Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 140

‘‘They Treated Me as if I Were Dead’’ 129 patients received media attention, and many health care workers opted not to practice in high incidence HIV areas. But the well-publicized case of Kimberly Bergalis, allegedly infected by her family dentist, refocused public attention on the risk infected health care workers could potentially pose to their patients. The U.S. Senate voted 99 to 0 to require testing of health professionals engaged in invasive procedures, and mandated ten- year prison terms and fines for health care workers who knew they were HIV-positive but failed to inform patients on whom they had performed such procedures (1). This bill did not become enacted, and the CDC subsequently advocated that individual states and health care institu- tions make their own decisions as to what procedures were ‘‘exposure prone’’ ones from which HIV-positive health care workers should be barred on a case-by-case basis. Yet HIV-infected health care workers may continue to face the possible loss of their jobs, and discrimination (2, 3, 4). Still, it is important to note that only twice have health care workers ever been documented to have infected patients—once in the U.S., and once in France (1). Nonetheless, some courts have argued that patients have the right to know a physician’s HIV status or alcohol history (5) because it is ‘‘material’’ to a patient’s informed consent decision (i.e., posing possible risk, no matter how small). Most patients have said they would change physicians if their physician had AIDS (5). Some county medical associations have arranged to have all patients of an HIV-infected physician HIV-tested after learning of the physician’s positive status. Patients have sued infected doctors, claiming ‘‘emotional distress’’ from learning that the physician was positive—even when the patient remained uninfected. Physicians with other diseases routinely encountered, or feared, dis- crimination as well. Such bias varied in directness and intensity. For instance, at times, doctors with other disorders experienced not clear, overt discrimination, but ‘‘inflexibility’’ from colleagues who failed to show empathy, or to acknowledge their colleague’s disease and decreased function (even if only temporary). As a resident, Deborah experienced a lack of accommodation, if not discrimination per se, when her schedule changed. I was starting radiation therapy every day for six weeks, and had to juggle time. So I went to the head of my new unit and said, ‘‘I’m having radiation. I may be late in the mornings.’’ He got very angry: ‘‘I don’t care what you do, or how you do it. But you have to