Letter: Risks to doctors in HIV panic

Sir: Your leading article on HIV panic displays a strange concept of the family doctor who is safe because he keeps a table between himself and the patient. There are some who conform to or approach that model, but they also verge on the category of charlatan. True doctoring is, and must always remain, a hands-on activity. A careful history will suggest the correct diagnosis in 80 to 90 per cent of cases, but this needs to be followed by physical examination in all but the most straightforward or trivial presentation. A variety of clinical tests may then follow, or in the more serious cases referral to a hospital consultant.

In the matter of HIV risk, the doctor may occasionally need to put a finger in a mouth to access a swelling, and other orifices more frequently call for exploration. The conscientious practitioner is involved in such procedures daily, and as you rightly stress it is the doctor who is thus at greater risk of infection from the patient than vice versa.

No sir, the good doctor must have a wide variety of skills other than the ability to use a biro on a prescription pad.

Yours sincerely,

P. O'BRIEN

Appleton, Warrington