J. Wesley Thompson, PA-C, MHS, DFAAPA, AAHIVS
Ballantyne Family Medicine
Charlotte, North Carolina
After receiving a Masters in Health and his Physician Assistant degree from Duke University, J. Wesley Thompson started out in primary care and recalls seeing his first HIV/AIDS patient in 1985. I was drawing blood early one morning before class and walked to a room that had all the red tape warnings, masks, gloves, jump suits, and respirators by the door. I heard the hall nurse telling the charge nurse that she refused to touch “those people” and threw her badge to the floor and quit. I told the charge nurse I would clean him up while I drew blood. The young man had end stage AIDS and had soiled himself. While I cleaned him up, I made light of seeing him naked and said I was a gay man and had seen a few wieners. It placed him at ease and then as I began to draw his blood, I removed my gloves and he became alarmed and I told him I couldn’t draw blood through gloves and he wasn’t going to give me anything anyway. His lip began to quiver, and I pretended not to see it. As I left, I pulled my respirator down and kissed him on the forehead and promised to see him after supper. I returned after supper to find the warning tape and personal protective gear gone. The same charge nurse was still there and saw me slow down and turn away. She came to me and placed her hand on my shoulder and said, “He told me what you did. You were last person to touch him and treat his as a someone worthy of love. Thank you.”. Says Thompson, “As an openly gay man, HIV positive patients gravitated towards me. I was initially leery of taking on HIV patients because of my own fears and biases. Very quickly, I realized this was my mission field.” Thompson recalls days in the dusk of the twentieth century when HIV/AIDS patients were thought of as “modern day lepers.” Thompson embraced this community and they embraced him.
Today, Thompson owns Ballantyne Family Medicine and is a co-founder of the recently started non-profit clinic Amity Medical Group. Of his practice at Ballantyne Family Medicine and Amity Medical Group, he says, “We have a large HIV positive patient population and we are the largest PrEP clinic in the region with more than 350 patients on PrEP and recently launched a PrEP pilot program with Mecklenburg County Health Department to provide PrEP to any uninsured county resident. We also provide care to the LGBTQI community, with more than 380 trans patients, and are members of the Charlotte Transgender Health Group.” Located in Charlotte, North Carolina, and between the two locations, Ballantyne’s faculty is comprised of Thompson, Richard Wynn, MD, Kristi Dougan, NP, Tamara Neely, NP, Rebekah Stockstill, PA-C, Mandy Irvin, PharmD, CCP, and a staff of 23. Ballantyne is a One Stop Shop model developed by Thompson which has on-site lab, on-site radiology, and on-site 340B and retail pharmacy. The clinic has community rooms to allow community partners such as case managers, social workers, mental health providers, Ryan White coordinators, and NC HIV Medication Assistance Program (HMAP) to provide their services to patients in the clinic in order to enhance the One Stop Shop Model and thus improve linkage and retention in care. Their payer mix is about 10 percent self-pay, 15 percent Medicaid, 15 percent Medicare, 15 percent Ryan White, and the rest are privately-insured patients. Their gender mix is 55 percent male, 40 percent female, and 5 percent transgender. They see about 100 patients per day. Says Thompson of his patients’ average age, “The average age of our HIV positive patients in 2000 was 32 and today the average is 49.”
“I don’t parent my patients, I partner with them and together we work out adherence and any other issues or challenges that arise,” says Thompson, Today’s regimens are less complicated and relatively free of side effects. Social determinants such as food security, housing security, transportation, access to mental health and substance abuse care are our biggest challenges to adherence and retention in care now. Collaborating with community partners who provide these psychosocial needs has been key to our success. Funding challenges for these services unfortunately remain and need to be addressed. “When I see in a patient’s eyes the return of hope, when I see their self-worth resurrected; these assuage any obstacles I could mention or even remember.” Thompson explains to his patients that having HIV is not the result of something they did wrong. Thompson doesn’t believe in a guilt trip approach to practicing medicine. “Trusting someone is not wrong. Making a mistake or having poor judgment is human,” Thompson tells his patients. He emphasizes that if his patients stress out their immune systems with guilt or experienced stigma internally or externally or self-deprecating thoughts, it can be more harmful than HIV itself. Thompson promotes a very sex positive approach to medicine.
Thompson points out how incredible it is to take care of patients with a virus that was a death sentence in 1985 and now has become a chronic medical condition that does not appreciably shorten one’s life. Says Thompson, “I have gone from holding my patient’s hands and going to funerals to now attending weddings and baby showers. One can choose to believe there are no miracles in this life or one can choose to believe there are miracles every day. What we have done in the field of HIV/AIDS care is nothing less than miraculous to me.” In practice, Thompson states the end of the epidemic is in what he calls his Holy Trinity of HIV care and that is Post-Exposure Prophylaxis (PEP), Pre-Exposure Prophylaxis (PrEP), and Treatment as Prevention (TasP).
In addition to serving as Co-Chair of AAHIVM’s Southeast Chapter, spanning eight states in the US, Thompson is active with local AIDS Service Organizations and the Quality Control Committee and Provider Committee for Ryan White. He also serves on the NC HMAP Provider Committee. He lectures locally and nationally in hopes of inspiring patients and motivating providers. He is writing a book about life in clinic with the humorous and life-changing twists that occur. As for why he is an AAHIVM Member, Thompson says, “Joining AAHIVM seemed to be a natural fit with my vision for care for my patients and as a part of my mission and vocation.”
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