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Specialized Primary Care Resources for People with HIV

Dr. Loftus (left) and Dr. Stansell (right) share a focus that extends beyond clinical care to research and education.
Dr. Loftus (left) and Dr. Stansell (right) share a focus that extends beyond clinical care to research and education.
The Palm Springs area has the fourth-highest prevalence of human immunodeficiency virus (HIV) — the retrovirus that causes AIDS — in all of California. Recognizing the complex health care needs of this significant patient population, Eisenhower Medical Center is offering a comprehensive range of clinical, research and education resources — starting with a team of dedicated primary care physicians who have exceptional experience and expertise in HIV/AIDS.

John Dee Stansell, MD, James Gaede, MD, MA, Richard Loftus, MD, and Brett Wolff, MD see patients as part of Eisenhower Primary Care. Board-Certified in Internal Medicine and Pulmonary Disease, Dr. Stansell is also recognized as an HIV specialist by the American Academy of HIV Medicine. He headed the Positive Health Program at San Francisco General Hospital — the HIV Program of the University of California, San Francisco (UCSF) — for more than 17 years before coming to the desert in 2005, and remains a clinical professor of medicine at UCSF.

“I’ve been caring for HIV patients for almost 30 years now,” he notes. “There are very few things I haven’t encountered, so I’m pretty comfortable with anything that presents itself.”

“In the early 1980s, I watched friends die one by one, and sat at the bedside of my best friend as he succumbed to pneumocystis [a form of pneumonia],” he adds, referring to his commitment to working with people who have HIV/AIDS. “It’s hard not to focus on something that so fundamentally affects the people you love.”

Dr. Gaede received his medical degree at the University of South Dakota School of Medicine, and served his Internship and Residency Program at the Mayo Clinic in Rochester, Minnesota. He is Board Certified in Family Medicine and has been certified by the American Academy of HIV Medicine as an HIV Specialist. Active in medical education, Dr. Gaede has also served at numerous universities as well as the Mayo Graduate School of Education.

Dr. Loftus was similarly motivated by the tragic toll that HIV/ AIDS was taking on gay men. His work as an AIDS activist with ACT UP in New York City in the early 1990s led him to clinical research and then to medical school at UCSF. He completed his residency in primary care medicine, a fellowship in HIV clinical care at UCSF’s San Francisco General Hospital and, after a few years in practice there, moved to the desert in 2010.

Dr. Loftus sees patients as a part of Eisenhower Primary Care 365, an innovative health care model that offers patients more time with their chosen physician, e-visits 365 days a year, and simplified appointment scheduling. To enable this enhanced level of personalized service, participating physicians limit their practice to 900 or fewer patients.

“The ratio of knowledgeable HIV providers to patients here needed improvement,” Dr. Loftus says. “Now we have a critical mass of primary care generalists with specialized HIV training. And with the Primary Care 365 model, we have more time to do things for the patient instead of just referring him or her to specialists.”

“We’re trying to develop a center of excellence here for people with HIV… a ‘onestop shop’ with primary care providers who understand how each body system is affected by HIV, and who can coordinate seamless access to Eisenhower’s extensive subspecialists when needed, and admission to the hospital at times of acute need. ”
—Dr. Stansell

“We’re like the conductor of an orchestra of health care providers, and it’s tremendously satisfying to coordinate the sometimes confusing mix of medications and treatment plans from various specialists,” he continues. “Patients benefit from having more time and attention from their physician. When you’re attentive to the needs of someone with a chronic disease like HIV and treat them appropriately, you can help keep them healthy and out of the hospital,” he adds. “It’s the ideal of what primary care can do.”

Dr. Wolff received both his Bachelor of Arts in Human Biology and his masters in Biological Sciences from Stanford University in Stanford, California. After graduating, he earned his medical degree from the Keck School of Medicine of USC in Los Angeles. In addition to HIV specialty care, Dr. Wolff practices preventive medicine, cardiac rehabilitation and primary care.

“We’re trying to develop a center of excellence here for people with HIV,” says Dr. Stansell. “This means we’ll have everything conceivable for the HIV-infected person; a ‘one-stop shop’ with primary care providers who understand how each body system is affected by HIV, and who can coordinate seamless access to Eisenhower’s extensive subspecialists when needed, and admission to the hospital at times of acute need.”

“If our patients go into the hospital, we manage their care during their stay,” Dr. Loftus adds.

But these physicians’ focus extends beyond clinical care to research and education.

“We’re very excited about what we can do collaboratively in all three arenas,” says Dr. Loftus, who is spearheading development of an HIV research agenda at Eisenhower. One upcoming protocol will make two experimental medications available on a compassionate need basis to HIV patients who are resistant to already-approved drug cocktails. The first patient was slated for enrollment by the end of 2011.

“We’re hopeful this new cocktail will help make this patient’s viral load undetectable and restore his immune system,” he notes.

Dr. Loftus is also investigating the possibility of Eisenhower serving as a satellite for a University of California, San Diego (UCSD) neurological HIV study that will examine how HIV affects the aging process —leveraging the desert’s significant population of retirees as well as people with HIV.

Additionally, as Eisenhower transitions into a teaching hospital, Dr. Stansell is closely involved with its internal medicine residency program and in developing a potential collaborative HIV fellowship program with UCSF — helping to train the next generation of primary care HIV specialists.

“This is really state-of-the-art,” says Dr. Stansell. “If you have HIV, you’ll be provided care by individuals who have the most current information at their fingertips, and are willing to use that information and technology for the betterment of your health.

“And it will be done in a culturally sensitive way,” he adds. “It’s incredibly important that anyone can come in and feel comfortable. We make no distinction between rich and poor, ethnic background or sexual orientation. You will be treated with the respect you deserve.”

To support this meaningful area of health care, contact Betty Wolf, Vice President, Foundation at 760-773-2966 or bwolf@emc.org

Eisenhower Primary Care HIV Specialist Locations

John Dee Stansell, MD James Gaede, MD, MA
Eisenhower Health Center at Rimrock 4791 E. Palm Canyon Dr., Suite 200 Palm Springs CA 92264 760-834-7950

Richard Loftus, MD*
Eisenhower Health Center at Sunrise 151 S. Sunrise Way, Suite 100 Palm Springs, CA 92264 760-969-7770

Brett Wolf, MD
Uihlein Bldg., 2nd Floor Eisenhower Medical Center 39000 Bob Hope Drive Rancho Mirage, CA 92270 760-834-7979

*Dr. Loftus is part of Eisenhower Primary Care 365, a membership program with a modest annual fee.

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