Your First Appointment

Your first patient appointment will be made over the phone through our front-desk staff. In order to create a comprehensive care plan that is unique to you, we set up three initial visits for all new patients: an intake with our Social Worker, an intake with the Registered Nurse (RN) of your doctor, and a new patient visit with your doctor.

You will need to check in with the front desk staff when you arrive at the clinic for any visit where they will verify information such as your name, date of birth, and insurance coverage. As a new patient you may be introduced to the Ryan White Program - a federal payment assistance program available to HIV and AIDS patients with minimal or no health insurance. You will also receive and be asked to sign necessary forms. You will also be asked to make your co-payment. No patient will be refused service because of inability to pay. However, if your medical complaints are not urgent, you may be rescheduled - so always bring your co-payment.

Your first appointment will probably be with our Social Worker. Once registration with the front desk is complete and your medical chart is ready, you are ready to be seen.

Social Work Intake

We recognize that HIV disease affects every aspect of your life, and that managing the disease requires a holistic approach. The purpose of the social work visit is to gather information about you as well as provide resources and answer questions. You will be asked questions about your social, medical, and treatment histories, and asked to complete questionnaires. During this visit you will receive information about payment assistance programs and the services that are covered. Newly diagnosed patients will be invited to participate in current research studies taking place in the UNMHSC Infectious Diseases division.

If you have received prior medical care you will be asked to sign a Relapse of Information so that we may obtain your most recent medical information. You will be asked about the circumstances of your HIV diagnosis (when and where) and how you believe you contracted the disease.

Enrollment in the Health Management Alliance (HMA)

Another element of the social worker visit is to learn about the partnership Truman Street Clinic has with New Mexico AIDS Services. The two agencies make up Health Management Alliance 1; one of the four in New Mexico that comprise the HMA Health Care System - offering comprehensive and accessible health care to persons with HIV. By enrolling in the HMA you are be entitled to free services that include both individualized and family case management, behavioral health and substance abuse counseling, and access to many social services including a food bank and housing assistance.

Access Forms - Enrollment occurs by completing an Access form (A Client Centered Entry System of Services) either at NMAS or during the social worker visit. A complete Access form is also required to enroll you in ADAP - the AIDS Drug Assistance Program - if you qualify. It is important to provide all the information requested on the Access forms, including financial eligibility information, and updating these facts regularly so that you can to use as many resources as possible to manage your complete health care. Incomplete Access forms, or failure to re-enroll with updated information annually, may result in a loss of service.

Nurse Intake

After the social work intake is completed, you will have a nurse intake visit. These visits can happen on the same day, but often do not - and sometimes happen in the reverse order. They may seem repetitive of one another; however, completing both intake appointments provides different information to the people who are working together to make and keep you as healthy as possible.

During the nurse visit, the HIV primary care nurse that works directly with your doctor will evaluate your medical symptoms and determine if you need to see the doctor sooner than your new patient visit is scheduled - which is usually a week or two later. The nurse will measure your height and weight, will review the TSC Health History completed during the social work visit, and will ask you about your past immunizations and your HIV diagnoses. All of this information is put into your medical chart.

The nurse will also present educational information about HIV, and help you to understand anything about your diagnosis and treatment that you may have questions about. HIV is an infectious disease and is required to be reported to the Department of Health, and the nurse will complete a confidential report for them. You will be oriented to the clinic's hours and procedures, and learn who to call if medication refills are needed. You will learn what to do if problems occur when the clinic is closed and how to judge the seriousness of the problem.

If you are already on Highly Active Anti-Retroviral Therapy (HAART), your medications will be thoroughly discussed along with the importance of staying on your medicine. If you're having any trouble with your medicines it's important to bring this up with the nurse at this time.

Getting Lab Tests

The doctor will order laboratory tests, and the nurse will draw your blood so that results will be available to the doctor during your new patient visit. These tests provide information about you that help your physician assess the current state of your HIV disease. They are critically important for your overall care and in prescribing correct HIV medications. You will be asked to have labs drawn throughout your care, and it's important to always follow through. These tests include a CD4 count for the number of a certain type of cells in your blood, a viral load that tells the amount of HIV RNA in your blood, a hepatitis profile to see which immunizations and/or treatments may be needed, tests for sexually transmitted diseases, and a basic metabolic panel including liver function tests, complete blood count (CBC), and baseline glucose and cholesterol levels.

New Patient Physician Visit

At the new patient visit with your physician, the RN will greet you after you have registered with the front desk. Since having a positive HIV test may be the reason for coming to Truman Clinic, you will be asked questions about prior HIV testing and any recent illnesses. If you have a history of HIV, you will be asked about your diagnosis date and treatment history. The physician will review your medical history and discuss all medications that you are currently using. You will be asked about any allergies to medications. whether you have experienced loss of appetite, nausea and/or vomiting, weight loss or gain, diarrhea, fatigue, or had fever and/or night sweats. All of your immunizations will be reviewed, along with your history with your primary health care doctor, your dentist, and your eye doctor.

The physician will also ask whether you have a known history of a positive TB skin test or chest X-ray. You may be asked about your living and employment situations, as well as alcohol, tobacco, and other substance use. You may be asked if you have experienced violence in the past, and if you have a social support system that is aware you have HIV. The doctor will also want to know if you are sexually active and with whom. Other questions may include if and where you travel, as you may have been exposed to infections unique to other locations.

The doctor will then perform a thorough physical exam including oral, eye, and ear exams. The doctor will listen to your heart and lung sounds, measure the span of your liver, and feel for any lymph node enlargement. Genitourinary and rectal exams may occur dependent on your medical complaints, needs, and comfort level.

The doctor will go over your lab results with you, discussing the significance of routine lab tests and what monitoring levels you should expect. You will talk about the need for various immunizations and routine health maintenance and develop a plan for your complete health care. You may be referred to other providers such as a dermatologist or for eye care if needed. It is very important that you follow-up on these referrals, as they are an vital part of your total health care.

After your visit your nurse will give you any immunizations the doctor ordered. Your next visit will be scheduled and you will be instructed on when and where to get your next lab tests drawn. If medications were ordered, the RN will fax or phone the prescription(s) to your pharmacy. If your doctor wants to refer you to a specialist the RN will make that appointment for you as well. Discharge instructions, with the doctor's orders, are completed and you will be asked to sign this paperwork.

Now you are an established patient at Truman Clinic! Routine appointments will follow a similar pattern in the future, while acute visits may focus more on an individual problem.