Q&A: Top Doctor Carrie Horwitch on Being an HIV Care Specialist and Why America Needs Universal Health Care

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This article appears in print in the April 2018 issue, as part of the Top Doctors cover story. Click here to subscribe.

Why did you choose this specialty?
Internal medicine spans the breadth of a patient’s lifetime as an adult. We cover the broad expanse of medical conditions, including end-of-life care. It is a cognitive specialty that requires listening skills, understanding the patient story and reasoning about the cause of a particular issue for the patient, much like solving a mystery. My goal is to help my patients live a healthier, better quality of life.

What are your areas of special interest?
I am an HIV care specialist, in addition to general internal medicine. I have been taking care of people with HIV since the early 1990s. I think HIV is unique in that it is a chronic infectious disease but also contributes to other health issues. If untreated, it can be devastating. However, excellent treatment is available that reduces mortality and improves quality of life. 

 

Is there a recent development that you’re excited about? 
I think the advancement of antiretroviral treatment options for those with HIV has been one of the true highlights of the 20th century. Through these better therapies, we have reduced death from HIV/AIDS by more than 75 percent. 

What are the most important things that patients can do to stay healthy or improve their health? 
Patients can stay healthier by being active—exercising, doing activities with others—laughing more, eating a healthy diet, being vaccinated against diseases and avoiding unhealthy or dangerous behaviors, such as smoking, using drugs and drinking alcohol to excess. If someone has a chronic disease, having a good doctor-patient relationship, staying on necessary medications and avoiding unnecessary treatments or procedures are also very important. 

Is there a new or emerging health threat that you are concerned about, and if so, what steps can patients take to reduce their risk? 
I think one of the biggest threats to health is the lack of universal health coverage and access to care. Our nation is the only higher-income country that does not provide affordable coverage to all people who live here. We need to work in nonpartisan fashion to change this. 

What’s the most important thing that patients should pay attention to when choosing a doctor? 
I think one of the key issues is to have a physician that listens to the patient’s story and meets the patient where they are. 

What’s the most fun—outside of medicine—that you’ve recently had? 
I’m a certified laughter leader and teach laughter therapy. I have a lot of fun with this as a way to stay healthy, get exercise and improve overall well-being. I also love to travel and hope to do more in the coming years.