When most physicians think of working with patients with addiction disorders, they often feel overwhelmed, frustrated and unprepared to meet their medical needs. That's not the case for Gerard Hevern, M.D. The Suncook, N.H., family doctor says his decades of caring for these patients have been extremely rewarding.
2018 Family Physician of the Year Gerard Hevern, M.D., splits his time between practicing comprehensive family medicine at his Elliot Family Health Center at Suncook office and providing pain management and substance abuse services at Elliott Health Systems' Elliott at River's Edge outpatient facility.
"I have success stories every day of my life," Hevern told AAFP News, recalling stories about three recent patients.
"I saw a woman just today who I have been taking care of for seven to eight years. She has chronic pain and has been through hell and back. She's on multiple medications, including opiate pain medications, and is now in the best state of her life."
Another patient was drinking two and a half gallons of scotch a week, he recalled. A few months ago, Hevern detoxed him in five days on an outpatient basis. "His wife texted, 'This is amazing. If only you were available 30 years ago, my father may not have died,'" he said.
As for the third patient he recalled: "I spent four months of my life yelling at a patient about a year and half ago," Hevern said. "He was hospitalized after his mother died because he became suicidal. Today, he's mentally much better, his pain is controlled and he's not taking opiates."
- Gerard Hevern, M.D., has been named the 2018 Family Physician of the Year for practicing compassionate, comprehensive family medicine that includes pain management and addiction treatment services.
- Hevern has provided comprehensive family medicine care in New Hampshire for almost four decades, first at Suncook Family Health Center and later at Elliot Family Health Center.
- Held in the highest regard by his patients and staff, Hevern is also known as a devoted teacher, delivering lectures on pain management and chemical dependency to health care professionals, students, law enforcement personnel, people in recovery and members of the general public.
Today, Hevern is being honored as the 2018 Family Physician of the Year (FPOY) for practicing compassionate, comprehensive family medicine -- including pain management and substance abuse treatment -- serving as a valued community resource on addiction and pain management, and training other health care professionals to tackle the opioid crisis.
Practicing Medicine Through the Lens of Sociology
A native New Yorker, Hevern was born and raised in Stuyvesant Town on Manhattan's Lower East Side. A high-school football standout at St. Francis Prep in Brooklyn, Hevern was recruited to play football for Harvard University. Although he loved football, he also took his academics seriously -- so seriously that he once fell asleep on the blocking dummy during practice after a late night of studying. He intended to go to medical school but considered sociology and city planning his plan B options.
That secondary interest in sociology led him to complete a research project on the criminal justice system. The project took him to Alcoholics Anonymous meetings, prisons and jails, and it helped him forge a relationship with the sheriff of Cambridge, Mass. He learned that the majority of federal inmates were involved with drugs, most often alcohol. He saw the impact addiction had on crime, families and health.
"It fascinated me. How can we begin to address addiction as the primary problem? If you address that, you can begin to change the outcomes of the entire family," he said.
After graduating from Harvard, Hevern attended medical school at State University of New York in Stony Brook and, at the recommendation of a family medicine faculty member, chose to become a family doctor. In 1979, he started his solo practice at Suncook Family Health Center in the medically underserved town of Suncook, N.H.
Despite being from the Big Apple, Hevern said he felt right at home in the city of 5,000. "New York is both a big and small town," he explained. "Your neighborhood becomes this very small location." Suncook is much like his Stuyvesant Town community, just without the tall buildings, he added.
Hevern and his wife, Donna, enjoy boating and hosting friends and family at their house on Lake Winnipesaukee.
The same year he launched his private practice, Hevern also served as staff physician in the alcohol treatment unit and medical director of the detoxification program at Catholic Medical Center in Manchester, N.H. He later became certified by the American Society of Addiction Medicine and went on to teach others about pain management, the appropriate use of opiates, and alcohol and drug abuse.
He's currently the medical director at Elliot Hospital's Pain Management Center at River's Edge, where he cares for patients with chronic pain syndromes and addiction. He's also a member of the Manchester Cooperative Pain and Opioid Project, an effort to deal with the community's surge in overdoses, ER visits and hospitalizations, and deaths due to opioids.
"He was a pioneer in New Hampshire with pain medicine and addiction medicine," said Leah Cadegan Paquette, A.R.N.P., a family nurse practitioner at Elliot Family Health Center, where Hevern practices broad-scope family medicine. "He really is passionate about caring for those patients and helping them find a way back to life, whether that be treating pain or coming out of addiction," she said.
Family physicians are in a great position to help their patients with addiction, said Hevern, but they have to be prepared to support patients during setbacks. "We already deal with chronic illness -- hypertension, diabetes, cardiovascular disease. We don't kick people out of our practice because they have diabetic neuropathy. We tolerate that as part of the disease."
Hevern focuses on the positive changes he can have on his patients. Detoxification, psychosocial support, and medications such as acamprosate (Campral) and naltrexone (Vivitrol) are all in his treatment arsenal. Ultimately, Hevern said, the treatment of addiction is about getting people to change their attitudes and behaviors, just as you would with a patient who has hypertension or diabetes.
Hevern has given numerous lectures on pain management and chemical dependency to health care professionals, students, law enforcement personnel, people in recovery and members of the general public throughout New England. He often uses a baseball analogy that resonates with Red Sox fans: He simply tells them that they all need to join Yankees Nation immediately.
Hevern is the proud father of three children and six grandchildren. This holiday photo shows him horsing around with grandsons Landen and Cooper Krause.
"There were actually people standing up and yelling at me. It's a visceral reaction," he said. That's what it's like telling someone with a chemical dependency that they can't use the drug anymore, he added. "These people believe in a god called drug. They believe that the god is going to provide them some value."
The analogy helps doctors and nurses understand how uncomfortable recovery is and how much support these patients need.
Serving as Friend and Teacher
Hevern doesn't just help patients with pain management and substance abuse. He has also provided comprehensive family medicine care for almost four decades, first at Suncook Family Health Center and later at Elliot Family Health Center. During that time, he's developed deep relationships with patients and has a loyal following.
"It's an amazing rapport that he has with his patients," Paquette said. "He can relate and speak to patients in a way I've never seen anyone else do. He knows who he can be firm with and who he can handle with gentle gloves. He's known and been friends with his patients forever."
One patient who began seeing Hevern for pain management credits him with saving his life. In a letter supporting Hevern's nomination as FPOY, Rollin Steiner wrote that Hevern has been his guardian angel.
"You were willing to truly hear me in the beginning and to treat my chronic migraine headaches and my developing peripheral neuropathy," Steiner said. "Shortly after accepting me as a patient, you correctly diagnosed my lymphatic cancer, which merely saved my life!"
No matter whether he's meeting with a patient or one of the residents or nurse practitioners who rotate through his office, Hevern is always coaching and teaching. "Doctor means teacher, and I take that literally," he said. "I've had incredible role models from high-school teachers and coaches to college and medical school faculty. It's been so much a part of who I am and what I do and what I see my role to be."
"He teaches every patient, going over everything in the office," Paquette said. "Anything I need, I can go to him. He will sit down -- most docs will stay standing -- and review it all, give you options and talk it out. It's one of the nicest relationships."
Teaching also includes advocating for family medicine, and Hevern served for years in leadership roles at the New Hampshire Physicians Organization, helping the organization begin to focus on quality care.
Above all else, Hevern is also passionate about his families and friends, Paquette said. "He has a full life, and he enjoys it."
Hevern and his wife, Donna, have three children and six grandchildren who he sees often. Together, they enjoy boating and travel, hosting friends and family at their lake house and traveling.
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