Physicians reflect on their lived experiences in long-term AIDS care

Throughout the history of the acquired immunodeficiency syndrome (AIDS) epidemic, the theoretical and empirical literature has emphasized the stressors related to the care of patients with AIDS, and the reluctance of health professionals, including physicians, to provide care to patients with AIDS. However, from the beginning, there have been individuals who have dedicated themselves to the care of patients with AIDS. This descriptive, qualitative study explores the perceptions and experiences of five physicians, specializing in AIDS care, within a large medical center in New York City. Using principles of qualitative data analyses set forth by Carini, the data reveal important themes related to how they became involved in AIDS care; the stresses associated with AIDS caregiving and ways of coping; the rewards of AIDS care; aspects of the physician-AIDS patient relationship and patient characteristics that promote their willingness to care; and recommendations to fellow physicians in caring for patients with AIDS. From what they have said, and not said, palliative care clinicians, educators, and administrators can learn ways of promoting physicians' caregiving potential, and understand the value and intimacy of the physician-patient relationship, particularly within the context of life-threatening illness. This has further implications in promoting the quality of care offered to patients with AIDS and to all patients with an incurable illness, as well as insuring "safe passage" for patients and for the physicians committed to their care.