By: Ana Holtey , DO, MS
When starting my fellowship, my goal was to develop a fund of knowledge to allow me the opportunity to implement evidence-based medicine and appropriate plan of care management for patients with substance use disorder within a primary care setting.
During the year of fellowship, I was exposed to a variety of different settings which involved substance use disorders ranging from inpatient detox, medicine ICU consultations, medication-assisted treatment in pregnant women, community-based consultations, and outpatient community care. This broad range of exposure allowed me to gain an insight in substance use management in different levels of severity of disease as well as provide a fund of knowledge one would otherwise be unable to receive.
When understanding the extensive range of substance use treatment and the levels of severity of the disease, appropriate management then becomes more of an integrated multi-modal model in outpatient and inpatient management settings.
As a family physician, you see, on a daily basis, patients suffering from substance use disorder and the impact that it has on their lives and the lives of their families. As a physician, one tries to address these issues and provide appropriate resources for the patient in order for them to receive the much-needed support from both the community and treatment modalities available through the clinic. These practices are not easy to implement. The idea of providing this support in a busy primary care clinic often seems overwhelming.
The concept of further educating and preparing oneself to provide support and treatment for addiction is an empowering tool. This field is a quickly evolving science which is constantly developing in further saving lives and changing the overall approach in primary care and physician-patient interactions.
I was fortunate to work with a wide range of specialists from psychiatry, primary care, maternal-fetal medicine, and critical care providers; from this exposure, I was able to see appropriate management in different contexts of medicine.
There is no doubt that the fellowship experience enhanced my patient care management and provided me with an opportunity to further develop my skill set that extended beyond clinical medical skills. I learned to develop therapeutic alliances with patients which can be integrated into all areas of primary care. During the year of fellowship, there was extensive focus placed on all different treatment modalities and resources that can be implemented in the practice of substance use treatment.
Ana Holtey , DO, MS, is an Adjunct Assistant Professor in the Department of Psychiatry at the University of Utah in Salt Lake City, Utah.