss this with me so we can resolve any difficulties.
To maintain the best patient-doctor relationship possible there needs to be open and honest communication. If you are unhappy with your care for any reason please let me or one of my staff know. If you are uncomfortable discussing it in person please feel free to discuss your feelings in writing. I encourage patients to keep a notebook and chart their own progress.
Prepare for your office visits to make the most of them by writing down any questions your may have before hand. You may want to call the office before you come in to make sure that certain expected reports are received prior to coming in.
Sometimes time can be an obstacle in effective doctor-patient relationships. If you have a list of several problems, please let me know before hand and prioritize them. Schedule another visit if necessary if there are more concerns than one office visit will allow.
About Extended Resources
The complexity of the clinical conditions brought about by HIV infection may require the expertise of specialists from several medical disciplines. As your primary HIV doctor and family physician I will coordinate your care among consultants should their input be necessary. Participation in an investigational drug study and the office visits associated with them are not a substitute for primary care and management of your disease. I am happy to work with you and provide your primary care if you are participating in a study at another institution. In fact, I may encourage you to participate in one if it is in your best interest.
If needed, I can access the country's leading HIV/AIDS clinicians and researchers through networks I have formed and links I have made over the years.
About My HIV Knowledge
I dedicate a large portion of my study time to reading HIV journal articles and attending national and international medical conferences. I have attended several of the last International AIDS Conferences. Attending these prestigious conferences keeps me abreast of all the current treatment trends expected to be implemented in HIV care in the coming year.
I am Board Certified in Family Medicine by the American Osteopathic Board of Family Physicians. I am credentialed as an HIV Specialist by the American Academy of HIV Medicine. I am a member of good standing of the American Osteopathic Association, The Michigan Association of Osteopathic Physicians and Surgeons, the Oakland County Osteopathic Association.
My Commitment to Community and Physician Education
I have lectured to several thousand doctors and medical students on "The Role of the Family Physician in HIV" over the last several years. I have given talks to HIV Specialists as well.
I have lectured in the community on several aspects of HIV including:
"You and Your Doctor — Making It Work"
"Imagining a Cure for AIDS"
"AIDS Updates and Conference Reports" and
"Caring for People in the Active Phase of Dying"
If you are aware of groups or organizations interested in learning more about the medical aspects of HIV care and management, please let me know.
I presently serve on the Board of Directors of The Midwest Aids Prevention Project and have done so since the organization was founded. I have been a Rotarian since 1981.
About What To Do If You Feel Ill
I know that illness can come upon you suddenly and you may be unsure of the significance of symptoms or what you should do in these situations. Because of this, my staff gives top priority to all of your questions and messages. Please do not hesitate to call us if you are in doubt.
If a medical emergency should arise and your condition would be jeopardized if there were a delay, you should seek care at the nearest hospital emergency room.
I have hospital admitting privileges at St. John Oakland General Hospital on Dequindre Road just north of 11 Mile Road in Madison Heights. My patients have been quite pleased with the quality of care they have received there.
About Your Lifestyle
Patients who maintain a positive mental attitude, eat a balanced nutritious diet, exercise regularly, avoid excessive use of alcohol, recreational drugs and tobacco, and who comply with recommended medical therapies, remain the healthiest. A healthy lifestyle is beneficial whether you are HIV positive or not.
About The Future
Many promising new therapies are on the horizon. We have made significant progress in the past. I am optimistic that scientific advances will continually afford more effective treatments and a therapeutic/protective vaccine. Taking a proactive approach to your care and practicing good general health measures will allow you to look forward to being here for the cure.
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