One of the privileges of being a health care provider these days is having access to innovative technologies designed to help save lives. My colleagues and I were recently surprised to discover a powerful tool that could be useful in our line of work: journalists.
I am part of an interdisciplinary team that focuses on finding better ways to identify, intervene, and treat substance misuse/abuse. We were approached by The GroundTruth Project, a nonprofit journalism organization, which was seeking underwriting from the Northwell Health Foundation, which is affiliated with my employer, Northwell Health. The journalists wanted to create a five-part podcast series on the problem of opioid and heroin addiction and requested access to our team. It also wanted the opportunity for various reporters to be a “fly on the wall” during physician-patient encounters. The one stipulation: In the spirit of true journalism, my colleagues and I would have absolutely no editorial control of the finished product.
We certainly understood the reporters’ and editors’ interest in this project: Opioid abuse represents a major health care crisis, and our organization has been proactive in creating and piloting potential solutions to better address the epidemic.
But it certainly wasn’t a small ask. We aren’t used to having reporters observing us as we work, and we were nervous that if we gave up editorial control we could run the risk of being inaccurately represented. Even so, we agreed to this intriguing proposition. High-quality journalism, we thought, might be able to shed light on the pressing problem of opioid abuse by uncovering deeper truths, highlighting things we just weren’t seeing, and exploring varying perspectives, all of which could help us better address the crisis and improve our approach with patients.
Right from the get-go, we were in the thick of the two-month-long reporting process. Various teams of reporters and sound engineers recorded interviews with members of our team and the Northwell Health Opioid Management Steering Committee. They shadowed clinicians as they went about their work. With help from the Northwell public relations team, they interviewed a patient and his psychiatrist. We also invited the journalists to observe a training session for medical office assistants, nurses, and health coaches on our Screening, Brief Intervention, and Referral to Treatment (SBIRT) service, which helps identify patients whose alcohol, drug, or tobacco use may be interfering with their health before it becomes a lifelong addiction. That piqued the journalists’ interest about our focused educational efforts on substance abuse underway at the Hofstra Northwell School of Medicine.
The focus of the series was on the stories of providers, patients, and family members, as well as the steps we were taking to address any gaps in clinical care and clinical training.
Even though my colleagues and I know quite a bit about the opioid and heroin crisis, since we deal with it firsthand as health care providers, participating in the project gave us a clearer understanding of the epidemic. In our state, New York, more than 110,000 residents are treated daily in the Office of Alcoholism and Substance Abuse Services system. It monitors a statewide network of certified treatment providers that operate more than 1,100 programs. That includes the direct operation of 12 addiction treatment centers, which provide inpatient rehabilitation services to more than 10,000 persons per year. Some states have even more difficult struggles, particularly Ohio and West Virginia. This epidemic is truly nationwide.
Our hope, when we first agreed to participate in this project, was that it would provide additional perspectives and serve as a learning opportunity for our team and other Northwell clinicians. The final product, “The Fix: Treating New York’s Opioid Crisis,” certainly delivered on that promise.
When we treat patients, most of us are laser focused on giving them the best care possible and sometimes saving them from life-threatening afflictions. We often don’t create opportunities for our patients to feel comfortable discussing their use of alcohol or drugs, which can constrain the flow of relevant information that can better inform clinical delivery and care plans. As we see the daily escalation of the opioid crisis in our communities, it is evident that there is no “face” to addiction. It can affect homemakers, students, lawyers, health care professionals, and construction workers. The podcast highlights this as folks from all walks of life share their accounts of addiction and how they could have been addressed, prevented, and better treated.
The project also brought to light a fundamental problem with clinicians’ skill sets related to substance misuse: In the current landscape of clinical education and training, the average physician receives just four hours of instruction related directly to addressing substance use. The same is true for most other health professionals. As a result, few feel comfortable talking with patients about substance abuse and addiction. And talk we must. To meet the challenges of the opioid epidemic, we need to become accustomed to asking patients about substance use as naturally and comfortably as we discuss blood pressure, blood sugar, and weight.
Much remains to be done for the country to overcome the opioid epidemic. Policies must change, patient-centered treatment models need to be developed, and the hardships that drive millions of Americans to feel hopeless must be met and conquered.
We try to teach every young doctor that you can’t really care for a patient unless you care about him or her as a whole person. What better way to show and grow this basic empathy than by learning how to have meaningful, sometimes difficult, and absolutely necessary conversations about substance use and abuse?
Participating in the podcast, developed in the spirit of neutrality and objectivity, helped us validate this commitment. We’re grateful to The GroundTruth Project for this insightful look at the many facets of the opioid epidemic as we work to stand up as a community and offer solutions to address it.
Sandeep Kapoor, M.D., is an assistant professor of medicine at Hofstra Northwell School of Medicine in Hempstead, N.Y., and director of Northwell Health’s Screening, Brief Intervention, and Referral to Treatment service.