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  • Family Physicians Serve on the Front Lines of Addiction Medicine

    Oct. 18, 2022

    By Ruchi Fitzgerald, M.D.
    Family physician and addiction medicine specialist

    While practicing family medicine for many years, I saw how substance use disorders affected many of my patients and their families. To provide them with the best comprehensive care possible, I pursued the addiction medicine fellowship at Rush University Medical Center in Chicago.

    It was one of the best career decisions I’ve ever made. Now, during National Addiction Treatment Week, I encourage other family physicians to learn about the critical role we can take in treating patients with SUDs.

    The addiction medicine training I began in 2019, amid the opioid crisis, gave me the skills to address the issue in my primary care practice. It was also an opportunity to draw on my own personal experience as a physician in long-term recovery, especially to advocate for clinician health and for abolishing stigma around addiction.

    Blending Family Medicine and Addiction Medicine

    My career as a family physician, already incredibly rewarding, has become even more exciting since I completed the fellowship in 2020. Addiction is a disease that affects so many of the patients we see in the primary care setting, and being certified in addiction medicine impacts my career every day.

    I’m energized when I go to work, knowing that I can care for patients who have not traditionally been offered addiction treatment. I also enjoy working on health policy issues and educating the next generation of clinicians about addiction medicine and evidence-based treatment.

    Often, it takes just one or two patient interactions to change a primary care physician’s perspective about why they should treat addiction and push them to learn more.

    Fighting Stigma

    Treating SUDs gives me an opportunity to collaborate with an incredibly dedicated team on offering compassionate care to people who may be used to being judged for their struggles with this disease.

    My patients have often been treated poorly in the health care system. When they finally receive compassionate, evidence-based treatment, they can develop trust in a clinician and in the health care system, often for the first time. By developing trust, they become more open to trying medication for addiction treatment and receiving education about that medication.

    Frequently, this leads to the powerful experience of seeing patients recover rewarding lives through holistic treatment that improves their overall health as well as their home life.

    Harm Reduction

    Practicing addiction medicine is a continuous learning experience.

    As with other aspects of family medicine, there are always new journal articles and clinical guidance on new practices. But addiction medicine also gives me new opportunities to learn from my community, my patients and local organizations about how to incorporate harm reduction practices into our health care systems.

    This has been critical to my journey as an addiction medicine specialist and as a family physician. Being able to treat SUDs while using harm reduction strategies means I can meet patients where they are with a menu of options to help improve their health and change their lives.

    Family physicians with deeper training in addiction treatment can better educate the patients we see in our clinics and, importantly, also encourage more education about the topic in medical schools, where it often receives little attention. Incorporating evidence-based addiction treatment and abolishing the stigma associated with SUDs starts at the medical student level.

    Resources for Family Physicians

    Addiction medicine has been an officially recognized subspecialty since 2016.

    Family physicians can pursue board certification in addiction medicine through the American Board of Preventive Medicine or the American Osteopathic Association, and Michigan State University College of Human Medicine’s MI CARES program helps with the process. I also encourage you to visit the American Society of Addiction Medicine’s online certification guide to see how you can apply for the practice pathway.

    In addition, the AAFP offers members a number of addiction medicine resources. These include

    I encourage you to spend time with these resources and consider how you can use them in your practice. Personally, I consider it a gift to be a family physician who also practices addiction medicine.

    Ruchi M. Fitzgerald, M.D., is a family physician and addiction medicine specialist who serves as associate program director of the addiction medicine fellowship and an assistant professor in the Department of Family Medicine and Psychiatry and Behavioral Sciences at Rush University Medical Center. She also is the service chief of inpatient addiction medicine at PCC Community Wellness Center, which operates more than a dozen health centers on the west side of Chicago and near west suburbs.