Clinical Excellence in HIV Care

Authors: Michael Fingerhood, MD


Clinical excellence in medicine is multifaceted and difficult to define. It requires an extraordinary commitment to patient care, which, it is hoped, translates into improved patient outcomes.1 In academic medicine, clinical excellence often becomes undervalued and assumed, with an emphasis on excellence in research and teaching.2-4 Based on interviews with 24 ‘‘clinically excellent’’ academic physicians, Christmas et al reported seven domains of clinical excellence deemed essential to all areas of medicine.5 A subsequent article has defined clinical excellence in cardiology.6

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Dhaliwal G. Clinical excellence: make it a habit. Acad Med 2012;87:1473.
2. Durso SC, Christmas C, Kravet SJ, et al. Implications of academic medicine’s failure to recognize clinical excellence. Clin Med Res 2009;7:127-133.
3. Wright SM, Kravet S, Christmas C, et al. Creating an academy of clinical excellence at Johns Hopkins Bayview Medical Center: a 3-year experience. Acad Med 2010;85:1833-839.
4. Grigsby RK, Thorndyke L. Perspective: recognizing and rewarding clinical scholarship. Acad Med 2011;86:127-131.
5. Christmas C, Kravet SJ, Durso SC, et al. Clinical excellence in academia: perspectives from masterful academic clinicians. Mayo Clin Proc 2008;83:989-994.
6. Ziegelstein RC. Clinical excellence in cardiology. Am J Cardiol 2011;108:607-611.
7. Alfonso V, Geller J, Bermbach N, et al. Becoming a ‘‘treatment success’’: what helps and what hinders patients from achieving and sustaining undetectable viral loads. AIDS Patient Care STDS 2006;20:326-334.
8. Sidat M, Fairley C, Grierson J. Experiences and perceptions of patients with 100% adherence to highly active antiretroviral therapy: a qualitative study. AIDS Patient Care STDS 2007;21:509-520.
8a. Smith DK, Herbst JH, Zhang X, et al. Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr 2015;68:337-344.
9. Schneider J, Kaplan SH, Greenfield S, et al. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med 2004;19:1096-103.
10. Kinsler JJ, Wong MD, Sayles JN, et al. The effect of perceived stigma from a health care provider on access to care among a low-income HIVpositive population. AIDS Patient Care STDS 2007;21:584-592.
11. Dang BN, Westbrook RA, Black WC, et al. Examining the link between patient satisfaction and adherence to HIV care: a structural equation model. PLoS One 2013;8:e54729.
12. Lucas GM, Cheever LW, Chaisson RE, et al. Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection. J Acquir Immune Defic Syndr 2001;27:251Y-259.
13. Fiellin DA, Weiss L, Botsko M, et al. Drug treatment outcomes among HIV-infected opioid-dependent patients receiving buprenorphine/naloxone. J Acquir Immune Defic Syndr 2011;56(Suppl 1):S33-S38.
14. Soeffing JM, Martin LD, Fingerhood MI, et al. Buprenorphine maintenance treatment in a primary care setting: outcomes at 1 year. J Subst Abuse Treat 2009;37:426-430.
15. Hoang T, Goetz MB, Yano EM, et al. The impact of integrated HIV care on patient health outcomes. Med Care 2009;47:560-567.
16. Allen CM, Al-Jahdali HH, Irion KL, et al. Imaging lung manifestations of HIV/AIDS. Ann Thorac Med 2010;5:201-216. .
17. Kremer H, Ironson G. To tell or not to tell: why people with HIV share or don’t share with their physicians whether they are taking their medications as prescribed. AIDS Care 2006;18:520-528.
18. Stone VE. Strategies for optimizing adherence to highly active antiretroviral therapy: lessons from research and clinical practice. Clin Infect Dis 2001;33:865-872.
19. Panel on Antiretroviral Guidelines for Adults and Adolescents, Department of Health and Human Services. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Accessed November 12, 2014.
20. Roberts KJ. Physician-patient relationships, patient satisfaction, and antiretroviral medication adherence among HIV-infected adults attending a public health clinic. AIDS Patient Care STDS 2002;16:43-50.
21. Schilder AJ, Kennedy C, Goldstone IL, et al. ‘‘Being dealt with as a whole person.’’. Care seeking and adherence: the benefits of culturally competent care. Soc Sci Med 2001;52:1643-1659.