mortiz095

Today I had a fairly routine day in my practice. On a typical day, I encounter a wide range of people, problems, challenges and successes. I suppose it's not much different from any medical practice that way. But all of my patients are pretty complex and challenging. They all have multiple problems that are intertwined and that cannot be fully teased apart. The most common problems I encounter are addiction, pain, depression, anxiety, insomnia, brain injury, ADHD and PTSD. Relationship, marital and family problems are very common, as are various social and economic problems such as unemployment, disability, poverty, lack of health insurance and homelessness. These are all common problems, and they usually occur in some combination of two, three or more of them. Often there are significant other medical problems as well, including arthritis, heart disease, cancer, multiple sclerosis, lung disease and many others. I have to say it's enough to scare a person once you realize what ...

My current organization, Allina Hospitals and Clinics, has embarked on an ambitious and to my knowledge unprecedented effort to rationalize our approach to alcohol throughout the system. (The Veterans Health Administration has been addressing alcohol use in primary care for several decades and is as usual way ahead of private care, yet another example where government beats private care by a wide margin. However, their system is so unlike private practice that what happens in the VHA is difficult to translate.) I am leading Allina's effort and we've developed an ambitious agenda and a very aggressive timeline. If we're successful it will be almost a revolution across a large HCO (health care organization.) Allina consists of 11 hospitals, about 60 primary care clinics and many speciality clinics. Last year, there were more than 1 million hospital admissions and almost 4 million clinic visits within the Allina system. I'm excited about this. It is nothing short of amazin...

Here's a comment I received yesterday from someone who didn't identify him or herself: Anonymous has left a new comment on your post " ALLTYR™ Is Born! ":  From this short introduction it is very apparent that despite your credentials you know very little about recovery from substance abuse or its underlying causes. This comment illustrates a fundamental problem we face in trying to bring addiction treatment into the 21st century and to advance the cause of addiction research and treatment.  I wonder what it is that I don't know? I've treated thousands of patients with addictions of all sorts and run a treatment program. I've conducted research on various kinds of treatments, on AA, and on implementing evidence based practices in addiction treatment. I co-edited the first version of the VA/DOD clinical practice guidelines for the management of substance use disorders. Many of my patients tell me that I understand them and their struggles more than anyone e...