doctors with infectious diseases...

[iwannagomed]

i just watched a tv show about a physician with a fatal disease...

and it got me wondering...

are there any policies at med schools against applicants with infectious diseases (HIV, hepatitis, etc.)?

i can see how they may be concerned about the health of the student body and faculty and, once u become a physician, i can also see how other doctors and patients may be reluctant to work with u or to be treated by u...

but a regulation against those applicants with such diseases may also trigger a debate on discrimination...

any thoughts?

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[supernareg]

taggin' along, i wanna know too

 

[gersh489]

Dunno about other cases - but I am 99% sure it is illegal to discriminate against someone w/ HIV because transmission is preventable.

 

[Soggun]

i just watched a tv show about a physician with a fatal disease...

and it got me wondering...

are there any policies at med schools against applicants with infectious diseases (HIV, hepatitis, etc.)?

i can see how they may be concerned about the health of the student body and faculty and, once u become a physician, i can also see how other doctors and patients may be reluctant to work with u or to be treated by u...

but a regulation against those applicants with such diseases may also trigger a debate on discrimination...

any thoughts?

I also am not sure about this stuff, but I do know that in my acceptance packet to Downstate there was a health form that had to be filled out and I believe there was something about matriculants needing to have a clean bill of health due to early patient contact (during the first year). Not sure exactly what that means or what you would have to have to get excluded from patient contact, but it does seem to at least be a concern for some schools.

 

[Tired Pigeon]

The 'universal precautions' that were instituted in the HIV era are based on the assumption that anyone (patient OR health care provider) could be carrying an infectious disease. This means that we can theoretically treat any patient regardless of their infection status OR our infection status because both parties are protected. So, a physician with HIV (for example) would not be precluded from practicing; he/she would simply observe universal precautions in patient contact just like every other physician.

 

[QuantumMechanic]

i can see how they may be concerned about the health of the student body and faculty and, once u become a physician, i can also see how other doctors and patients may be reluctant to work with u or to be treated by u...

or relationships for that matter...what about genital herpes and genital warts?

Fraternization with faculty could become much more open when faculty spouses come to tar and feather the infected individuals...

 

[alphaeve]

Providing information about someone's HIV status without his/her permission is completely illegal. So if a person did not report the disease, I'm not sure that med schools or prospective patients could really know.

 

[psipsina]

The 'universal precautions' that were instituted in the HIV era are based on the assumption that anyone (patient OR health care provider) could be carrying an infectious disease. This means that we can theoretically treat any patient regardless of their infection status OR our infection status because both parties are protected. So, a physician with HIV (for example) would not be precluded from practicing; he/she would simply observe universal precautions in patient contact just like every other physician.

Not to mention that it would be mighty screwed up if you could be removed from your proffession for getting a disease via the practice of your proffession.

 

[NickRiviera]

I'm not so sure about this one...wouldn't this be considered a risk to the patient? Say you're a surgeon with HIV and a patient comes back a year later and got HIV. Are you just going to say, "Oh yea, forgot to mention that risk on the little waiver you signed." Universal precautions are mostly to protect yourself from others, not vice-versa.

 

[psipsina]

I'm not so sure about this one...wouldn't this be considered a risk to the patient? Say you're a surgeon with HIV and a patient comes back a year later and got HIV. Are you just going to say, "Oh yea, forgot to mention that risk on the little waiver you signed." Universal precautions are mostly to protect yourself from others, not vice-versa.

According to my understanding from small group discussions HIV+ (or HepC+) surgeons are not precluded from performing surgery, nor are they required to disclose their status to a patient. Who on earth would go thru 7+ years of training to be a surgeon, thereby placing you into the highest risk group for the aquisition of a blood borne pathogen, if they knew that once postitive their training would be for naught? People need surgeons more than they need protection from whatever miniscule chance there is of catching a disease from their surgeon.

It is very rare for HIV to be transmitted from infected surgeons or dentists to patients. The only known case involved a Florida dentist and six of his patients. Luc Montagnier and colleagues now provide a second example, documented with molecular virology evidence, strongly suggesting transmission of HIV from an infected French orthopedist to a patient. http://infectious-diseases.jwatch.org/cgi/content/full/1998/601/1

It would be pretty difficult to pass it on to the patient, the danger of an infectious patient in surgery lies in the profuse amount of their blood that can be squirting about, usually the surgeon is not spurting their own blood.

With the dexterity of a surgeon, its highly unlikely that they would cut themselves severely enough to bleed into a patient. The problem is that if the surgeon knicks themselves the already profusely available patients blood is likely to enter that wound, not that the surgeon slices themselves open and bleeds into the patient. Even if the surgeon gave themselves a good cut they would likely be able to get out of the field before the blood leaked back out of their glove. And even when you are stuck in the presence of patient's infectious blood the rate of transmission for HIV is extremely low, and HepC is pretty low.

 

[Tired Pigeon]

I'm not so sure about this one...wouldn't this be considered a risk to the patient? Say you're a surgeon with HIV and a patient comes back a year later and got HIV. Are you just going to say, "Oh yea, forgot to mention that risk on the little waiver you signed." Universal precautions are mostly to protect yourself from others, not vice-versa.

No, the whole idea is actually based on protection for both sides.

 

[diosa428]

There is an ID doctor who graduated from Duke and works for Harvard who is HIV+ (got it through a blood transfusion when he was a child). So, it obviously can be done. However, there was a huge discussion in my medical school class about how surgeons are required to treat a patient regardless of what diseases they may have (ie, HIV), but that it's not recommended for a someone who is HIV+ to go into surgery because the surgeon could transmit the disease to patients, which, among other things, is unethical and could obviously cause major lawsuits. This spiked a huge, incredibly angry debate in my class... but I don't know if there are official guidelines about this or not. In fact, I can't even remember who was leading the discussion about this one.

 

[gujuDoc]

You are failing to realize something. Most of the doctors who have Hepatitis and/or HIV have it because they contracted it during procedures as attendings, residents, or god forbid even as med students.

The former Dean of USF COM had Hepatitis. He got it because he got knicked during a surgery he was performing on an Hepatitis infected patient. This is one of the things that makes surgery kind of scary.

i just watched a tv show about a physician with a fatal disease...

and it got me wondering...

are there any policies at med schools against applicants with infectious diseases (HIV, hepatitis, etc.)?

i can see how they may be concerned about the health of the student body and faculty and, once u become a physician, i can also see how other doctors and patients may be reluctant to work with u or to be treated by u...

but a regulation against those applicants with such diseases may also trigger a debate on discrimination...

any thoughts?

 

[psipsina]

You are failing to realize something. Most of the doctors who have Hepatitis and/or HIV have it because they contracted it during procedures as attendings, residents, or god forbid even as med students.

The former Dean of USF COM had Hepatitis. He got it because he got knicked during a surgery he was performing on an Hepatitis infected patient. This is one of the things that makes surgery kind of scary.

According to my small group leader, once you matriculate into medschool you can never get life insurance cheeply again because you are considered to be in a high risk group.

 

[njbmd]

According to my small group leader, once you matriculate into medschool you can never get life insurance cheeply again because you are considered to be in a high risk group.

My life insurance rates have decreased since graduating from medical school. Perhaps this is a state problem.

 

[pagemmapants]

Dovetailing off of what diosa said, I'm pretty sure that in NC it's illegal for a surgeon or other physician to refuse to treat an HIV+ or otherwise infected patient, but it's perfectly fine for a patient to refuse to be treated by an HIV+ surgeon.

I'm not sure what the disclosure requirements are. Obviously a surgeon would know that the patient was HIV+, but does the patient necessarily know that the surgeon is? It'd be interesting to find out what the rules are regarding this. It wouldn't surprise me if full disclosure was mandated in any and all situations, given the public health risk.

So yes, HIV+ status does not preclude you from becoming a surgeon, but whether you'll get many patients is probably pretty dependent on the levels of tolerance and specific disclosure laws within your practice area.

I imagine that any surgeon that is knowingly infected will triple-glove and be especially careful. Wouldn't hurt to have a few shots of AZT on hand for the patient just in case either.

On a similar note: ER addressed this issue with one of their PAs; I think she kept her job despite being infected even when people found out, which I'm pretty sure is what would happen in most places nowadays. Then when she got fired due to budget cuts she (annoyingly and falsely) said she was fired because of her HIV status and got reinstated. I lost interest in her character after that.