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This week we respond to questions about syphilis and blood types.

Dear HOUSE Calls,

My brother was recently diagnosed with syphilis. He was treated at a free clinic and got a prescription, but did not get any better. He went back and had to get another prescription. Is there any difference in the quality of care given at a free clinic versus a private practice?

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We generally feel that the level of care given at free clinics is excellent. They often have an impressive staff of volunteers to help with pharmacy needs, care management, and other types of therapy. The clinicians usually work in private practice or are retired from private practice and are generally very skilled.

There are some down sides to free clinics. Because they are staffed by a rotation of fill-in doctors, it is a very hard place to develop a relationship with a primary care physician. They sometimes are not well set up for continuity care but offer excellent acute care and episodic care. They may not have a full range of resources such as medicines, and might have to settle for a second choice which is less optimal for a condition. The alternative might be a prescription to fill at a drug store which many clients at a free clinic cannot afford.

Specific to your brother’s condition, syphilis has different stages and in later stages can be harder to treat. It is usually best treated with injectable penicillin, and the number of injections varies with the stage. The free clinic might not have had the injectable penicillin or perhaps your brother is allergic to it. Hopefully that helps clear things up a bit. If things don’t seem right, the health department is another excellent resource for communicable diseases.

Dear HOUSE Calls,

I give blood regularly. I’m told that I’m O negative and the Red Cross loves it. What does that mean?

It is great that you give blood regularly, especially because you are O negative. This means you are a universal donor.

Basically, anybody can accept your blood. Most people have to be cross-matched to a specific blood type to receive blood, but your blood can be received by anyone and in an emergency, we’ll use O negative to transfuse somebody we don’t have time to type.

The bad news about your blood type is that you are the most restrictive receiver of blood. You can only get blood from other people with O negative blood. We should say that blood is needed from people with all types of blood. Consider giving blood if you are in good health. Your body will build back up that blood in no time and you may be saving a life. Check with your local American Red Cross for upcoming blood drives.

HOUSE Calls is a weekly column by Dr. Cristy Page, Dr. Adam Zolotor, and Dr. Adam Goldstein on behalf of YOUR HEALTH and the UNC Department of Family Medicine.

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