It’s not a super high tech microscope. More like an old school clunky retro 1960’s microscope. Agencies from the government and insurance companies are looking for wrong-doing, bad billing and illegal activities. And per news reports, they’ve found some bad things: extortion, gambling, fraud, sex crimes, fake patients, fake policies, improper urine testing, billing problems and many, many others.
But, in the near future, this industry will be analyzed under a cutting edge, high tech, modern day “bells & whistles” microscope. And not just for financial or illegal wrong-doing but for bad care, bad outcomes, bad clinical and bad philosophy.
The problem is that there’s wide disparity in clinical care at rehabilitation facilities.
Let’s look at the rehab landscape.
New rehab facilities are popping up all over the place – especially in the intensive outpatient world – which seems to be the new “in” way of serving the public or starting a business. This dilutes the field and creates a type of competition which seems to have altered the way some companies operate and bill insurance thus inviting the high powered “microscope”.
Almost all rehab facilities claim to be experts in dual diagnosis regardless of whether they have a full time psychiatrist on staff or numerous licensed psychologists and MFT’s practicing with a mental health team philosophy and certification. Psychological and Psychiatric medicine is complicated and needs experienced and well trained providers.
It’s all about the marketing. Consumers and their families aren’t necessarily hearing about the best clinical programs; they are hearing about the facilities with the best marketing. Some programs put much more time, energy and finances into their marketing than they do any other aspect of their program including their clinical treatment. It’s difficult for families with loved one’s who are suffering from a mental health or addiction problem to know the difference between facilities and to assess which ones offer quality care and which ones don’t.
Outcomes Data, published by the rehab itself, can be misleading.
We hear about cure rates or sobriety rates of 80%, but further investigation finds improper ways of gathering data and improper self-reporting. Many rehabs don’t include former patients who they can’t get hold of or simply ask someone “are you sober?” or “are you depressed?” for a subjective screening outcomes process instead of objective measures like actual urine testing results or psychological screeners for anxiety, depression, ADHD, trauma, etc.
Individual Sessions with licensed doctors and therapists are not that common. Many rehab centers use less credentialed staff or offer only one licensed clinician session a week. People in psychological distress need more care – not just group care – but individual care as well.
The hot topic of rehabs, their effectiveness and their corruption, was debated on our new online show Reef Madness (ReefMadnessShow.com) with actor Eric Roberts, politician Paul Chabot, drug advocate Bob Bowerman and Human Behavior expert Dr. Reef Karim (doctorreef.com).
Reef Madness is a new online talk show focusing on human behavior.
“Where Clinical meets Comedy”
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It’s time we discussed self help and human behavior in a fun, smart, provocative and comedic setting.
Dr. Reef Karim
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