182 Chapter 6 commented that during the early years of their HIV infection it was important to see both the nurse consultant/practitioner and ID specialist, while now that they are in the chronic phase without any medical problems seeing both healthcare professionals on the same day does not provide any additional value. They argue that the double consultation takes more time and that they have to repeat themselves to explain any potential problems to both the nurse consultant/practitioner and the ID specialist. For example, one interviewee (participant 11) said, “No, normally you discuss everything with one person and now you discuss a little with the doctor and a little with the nurse. … Because you see two people, I also think it [the consult] takes a little longer. Well, I prefer for my visit to the hospital to be as short as possible. I have been busy for a little over half an hour now. In the past it was only fifteen minutes. So that’s twice as long”. Moreover, these four participants indicated that they could find their way to the nurse consultant/practitioner if necessary. DISCUSSION The implementation of VBHC at the Erasmus MC incentivised the HIV outpatient clinic to increase the value of the patient-healthcare professional interaction during a consultation. To improve this interaction, the HIV outpatient clinic, subsequently to the implementation of the generic quality of life questionnaire, implemented two additional interventions related to the schedule and structure of the consultations. The consultations now consist of an annual face-to-face double consultation with both the ID specialist and nurse consultant/practitioner on the same day and one remote consultation per year. This study explored how patients experienced these changes. We found that patients do not always see the added value of the generic quality of life questionnaire or the double consultation, especially if they do not experience any health problems or are in the chronic stage of their HIV infection. The majority of the patients however, responded positively towards both interventions. They expressed no objection towards completing the questionnaire if it provided the healthcare professional with additional information about how they are feeling. Patients also indicated that the addition of the consultation with the nurse consultant/practitioner to the consultation with the ID specialist allowed for more attention to potential psychosocial problems. This positive attitude towards more focus on the physical, mental and social situation of the patient is important since people living with HIV often experience anxiety, depression and stigma, which, among
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