Ethics, morality, legalities, best practices are words one might logically associate with any medical treatment for a disease or a condition. Sadly, when it comes to addiction private treatment providers, rules of decency and concern may be left behind. Addiction treatment is BIG business, as is its close relative Sober Living Environments. Devious practices are everywhere, and though they may be close to the letter of the law and legal in the strictest sense, they are far from ethical.
The addiction treatment industry is rife with not so professional practices.
• Dubious marketing practices
• False statistics
• Questionable insurance billing practices
• Paying for referrals
• Feeder websites
• Questionable treatment practices
• Billing patients for procedures that have not be proven to be successful
• Paying gifts to interventionists
• Sharing patient information
• Taking in clients that cannot be treated
• Taking in patients whose insurance will not cover the treatment
The November 17th article in Addiction Magazine by Bob Ferguson dealt with this issue. In this article, Ferguson discusses the move by panelists in NCAD’s last Augusts’ conference. Panelists raised the bar on the issue of ethics by posting a draft of what they considered ethical precepts for addiction treatment providers. The challenge was picked up by Bob Ferguson of Jaywalker Lodge whose administration posted its own attempt at transparency and ethics. Below is a brief summary of some of the Jaywalker Code of Ethics. (The list below includes only a few of many of the items listed in the article)
• Jaywalker does not engage in …misleading or deceptive practices
• We do not admit clients who are not clinically appropriate for our milieu
• We do not believe in a la carte pricing, add-ons or nickel-and-diming
An Ethical Culture of Transparency
J.O Toole and W Bennis wrote in A Culture of Candor (2009 Harvard Business Review) that the standard business definition for transparency was too narrow and far too focused on legal compliance. Instead, the authors’ felt that transparency more broadly defined allowed for a free flow of information within an organization, among managers, employees and stakeholders. “Companies cannot innovate, respond to changing stakeholder needs or function efficiently unless people have access to relevant, timely and valid information.”
The goal of the 2013 webinar from ATTC (Addiction Technology Transfer Center Network, funded by SAMHSA,) was to broaden the understanding of ethical behavior for addiction treatment professionals. Among common misperceptions that interfered with ethical practice were:
• Therapy as mystery
• Therapy as business
• Rigid adherence to administrative standards
• Ethics as mindless rule-following
• Ethical dilemmas as a rarity
Missing from the addiction treatment industry’s current approach are the medical ethical principles that state:
• Autonomy or respect for persons – providing an environment that promotes dignity, intrinsic worth, and enables autonomy
• Do good, do no harm, choose actions that bring the best result
Technology Can Assist in Improving Recovery Outcomes and Strengthen Ethical Conduct
Treatment Providers seeking to improve real outcome measures of their facilities can utilize technology to benefit the facility, the clinicians, and the patients. The current technologies available now, such as Recovery Passport Solutions help clients develop strong, healthy behaviors and thinking patterns.
First, these strategies allow patients to develop autonomy and take responsibility for their recovery. Without feeling ownership of their recovery risk of relapse is increased.
Second, the dynamic between clinician and patient can shift toward mutual respect, positive goal setting, better communication, and better utilization of time to name a few. Small successes lead to large successes resulting in improved therapeutic relationships and cost effective therapies.
Third, improved outcomes can decrease inappropriate cost cutting measures that leave clients vulnerable and staff frustrated. Improved outcomes can be the impetus to improve standards applied to both staff performance and quality of facility and lead to an open environment of team building and consensus.
Treatment Providers who seek to uphold their ethical responsibilities will be glad to engage in transparency. Treatment that works can be proven by the real-time data collected through this new wave of unique technology. Unlike the unscrupulous practices used now that violates client confidentiality and honesty in advertising, real-time data will not violate patient/clinician relationships nor cause confidentiality issues.
Our unique technological tools offer a comprehensive approach to all levels of treatment and strengthens the continuum of care thus enabling Providers to build ethical behavior in their administrative practices, their clinical practices as well as their marketing practices.