Ethics and business standards and practices have been at the forefront of the discussion regarding the addiction industry for decades and have only gotten louder over the last 5 years. Issues with patient brokering, predatory online marketing, lack of clinical oversights and standards and a number of other issues have continued to give the addiction treatment industry a black eye in regard to how the field is seen by the public. Families that have been impacted, and often lost a loved one due to the actions of bad actors in the field, are rightfully angry. And while millions of people know that addiction can be effectively treated, the behaviors of many unscrupulous addiction treatment center operators is doing nothing to change the overall perception in society that “addiction treatment doesn’t work.” Every day, more treatment centers are opening with ownership and leadership that seek to make a buck off the addicted population and their families. Fortunately, that is not the entire story.
Over the course of the last several months, the leadership here at Maryland Addiction Recovery Center was introduced to several people new to the field of addiction treatment that sought to or have recently opened new treatment facilities and had concerns about making sure they were doing it “the right way.” They came to the leadership here (as well as several other leadership teams at other facilities) for advice, for direction, and with questions for the purpose of wanting to make sure that in the current climate of unethical and unscrupulous addiction treatment operators, that they could begin their new centers operating with ethics, integrity, and standards and practices around both business and clinical operations.
This got us thinking what more could we do in terms of helping people with the right motives to succeed in creating high quality addiction and mental health programs that could positively impact those suffering from substance use disorder throughout America? What could we do to help them succeed? Which turned us to look within with some reflection, self-observation and awareness. When the leadership here at MARC began, why were we able to operate with standards, practices, integrity and principles when it seems so many treatment center ownership and management are not? There are many rehabs that operate with principles and ethics, but we needed to look at our own experience to see what it was in our own story that allowed us to open for the right reasons and then continue to operate by those principles, so that we might be able to translate that experience to new operators within the addiction treatment field.
We came across several reasons. First, was the experience from working as some not so reputable organizations early on, learning what not to do and realizing that that experience and behaviors didn’t jive with our own personal morals, values and principles. Second, was the ability to be open-minded, to ask questions and understand that we didn’t know everything and that there were many people that could teach us the “right way” to operate our facility that had been working in the field long before us. Third, and probably most important, was the direct experience and insight we received and continued to receive from those within the industry that came before us. Entering the field with mentors, allowing ourselves to be mentored and led by people that had our best interest at heart and wanted us to learn from their experience. Experience, of course, is often the best teacher and before we had our own experiences, we could learn from those addiction treatment industry veterans that had been successful in our chosen field before us.
So, with that thought and having been in contact with leadership and ownership new to the addiction treatment field that had recently reached out to us, we thought “How could we not only transmit our experience to these organizations but also transmit the experience of those that we look to for guidance and direction?” So we decided to reach out to several veterans of the addiction treatment field. Individuals with vital experience of leading successful treatment organizations that have sustained through many turbulent times in the industry and continue to operate with integrity. We thought, if we are being approached by people new in the field that are seeking help in the best way to help others, and they are coming to us for our experience, what could some of the people that we lean on for guidance and direction offer through their experience?
We reached out to these treatment industry veterans and had a conversation and explained the recent experience we had gone through with several new facilities outreaching us for help. We posed the question to these veteran industry leaders: What advice would you give to someone new in the addiction treatment field regarding how they should operate a facility in terms of ethics, integrity and standards and practices? What does someone new to ownership or leadership need to know to make sure that they can run both a successful treatment center in regards both business and clinical quality? What does someone opening a treatment center need to know in terms of leadership practices?
These were their responses:
Doug Tieman, CEO, Caron Treatment Centers (www.caron.org)
“From the 100,000 ft. view, every organization, whether in infancy or later stages, needs to keep four concepts as critical priorities: Mission, vision, values and culture.
- Mission defines what you are going to do and with whom you are going to do it.
- Vision describes where you eventually want to go, what you want to be, and what you want to accomplish. This vision should be developed and embodied in an organization’s strategic plan.
- Values describe how you are going to do what you do. In your values proposition it is critical to address the role of clinical care, finances, ethics, and integrity. Basically, put into words what is most important to your organization. At Caron, we address all of these in our values statements and share them with everyone in our organization so that what we value is clear to all.
- Finally, an organization’s culture defines the environment in which you fulfill your mission. Specifically, your culture determines how the members of your organization treat and interact with each other, your clients and your external constituencies. History helps establish an organization’s culture. At Caron, respecting and remembering our heritage is key. The idea of “loving a person with substance use disorder until they can love themselves” – is a core tenet of our culture. It originated with our founders and is a simple reminder of our belief system. That simple statement both establishes and maintains our organization’s culture.
Every organization needs to give each of these four concepts considerable thought so there can be a level of alignment across the entire organization. While each of these concepts may evolve or change over time, being transparent and thoughtful about those changes provides clarity for the entire organization and contribute to long-term sustainability of the organization. While the mission and vision are modified during each strategic planning cycle at Caron, our values and culture remain consistent because we believe our values and culture are the bedrock foundation of our organization.
What is surprising it that, while many organizations invest money, time and resources to develop a mission statement and visionary plan for the future, they do not give similar consideration to what their values are and what their culture is or should be. We believe the same emphasis and investment on mission and vision should also be present for the development of values and culture. When “push comes to shove” what is more important: a financial decision or a clinical decision? When those challenging decisions present themselves, values and culture help the organization determine the “right/best” answer.”
Rebecca Flood, CEO, Ashley Addiction Treatment (www.ashleytreatment.org)
“I always say my Dad taught me ‘There is no right way to do a wrong thing, ever.’ Also, I believe in this business if it seems too good to be true, it most likely is. In a business that cares for people, there isn’t much of a profit margin. Quality care costs what you collect, so that quality care is ensured and staff are well taken care of. So for me, I believe in asking a lot of questions of those that have been there before me and then asking them before I act to ensure that I am making well-informed and ethical decisions.”
Don Sloane, Interventionist/Founder, Recovery Care Partner (www.recoverycarepartner.com)
“Mission – provides a concise explanation of the organization’s reason for existence
Vision – creates a mental image of the ideal state that the organization wishes to achieve
Values – the core principles that guide and direct the organization and its culture
Ethics – puts those values into practice
All guiding decisions, both clinical and business, have to answer the question, “Will this decision support our mission, vision, values and ethics that together allow us to prevent one person dying from their disease and/or one family system to no longer collude in supporting their loved one’s disease? If yes, then we do it, and if not, we don’t. It’s that simple”
Jay Crosson, CEO, Cumberland Heights (www.cumberlandheights.org)
“In my 25 years here at Cumberland Heights, three mantras stick out:
- The needs of the patients come first.
- If you take care of the patient, the patient will take care of you.
- What can we do to get more people into lifelong recovery?
The first mantra guides us in regard to customer service and budgeting considerations. The second reflects our belief that if you provide good care and the patient has a good clinical experience then they will achieve recovery and strengthen the recovery community. Our alumni then become our number one referral source, from a business perspective. The last mantra is a north star for our leadership team as we create the vision for the organization. When deciding how to allocate resources and what new services to provide, this is our measuring stick. I should also point out that we include the family in the global ‘patient’ and that it is impossible to achieve any of the above without hiring and retaining mission-driven, recovery-focused, clinically trained staff. Finally, a facility should be licensed, accredited and abide by the NAATP code of ethics.”
Gary Fisher, CEO, Cirque Lodge (www.cirquelodge.com)
“There are several quotes I tend to use, some for business and some more philosophical. In the context that I always saw treatment as more motivational than confrontational, I like the quote ‘We never saw anyone get better from a disease because we were mean to them.’ I believe people need to be treated with kindness and respect. No matter what the malady. It didn’t mean that we didn’t hold firm boundaries, but that we did it with love. I also tend to use the quote ‘Let’s be the very best. It’s the only niche that isn’t crowded!’ I saw that in the context of staff going the extra mile. It really isn’t that much more effort or that much more expensive to make the treatment quality or experience special or for an organization to do the right thing. Aligned with that I like ‘Well done is better than well said,’ which is a Benjamin Franklin quote. Finally, I am known to say a lot ‘We would do better if we had the family for 30 days and clients for 4!” I reference that to the fact that families come for 4 days during a client’s stay in treatment and it is often codependency that tends to add fuel to the chemical dependency. If we can get the family on board, we often to better long-term with the client. It hopefully tends to bring focus to the importance of the family’s participating in their loved one’s care.”
This is important advice both for anyone that is entering or currently working within the field of addiction treatment, no matter their position within a given organization. These thoughts, opinions and experience from some of the addiction treatment industry’s tenured leaders or long-standing respected and renowned organizations are as valuable for owners, C-Level executives and directors of facilities as they are for behavioral health techs, clinical staff, business development or marketing staff or admissions specialists. The combined knowledge and experience of these individuals are valuable tools for those of us within the industry to learn from and incorporate into the way that we conduct our organizations and ourselves within our chosen profession. This is a field that deals with people’s lives and that impacts millions of individuals, families and communities worldwide. When we make the decision to work in the field of addiction and mental health, we must know we are making a commitment to work in the field of healthcare and that every decision we make can impact the lives of our patients, their families and our communities. We must be responsible. We must be educated and informed. We must hold ourselves accountable. We must stay open-minded and allow ourselves to learn from those that have come before us and let that experience and mentorship guide us into how to run an quality, ethical organization where patients come first, clinical services are held to the highest standards of quality and principles are not compromised.
Addiction treatment is a healthcare business. We serve the needs of patients with a life-threatening illness. Physician’s take the Hippocratic Oath, an ancient Greek medical text that required a new physician to swear, by the healing Gods, to uphold specific ethical standards. Another fundamental principle of healthcare that is taught to medical students is the phrase “Primum non nocere”, a latin phrase that means “First, do no harm.” The addiction treatment industry and many of those within the field have done much harm to the individuals, families and communities that suffer from addiction, often due to being unable or unwilling to seek out guidance, ask questions and learn from those that came before them. We are absolutely grateful for these industry leaders (and many, many others) that have tried, failed, succeeded and continue to strive to operate at the highest of ethical and quality standards to best serve their patients. We are grateful to them for their friendship, their guidance, their mentorship, and their humility. There are many great organizations doing incredible work within the field of addiction treatment and if we, as young organizations entering the field, believe in what we are doing, we would be fools to not let them guide us and support us with their combined knowledge and experience. It is our responsibility to seek these types of mentors out and ask for guidance and direction from them in order to make sure we are doing what’s right by our patients and insure that we are not only helping those in need but also, in fact, doing no harm.
If you or someone you know needs help for addiction or dual diagnosis issues, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (410) 773-0500 or email our team at [email protected]. For more information on all of our drug addiction, alcohol addiction and co-occurring disorder services and recovery resources, please visit our website at www.marylandaddictionrecovery.com.