Many New Doctors Won’t Treat AIDS, Study Finds : Conference: Researcher says personal bias toward gay men, minorities and drug abusers affects attitudes.
Many young physicians entering practice intend to go out of their way to avoid treating people infected with the AIDS virus--less out of fear of infection than out of personal bias against the types of people who most often have the disease, new research shows.
Sixty-three percent of aspiring internists surveyed by UC San Francisco researchers said they were not planning to treat people infected with the human immunodeficiency virus (HIV). Only 17% of the physicians-in-training were strongly in favor of caring for AIDS patients.
“We need to look at what the profession is all about,” said Dr. Molly Cooke, who headed the study. “What are our fundamental obligations to the sick? What does it mean when our young medical trainees say they don’t want to have to deal with one of the most urgent health problems of this generation?”
Some health-care workers expressed shock upon hearing Cooke’s findings.
“Did these physicians say what planet they were going to be working on?” a Seattle nurse asked Cooke after presenting her findings Saturday at the Sixth International Conference on AIDS.
Cooke and her colleagues undertook the study of 1,045 residents in internal medicine to find out whether future doctors intend to care for HIV-infected people and why. The researchers also sought to explore what characteristics distinguish doctors who do from those who do not.
They found that perception of the risk of becoming infected on the job was not the principal determinant. What made the difference was the young physicians’ attitudes and prejudices toward gay men, members of minority groups and intravenous drug users--the groups hit hardest by the epidemic.
Many expressed the view that intravenous drug users and gay men had “brought the disease upon themselves.” Many also said they would not want a lot of intravenous drug users, gay men or members of minority groups in their medical practices. Some said they found that the demands of patients in these groups especially annoying.
Nearly two-thirds of those surveyed said they would withhold life-saving treatment if they faced a 1 in 100 chance of becoming infected themselves. Five percent said they would not provide life-saving treatment even if the physician’s risk was as low as 1 in 100,000.
“As the benefit to the patient declines, from the point of view of the physician, the percentage of residents who would not treat increases,” Cooke said. “This is particularly remarkable given this degree of risk (1 in 100,000), which is almost incomprehensibly small.”
Other considerations shaping attitudes toward treating infected patients were the sense of futility in the face of an incurable disease, and whether physicians believe they have a professional or ethical responsibility to care for all patients, Cooke said.
