WHAT DOES AN INFECTIOUS DISEASE DOCTOR DO?

This article was medically reviewed by Dr. Fazila Aslam.

Many patients aren’t aware of infectious disease as a medical sub-specialty and are unclear about what these doctors do or how they can help solve many health challenges. But in an era that has brought an uptick in international travel, the COVID-19 pandemic, major advancements in the treatment of chronic infections such as HIV and hepatitis C, and a deepening struggle with drug-resistant bacteria, infectious disease doctors are playing an increasingly crucial role. These specialists are not only the top experts when it comes to treating and often curing a variety of diseases that can strike anywhere in the body, but they can conveniently provide much of that therapy in outpatient settings, including their offices and wound and infusion centers, so that patients don’t need to be admitted to hospitals. In this blog, ID Care’s Dr. Fazila Aslam explains what infectious disease doctors do and when patients should seek them out.

What is an Infectious Disease Doctor?

An infectious disease doctor treats illnesses anywhere in the body that are caused by microorganisms: bacteria, viruses, fungi, or parasites. Patients can contract these diseases from other people, the environment, animals, and ticks or other insects.

The care provided by these doctors falls into four basic categories:

• Infectious disease care, for which these specialists use the minimal level of medication possible for the safest, most successful outcomes in patients with bacterial, viral, fungal, and parasitic infections.
• Wound care, which can include treatment with antibiotics, antimicrobial dressings, vacuum-assisted wound closures, and topical agents. Another strategy is hyperbaric oxygen therapy, which involves breathing pure oxygen inside a pressurized chamber, allowing the lungs to gather extra oxygen to support healing.
• Infusion care, which brings treatment for many conditions into the outpatient setting. Treatments include antibiotics, antifungals, hydration therapy, immunoglobulins, iron therapy, osteoporosis therapy, and steroids given through IV infusion.
• Travel care, from vaccination for prevention of diseases, including Tetanus, whooping cough, hepatitis A and B, to treatment of illnesses acquired during travel including tuberculosis, malaria or Dengue fever.

What are the Top 10 Conditions Infectious Disease Doctors Treat?

Infectious disease doctors treat conditions that have a variety of causes and affect different parts of the body. The 10 conditions treated most frequently at ID Care are:

1. Clostridium difficile (C. diff)
2. HIV
3. Pneumonia
4. Sexually transmitted diseases
5. Diseases carried by ticks or mosquitos
6. Urinary tract infections
7. Hepatitis B
8. Hepatitis C
9. Wounds that aren’t healing, or wound infections
10. Skin infections

Do Infectious Disease Doctors Treat Patients in Offices or Hospitals?

Infectious disease doctors treat patients in inpatient settings (hospitals), as well as outpatient settings (offices).

In hospitals, they play a vital role in both preventing and managing hospital-acquired infections and surgical-site infections. Infectious disease doctors help direct the treatment of patients who develop infections such as sepsis and pneumonia while in the hospital. In addition, carefully constructed infection control plans allow these specialists to take preventive measures; this can include overseeing the proper use of antibiotics to avoid the development of drug resistance or infections such as C. diff, as well as harnessing outbreaks of MRSA by isolating them to affected patients and finding and eliminating the sources of the pathogens.

“It is now the standard of care to involve an infectious disease doctor in difficult cases in these facilities, as our expertise helps to keep patients safe from complications that could lengthen their hospital stays and lower their quality of life,” Dr. Aslam said.

In their offices, infectious disease doctors consult with, diagnose, and treat patients who have a range of conditions including HIV, hepatitis B and C, Lyme disease, COVID-19, recurrent urinary tract infections or sinusitis, and non-healing wounds, including diabetic foot ulcers that aren’t getting better.

What Preventive Treatments Do Infectious Disease Doctors Offer?

In addition to providing treatment to people who are sick, infectious disease doctors offer comprehensive care aimed at preventing illness.

For instance, in recent years, ID Care doctors have seen a rising demand for travel-related care as more people take trips outside the United States. In addition to offering post-travel care to patients who have contracted infections such as malaria, these doctors can administer the vaccines required before visits to certain countries, including inoculations against meningococcal disease or exotic diseases such as Japanese encephalitis and yellow fever, which are not widely available. “If you’re going to a developing country, you would want to take antibiotics with you, so we counsel about that, too,” Dr. Aslam said.

Infectious disease doctors can also counsel people who engage in high-risk sexual behavior and offer short-term, post-exposure treatment with HIV drugs to help prevent the development of the virus. Likewise, for healthcare workers who have been accidentally stuck by needles, they can offer appropriate testing and treatment.

Why are Many Unfamiliar with What Infectious Disease Doctors Do?

Although infectious disease doctors hold the key to diagnosing and treating a host of conditions, many patients aren’t aware that their specialty exists, and thus don’t realize that seeing them is an option.

This may be because the specialty is relatively new, but the field of infectious disease prevention and treatment has been gaining recognition since cases of the Zika virus started arising in the U.S. in 2016, and now as the COVID-19 pandemic continues.

That’s important, Dr. Aslam said, not only because infectious disease doctors are the top experts when it comes to properly prescribing antibiotics, but because they are trained to consider the whole body when making a diagnosis.

“At ID Care, we are frequently consulted on cases that two or three other physicians have been unable to figure out,” Dr. Aslam said. “We are like the detectives in this field. We really carefully look at all the data and try to make the ultimate diagnosis when most people cannot solve a case.”

When Should You See an Infectious Disease Doctor?

People who are sick and not getting better should consider visiting an infectious disease doctor.

For instance, as the go-to resource for infectious disease care in New Jersey, ID Care doctors often treat people who have taken a couple of courses of antibiotics for a urinary tract infection and are not seeing improvement. They also frequently help when someone has a wound that has not healed in a month with usual treatment, or when a patient’s cough has not improved with antibiotics.

“In cases like these, don’t wait,” Dr. Aslam said. “You should seek a specialist, just like you would if you have blood in your stool. We can offer more if you come earlier.”

Other key reasons to visit an infectious disease specialist include an unexplained fever or wound, anticipated international travel, an autoimmune disease, and chronic illness such as HIV, hepatitis B, or hepatitis C, which infectious disease doctors can now treat with a pill rather than an injection.

“I know that some primary care doctors like to treat HIV, but I would say that patients should definitely see an infectious disease physician, because not only is the virus very manageable now, but there are new treatments coming and the guidelines change often,” Dr. Aslam said.

Should You See an Infectious Disease Doctor if You Have COVID-19?

For several reasons, infectious disease doctors are the specialists to see for COVID-19 — to be tested for the condition if symptoms are present, and then for treatment, Dr. Aslam said.

First, she said, “we have monoclonal antibodies to treat patients in our office which are not available through most physicians, who will send you to the emergency room.”

Furthermore, time is of the essence. “If you see us during the first 10 days of symptoms,” she said, “there are treatments we can give that are different from what you will get from a primary care doctor.”

Finally, infectious disease doctors have the most experience treating COVID-19. “It’s a new disease, and things are changing very rapidly in its treatment,” she said. “Unless a doctor is seeing it every day, as we do at ID Care, they may not know what the most current guidelines are.”

Can Infectious Disease Doctors Help Patients Avoid Hospital Stays?

In the past, people who had skin and soft tissue infections, pneumonia, or drug-resistant urinary tract infections were admitted to the hospital for 10 to 14 days to receive IV antibiotics. Now, under the care of an infectious disease specialist, patients can receive those drugs as infusions at the doctor’s office in the morning and then go on with their daily activities.

“At ID Care, we offer IV antibiotics in outpatient infusion centers and find that our patients consider that an enormous advantage, especially if they’re not very sick and just need to be treated for one health issue,” Dr. Aslam said.

Keeping high-risk patients out of the hospital is particularly important in nursing homes. “When elderly patients go to the hospital, they tend to get deconditioned physically and mentally,” she said. “So, we try to see them in their nursing homes, treating them there with standard medications, including IV antibiotics.”

Finally, when a patient anticipates surgery or an invasive procedure such as a prostate biopsy, cystoscopy, or kidney stone removal, planning ahead with an infectious disease doctor can prevent infection that necessitates a longer hospital stay. Using the appropriate antibiotics in advance of the procedure to manage any bacteria already present in the body can make all the difference toward having a good outcome.

What Sets Infectious Disease Doctors Apart from Other Providers?

Several areas of expertise distinguish infectious disease doctors from their colleagues in other specialties, many of which stem from their understanding of the entire body, as infectious diseases can strike anywhere, from head to toe.

1. Understanding infection: While generalists often treat an infection with antibiotics to see if a patient gets better, infectious disease doctors ask why the person got sick in the first place. For instance, if an immunodeficiency is present, it must be identified and resolved in order to stop infections from repeatedly occurring.“We focus on what is causing the illness,” Dr. Aslam said.

   “We want to know why you’re having recurrent urinary tract infections, or why your pneumonia is not getting better. We try to go after the root cause to see what we can do to stop it.”

2. Providing travel care expertise: No other type of specialist can do a better job of guiding patients prior to international travel. Infectious disease doctors are extremely well-versed in preventive treatment through inoculation or the prescription of antibiotics, as well as in the care of exotic diseases picked up overseas, because travel medicine is a key component of their field.
3. Staying up to date: The best infectious disease doctor has access to the latest knowledge, treatment guidelines, and therapies, which translates into a better quality of life for patients who are experiencing health challenges caused by infections. For instance, Dr. Aslam said, ID Care offers a new, injectable medicine for skin and soft tissue infections that lasts a week and thus is very convenient. Furthermore, she said, when treating patients for hepatitis C, ID Care’s experts know how to work with health insurers to control medication costs, which otherwise could be “sky high.”
4. Prescribing conservatively: Some might find it surprising that infectious disease doctors tend to be more conservative than other specialists when it comes to prescribing antibiotics.

“Making antibiotics too available creates resistance, because these medications simply don’t work if people keep taking them when they’re not needed,” Dr. Aslam said. “It’s crucial that we avoid population-wide resistance, because that makes it very difficult to treat people who are sick with infectious diseases.”

What Education is Required to Become an Infectious Disease Doctor?

Infectious disease specialists are capable of diagnosing complex conditions and providing appropriate treatment because they have pursued extensive education and training.

After finishing four years of medical school and three years of residency, often in internal medicine, these subspecialists complete two years of fellowship in infectious disease (three if they plan to focus on HIV) and then take a test to become board certified as infectious disease doctors. Once on the job, infectious disease specialists must get recertified every 10 years, demonstrating that they are up to date on progress in their field.

Dr. Aslam completed her fellowship at the University of Rochester in New York and in 2013 joined ID Care, where she provides outpatient care while also supporting infection control at numerous hospitals and nursing homes in Northern New Jersey.

“To be at the top of our game as infectious disease specialists, we have to constantly read up on the latest research and trends, because new infections arise and we need to be immediately prepared to diagnose and treat them,” she said. “It’s an ever-changing field, and that’s why it’s important that there are dedicated specialists who are devoted to keeping up with advances.”

What Makes ID Care Physicians the Best Infectious Disease Doctors?

There is power in numbers, Dr. Aslam said of ID Care, which is staffed by over 40 board certified infectious disease physicians, several physician assistants, and more than 30 advanced nurse practitioners who work with hospitals from Newton in the north to the shore communities in the south. As the largest infectious disease practice in New Jersey and the second largest in the country, ID Care has offices and infusion centers all over the state.

“So, if you’re a patient in Newton and then you move to Edison or the south, you can have continuity of care,” Dr. Aslam said.

The diversity of the group at ID Care makes it both appealing to patients and effective. “Some people are fresh graduates and others have been in the field for 30 years,” Dr. Aslam said. “We have people who love treating HIV, those who have expertise in tropical and travel medicine, and others who specialize in wound care. We are an incredibly well-rounded group, and we discuss difficult cases with our colleagues, so patients get an automatic second opinion.”

The group’s size also offers another advantage: “If you are a patient and you call after hours, you will always get a board-certified infectious disease doctor on call,” she said. “Most other groups don’t have that kind of manpower.”

Seeing an infectious disease doctor can help you prepare for travel, solve a health mystery, or treat an infection that isn’t getting better. To schedule an appointment with an ID Care infectious disease expert today, call 908-281-0221 or visit idcare.com.