By Donna Sweet, MD, AAHIVS
National Board of Directors, American Academy of HIV Medicine (AAHIVM)
Chair, Credentialing Committee, American Academy of HIV Medicine (AAHIVM)
A little over ten years ago a group of HIV care providers, many of whom had been in practice at the dawn of the AIDS epidemic, came together to discuss ways they could harness their nearly three decades of knowledge, experience and insight to document and improve standards of HIV care delivery, while cultivating a new generation of HIV care providers.
What resulted was the formation of the American Academy of HIV Medicine (AAHIVM), and the development of the Academy’s HIV Specialist™ Credentialing Program. Open to physicians, nurse practitioners, physician assistants and pharmacists, the AAHIVM HIV Specialist™ credential remains the only one of its kind nationwide, establishing a standard by which all HIV care providers should deliver quality HIV care. The credentialing program has three simple – but important – objectives:
- To improve the quality of HIV care,
- To broaden patient access to quality care, and
- To expand the number of HIV-specialized medical care providers.
We live in an increasingly complex health care environment that demands that we keep up with its rapid evolution. Treating HIV is not the same as it was 25 years ago, as many HIV care veterans know. Breakthroughs in treatment and care that combat HIV and extend life are often followed by perplexing trends, drug interactions and trends in new toxicities and drug interactions. Social and cultural responses to HIV have a direct impact on both our HIV-positive and negative patients. This in turn affects how we provide – and how our patients receive – HIV care and treatment, as well as our messages of wellness, risk reduction and prevention. Increased life expectancy for people living with HIV has presented a growing list of issues that includes: treatment adherence, hepatitis B/C co-infection, cardiovascular disease, and more. The definition of quality HIV care, then, must necessarily evolve as people live longer with the disease. It also must integrate the complexities of HIV with health risk factors typically associated with the normal aging process.
Guidelines and resources are indeed available to help health care providers in treating HIV/AIDS (particularly in the use of antiretroviral therapy), but these guidelines are no substitute for the judgment of an expert in the care of people living with HIV. Even the guidelines themselves stress that, where possible, the treatment of HIV patients should be directed by an expert in HIV care.
Becoming an Academy-credentialed HIV Specialist™ is a way to remain current, demonstrate frontline experience, and evolve with changes in HIV technology, with discoveries of new treatments and with shifts in the nation’s health care system. The AAHIVM HIV Specialist™ credential demonstrates to patients, colleagues, employers and third party payers a care provider’s commitment to maintaining continuing competency through ongoing learning, experience and self-assessment.
Most of us already know from other professional credentialing opportunities that an objective credentialing program with rigorous standards establishes documented accountability for quality care delivery. Patients have become active in their care and treatment, and those with a choice in health care providers are increasingly seeking out experts with verification of HIV-specific knowledge and experience. Health plans and medical clinics also are beginning to encourage, or even require, that those serving patients with HIV become AAHIVM HIV Specialists™.
To apply for the credentialing exam a provider must actively care for more than 20 HIV patients over the last two years. In fact, 55% of AAHIVM HIV Specialists™ have fewer than 150 HIV patients, and only 20% have more than 300. The reality is, then, that the average credentialed AAHIVM Specialist™ is an HIV-specific practitioner for only a part of his or her time.
Becoming credentialed through a process like the Academy’s program demonstrates to the medical community-at-large that we as HIV care providers voluntarily seek to establish for ourselves a rigorous, uniform national standard for the knowledge and experience base expected of all practitioners serving on HIV care teams. Developing a universal assessment tool of HIV knowledge for physicians, nurse practitioners, physician assistants and pharmacists also helps reduce barriers to entry into this specialized area of care. The AAHIVM HIV Specialist™ designation is available to health care professionals from diverse health care settings, educational backgrounds and frontline care experience. Credentialing improves our professional development, benefits our patients’ care, and provides a foundation for the creation of better treatment and care access opportunities.
Those of us who have cared for patients living with HIV know that this disease is unlike any other. Those who continue to care for people living with HIV, despite HIV’s clinical, social and epidemiological challenges, know that we must act now to ensure we have a new generation of HIV care providers who have the knowledge, tools and resources they need to effectively deliver quality HIV care. Becoming credentialed is a simple, yet powerful, action we can take both as individuals and as a profession, to improve HIV care quality and grow the number of knowledgeable, qualified HIV providers.
Applications for the AAHIVM HIV Specialist™ credentialing exam, as well as program eligibility requirements and frequently asked questions, are available at the Academy’s web site, www.aahivm.org.
Dr. Sweet is currently Professor of Medicine, University of Kansas School of Medicine – Wichita; Director of Internal Medicine Education at Via Christi Regional Medical Center – St. Francis; Medical Director, UKSM-W MPA HIV Program; Principle Investigator/Director, The Kansas AIDS Education and Training Center, Wichita, Kansas. In addition to serving on the board of the American Academy of HIV Medicine, her other professional activities have included: Past national Chair of the Board of Governors for the American College of Physicians-American Society of Internal Medicine and is currently a member of the Board of Regents. Dr. Sweet was recognized by the American Medical Association with the “Pride in the Profession” national award in 2000. She was recently honored as one of the “Shocker Top 40” by Wichita State University, an honor given to just 40 graduates of the last century.