{"id":101,"date":"2008-10-18T06:16:59","date_gmt":"2008-10-18T11:16:59","guid":{"rendered":"http:\/\/blogs.nejm.org\/pov\/hiv-id-observations\/?p=101"},"modified":"2015-06-04T15:31:44","modified_gmt":"2015-06-04T19:31:44","slug":"back-to-school-day-2","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/back-to-school-day-2\/2008\/10\/18\/","title":{"rendered":"Back to School, Day 2"},"content":{"rendered":"

During the course, often the best questions and anecdotes come during the breaks.\u00a0 Here are a few:<\/p>\n

    \n
  1. Tons of questions about our favorite nemesis, MRSA<\/a>.\u00a0 What works for chronic carriers?\u00a0 How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient?\u00a0 What if the vet won’t culture the family dog?\u00a0 What are the guidelines for infection control in the outpatient setting?\u00a0 What is the best non-linezolid (which still costs > $150\/day<\/a>) oral antibiotic?\u00a0 What’s the right dose of trimethoprim-sulfa?\u00a0 (Many advocates for two double-strength tablets twice daily.)\u00a0 Number of definitive answers to any of the above questions?\u00a0 None. <\/em>I guess misery loves company.<\/li>\n
  2. A primary care MD working at a college health clinic gave me some insight into just how far we still have to go to make those revised HIV testing guidelines<\/a> a reality.\u00a0 In this campus-based practice, if one of the students requests an HIV test, or the clinician thinks an HIV test is indicated, several restrictions are in place that go way beyond the state-mandated requirement for written informed consent.\u00a0 First, extensive pre-test counseling is required; second, only one of the providers is allowed to order the test (so the student must return to see that clinician if he is not available that day); third, mention of HIV testing in the medical record is forbidden; and fourth, the results of the test do not appear in the student’s chart.\u00a0 (They are kept in some locked remote location<\/a>, no doubt.)\u00a0 Hey, can we stop this madness already?\u00a0 Is there any evidence that such policies help anyone?\u00a0 (The MD at our course was complaining about them, not surprisingly.)\u00a0 Of note, the revised HIV testing recommendations — explicitly outlining the rationale for\u00a0eliminating barriers to testing — are now over two years old.<\/li>\n
  3. Only two course participants thought I was Paul Farmer<\/a>.\u00a0 Interestingly, one of them thought I was Paul Farmer immediately after<\/em> he gave his lecture, during the coffee break, when the real thing was standing right across the room. My clue she had the wrong Paul Edward was when she\u00a0told me my work inspired her to apply to medical school\u00a0when she was growing up in Port-au-Prince.\u00a0 There are definitely worse people one could be mistaken for — back when I had more hair (lots<\/em> more hair), someone thought I was a dead ringer for this guy.<\/a> Yikes.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    During the course, often the best questions and anecdotes come during the breaks.\u00a0 Here are a few: Tons of questions about our favorite nemesis, MRSA.\u00a0 What works for chronic carriers?\u00a0 How do you manage family members who you suspect would be culture-positive (and the source of recurrences), but are not your patient?\u00a0 What if the […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,5,6,8],"tags":[423,564,630,701,706,742],"class_list":["post-101","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-infectious-diseases","category-medical-education","category-patient-care","tag-hiv","tag-linezolid","tag-mrsa","tag-paul-farmer","tag-pep","tag-post-exposure-prophylaxis"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/101","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=101"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/101\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=101"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=101"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=101"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}