February 2012

Growing up in Africa and going to hospitals there for all sorts of ailments from malaria to pneumonia, the doctor was always in-charge and in most countries on the continent still is. In charge of asking the patient questions about what is ailing them, confirming what is wrong with the patient and basically having the last word on what the patient does going forward or not! As a patient, challenging a doctor feels in some cases like challenging a soldier with a gun! They basically have the power over whether you live or die. In my view, this absolute power has led many to believe that the Doctor is King, not just in Africa but in many other parts of the world. Never mind that there are very few doctors especially in the developing world, so many people are treated by health advisors, workers or medical officers – really scary!

The reason I am writing about this now relates to all the reforms that are being debated about the National Health Service (NHS) in the UK. I can’t claim to understand everything the health reforms are supposed to deliver, but all I know is that changes in how I access health services have been happening for a while now.

Many HIV positive people will be aware that for the last few years we have been encouraged to go to our General Practioners (GPs) for non-HIV related issues. I do not dispute the fairness of this, but for many of us our HIV doctors have been able to resolve all our health issues to a point where we never needed to go to our GPs. One of the things I have worked hard at since I learnt of my HIV infection, is becoming an informed patient. Being an informed patient has helped me have a balanced relationship with my HIV doctor, where we have a discussion and come to a mutual understanding on a way forward for me regarding my healthcare. I have been so happy with all the HIV doctors I have had, I didn’t have to bother with a GP. But thanks to the economic environment and inevitable changes in the NHS, I now have to start nurturing my relationship with my GP!

I first registered with a GP in 1997 and while undergoing this process I was happy to disclose to the team of nurses and GP at my clinic that I was HIV positive and had been for at least 9 years. When I uttered those words, the room went quiet! One of the nurses wanting to disguise what had just happened proceeded to ask the next question on the list but was unable to get through it without stammering. I made a decision that day that I would not go back to my GPs unless I was desperate or dying.

They say be careful what you wish for or in my case what you tell yourself, I had to go to my GPs last year because I was desperate! It was a difficult meeting, at least for me. I felt like I was 6 years old and was being told what do. After what seemed like a tug of war, with the GP telling me one thing and me telling him that I wasn’t leaving his office until I got what I needed! We finally reached a compromise that we were both happy with. But I feel that my GP clinic has little or no time for informed patients (not sure I am alone on this). I want to be able to have the best health service I can. So I am afraid I am going to become a challenge for my GP as we embark on this new (and, may I add) forced relationship!