An article on MSNBC.com talks about some of the complications arising from the plan to recommend HIV AIDS testing for almost everyone. The article says state laws and reluctance by local doctors are hindering plans to test everyone.
"How challenging this is going to be depends on where (what state) the doctor practices," said Dr. Nancy Nielsen, a Buffalo, N.Y.-based physician who sits on the governing board of the American Medical Association.
And then there's the daunting issue of dealing with a patient who has HIV, which some pediatricians and family doctors have rarely faced.
Many primary care doctors customarily refer a patient with HIV to a specialist better equipped to treat the virus and put the patient in touch with support services. That's expected to continue.
The plan is also hard on the patient's primary doctor who will have to deliver the bad news. The cost of the tests, $15 each, is also a burden.
But the primary doctor will be expected to break the initial news of the diagnosis to the patient - a task requiring skills some physicians don't always demonstrate, said Dr. Kimberly Manning, an internist at Atlanta's large public hospital, Grady Memorial.
"It's not like someone's cholesterol being high," she said. With HIV, a physician must be prepared to empathize, educate and guide patients into such steps as notifying intimate contacts, she added.
And there is the issue of cost. A routine blood test for HIV can cost between $3 and $5, some health experts say. New rapid tests, done through finger pricks or oral swabs, cost $15 or more.
Given time some of these hurdles will probably be overcome but it will be a long process.
