October 25, 1993

Recruitment of Primary Care Physicians to Care for Patients With Human Immunodeficiency Virus Infection in a Large Northwestern County

Author Affiliations

From the Department of Medicine, University of Washington, Harborview Medical Center, Seattle.

Arch Intern Med. 1993;153(20):2341-2345. doi:10.1001/archinte.1993.00410200063007

Background:  We evaluated an initiative to recruit and to educate physicians to care for persons with human immunodeficiency virus (HIV) infection in King County, Washington, and to refer patients to them through a centralized telephone referral service (the acquired immunodeficiency syndrome [AIDS]/HIV Care Access Project).

Methods:  Six physicians trained in AIDS care recruited primary care physicians in clinics throughout King County; the physician cohort was monitored for behavior in accepting referrals during the ensuing year.

Results:  Of 250 primary care physicians contacted initially, 79 of 120 who met with AIDS-trained physicians were willing to accept patient referrals. Willingness was not related significantly to age, sex, years in practice, or specialty, but was related to level of experience with HIV/ AIDS care and current practice. The recruitment initiative increased the physicians available to the telephone referral service by 93% (from 85 to 164). More physicians (41) joined the referral service in the ensuing year, during which 647 patient referrals were made to these 205 physicians (median referral rate of one patient per quarter). Four physicians requested cessation of referrals, however, two later asked for referrals to continue.

Conclusion:  The recruitment initiative was successful in increasing the number of primary care physicians available to accept patients with HIV infection into their practices (thereby reducing the burden of HIV referrals on a small pool of providers), and in establishing a countywide telephone service to coordinate these referrals. The initiative was self-sustaining, with an ongoing influx of new providers willing to take referrals.(Arch Intern Med. 1993;153:2341-2345)