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When Physicians Become the Patients

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LOUISVILLE As health professionals, you know Kentucky is suffering from a substance abuse epidemic, particularly when it comes to opioids. In fact, Forbes ranked Kentucky as the fourth most medicated state in the nation in 2010. But, did you know the number of health professionals with substance abuse problems is on the rise in Kentucky?

According to the Kentucky Physicians Health Foundation, a not-for-profit foundation whose charge is to assist and monitor licensed healthcare professionals with addictive, emotional, or mental illnesses, 125 to 160 physicians are monitored annually with an average of 40 new cases per year.

However, Priscilla McIntosh, CEO of The Morton Center in Louisville, says her organization can help. The biggest misconception about The Morton Center, according to McIntosh, is a lack of knowledge about their services. The Morton Center treats adults, adolescents, and children, including health professionals affected by substance abuse and chemical dependency, and their services are available not only to patients but also to family, loved ones, and co-workers.

Recovery Services

The Morton Center provides outpatient chemical dependency treatment in four locations in Kentucky: Louisville, Lexington, Paducah, and Ft. Mitchell. “Many of the physicians I work with who refer to us are shocked to find out the Intensive Outpatient Program is really the highest level of care that most third-party payers will recognize to reimburse,” says Claude C. Drouet, M.Div., ACSW, LCSW, health professional recovery counselor in Louisville. He contends inpatient programs can be very costly and are not typically covered by insurance. McIntosh emphasizes that all the organization’s services are billable through third-party payers, and because they are privately funded, they have resources for assistance. “We want to make sure [potential clients] get the help they really do need and not let that financial burden stop them,” McIntosh says.

For Drouet, a major component of treatment is helping the individual understand that recovery is a lifelong endeavor. Treatment services at The Morton Center begin with a thorough assessment from a licensed psychotherapist. Each participant is assigned an individual counselor and undergoes individual sessions, as well as family sessions, throughout treatment. The Intensive Outpatient Program (IOP) includes four phases designed to decrease in intensity and allow for gradual return to functional living. Group therapy and expressive therapy are also vital parts of the program.

Health Professional Recovery Program

The Morton Center’s Health Professional Recovery Program is focused exclusively on the needs of physicians, nurses, allied health professionals, and anyone who holds a license to practice medicine. Drouet and his co-worker Karen L. Smith, CADC, are the two primary health professional recovery clinicians at the center. According to Drouet, chemically dependent physicians are oftentimes blindsided by their dependency. “It almost always used to be their patient loads and family responsibilities at home, but let’s face it, more and more doctors are feeling the crunch of the business model impinging on them, more and more doctors are employed and are not accustomed to that … So many doctors have to deal with patient satisfaction surveys, and many times satisfying a patient is not necessarily the same thing as good medicine, so doctors are just getting caught every which way,” says Drouet.

Physicians typically come to the center because they are under contract with the KPHF. KPHF Medical Director Greg L. Jones, MD, acts as an intermediary between The Morton Center and the Kentucky Board of Medical Licensure. “We have had a long and fruitful relationship with The Morton Center. Our participants all over Kentucky benefit from this relationship. The level of professionalism and caring our participants are shown has resulted in improved long term outcomes,” says Jones.

At The Morton Center, catering to the needs of health professionals is key. Meetings are held in the evening and at times convenient for those who are still working. To maintain confidentiality, the center has a back entrance and is developing a connected treatment area. This is particularly important for some physicians who do not want to chance seeing their own patients in the waiting area.

Abstinence Alone is Not Recovery

Typically physicians who are on a multi-year contract with KPHF are required to undergo random drug screening, group therapy for one to three years, and individual therapy, which may include the physician’s family or spouse.

“[The boards] are interested in whether a person is understanding the principles of recovery because recovery is far more than just being abstinent of the substance of choice,” says Drouet. Abstinence means avoiding the behavior. However, a psychoactive substance, whether legal or illegal, such as alcohol or opioids, changes the brain’s emotional, reasoning, and cognitive processes. “A lot of our treatment is identifying these emotional changes and how to deal with them,” says Drouet. For instance, if a patient brings their leftover Oxycontin back to the doctor because they are feeling better, it can be a trigger for someone with chemical dependency. In recovery, The Morton Center addresses many situations and provides a repertory of responses to deal with the triggers of their unique situations.

“I think we’ve been very successful in treating health professionals. Health professionals tend to get better in the context of group work,” offers Drouet. Their success is also measured empirically by the number of health professionals who complete their contracts, however even those not on contract are on a treatment plan that can be reviewed, evaluated, and fine-tuned as necessary.