MEDICINE : HIV-Infected Doctors Being Retrained in Related Fields

Dr. Alvin Novick recalled the chill he felt when he began receiving calls from health care professionals who had lost their jobs. They felt “stripped of their professions, their future productivity, their income,” he said. “Listening to them, my blood ran cold.”

Novick, a professor of biology at Yale, has been instrumental in starting a program to counsel and retrain physicians and other health care workers whose careers have been jeopardized because they are infected with the human immunodeficiency virus, which causes AIDS.

The program is being offered by the American Assn. of Physicians for Human Rights, a national gay physicians’ group. Novick, who has become increasingly concerned over what he perceives as growing hostility toward HIV-infected health care professionals, is an active member and past president of the group.

“There are wonderful health care providers who one day will be practicing their profession and the next day will be kicked out because they will be seen as a threat to their patients,” he said. “Those same professionals could perform hundreds of other services where they will pose no threat whatsoever.”

BACKGROUND: The program has evolved in response to a growing number of incidents nationwide in which health care professionals found to be infected have been abruptly dismissed from their jobs.

“Some of the people who have called me are in desperate need of counsel and support and referral,” Novick said. “They are in a personal and financial state of shock.”

One of the reasons for the increased interest in the issue is the recent publicity about a Florida case in which a dentist--who later died of AIDS--may have infected several patients.

As a result, the federal Centers for Disease Control has been re-examining its guidelines for dealing with infected health care workers who perform invasive procedures and is expected to decide in the coming months whether to revise them.

Regardless of the outcome, the issue has been around almost as long as the AIDS epidemic itself.

“At least half of the instances of discrimination that come to us arise in health care facilities,” said Thomas Stoddard, executive director of Lambda Legal Defense and Education Fund, the nation’s largest gay rights organization. “Some are against patients, but most are against (infected) workers. Except for schools, there’s been more (AIDS-related) litigation over health care workers than any other field.”

The physicians’ organization has applied for funds from several foundations and has enlisted the support of several Establishment medical groups, including the American Medical Assn.

“Physicians ought to look on this as caring for their own,” said Dr. M. Roy Schwarz, the AMA’s senior vice president for medical education and science. “I think it’s an excellent idea.”

GOALS: Under the new program, counseling services will be provided and health care workers will be helped to find new professional opportunities where they can use existing skills “through networking with major institutions to identify specific slots,” Novick said.

Further, he said, medical schools and teaching hospitals will be contacted to “identify opportunities to enter training programs to retrain them into a new kind of practice.”

Schwarz has suggested broadening the program to include health professionals with other diseases, although he acknowledged that discrimination is not as great as it is with AIDS.

Nevertheless, he said, “if it’s HIV and other disorders, it takes away some of the stigma. I don’t want to see a stigma attached to people who go into this program. That’s why I’d like to broaden it.”

Unlike Stoddard, Schwarz does not believe discrimination against HIV-infected health care workers is rampant. “But,” he said, “if the public happens to think infected physicians are a risk to them, it’ll become rampant.”