The Future of Healthcare: “Treat addiction, depression and the like as brain diseases” with Michael Genovese of Acadia Healthcare

The brain is an organ of the body, and a critical piece of overall health. Since mental health conditions are not traditionally seen as the diseases they are, a recurring dialogue grounded in misunderstanding and mischaracterization remains, further complicating the issue. Ihad the pleasure to interview Michael Genovese, M.D., J.D.. Michael is a clinical psychiatrist, addiction […]

The brain is an organ of the body, and a critical piece of overall health. Since mental health conditions are not traditionally seen as the diseases they are, a recurring dialogue grounded in misunderstanding and mischaracterization remains, further complicating the issue.

Ihad the pleasure to interview Michael Genovese, M.D., J.D.. Michael is a clinical psychiatrist, addiction specialist and the chief medical officer of Acadia Healthcare. Acadia operates a network of 585 behavioral health facilities with approximately 18,000 beds in 40 States, the United Kingdom and Puerto Rico. Dr. Genovese is also the medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates (FBINAA), helping to equip first responders with the tools they need to withstand, recover and grow following repeated trauma. He has previously served as the chief medical advisor to Acadia Healthcare’s Treatment Placement Specialists®, a service that helps individuals find the best and most appropriate professionals to work with based on their needs, as assistant clinical professor of medicine at the University of Arizona, and as chief medical officer of Sierra Tucson. He is a diplomate of the American Board of Psychiatry and Neurology, a member of the American Psychiatric Association, the American Medical Association, the American Academy of Addiction Psychiatry and the American Society of Addiction Medicine.

Thank you so much for joining us! Can you tell us the “backstory” about what brought you to this specific career path?

My dad was an internal medicine physician and my mom was a nurse. I grew up around the hospital and conversations at home frequently revolved around the cases my parents were treating. I have always had respect and admiration for doctors and chose to pursue law school with an interest in defending them in medical malpractice cases. In the end, as much as I was interested in the judicial aspect, it was through learning and truly understanding disease pathology that I found my passion for medicine. I chose psychiatry because I wanted to help people suffering from diseases of the brain.

Can you share the most interesting story that happened to you since you began leading your company?

A couple months ago, I was fortunate enough to moderate a discussion between David and Nic Sheff about their book, Beautiful Boy, which chronicles the story of Nic’s decade-long struggle with addiction, and the toll it took on his father and their family. One of the biggest takeaways from my conversation with David and Nic was how much it opened my eyes to how little the public understands addiction and its underlying causes, and how there is a desperate need for addiction education.

Can you tell our readers a bit about why you are an authority in the healthcare field?

I have spent my entire professional life treating patients and learning about the role of psychiatrists in the medical field. I have worked in inpatient, outpatient and residential settings so I have seen the entire continuum of psychiatric care. Because of the experience I have garnered over the years, I have been given the great opportunity to see things on a larger scale across all treatment settings and, in turn, effectively deliver quality care to thousands of people across the country.

What makes your company stand out? Can you share a story?

At Acadia, the delivery of exceptional healthcare is our top priority. Our leadership is focused on good medicine which allows us to be effective in treating one of the most vulnerable populations. Our culture and society like to blame and shame people who are suffering from mental illness or addiction, instead of offering them the help they so desperately need during some of the lowest points in their lives. Acadia is dedicated to helping this population and I have witnessed firsthand how my company has changed peoples’ lives for the better. I remember receiving a letter from a woman whose son had struggled with addiction and been in several rehabilitation facilities, as well as tried multiple treatment options before coming to us. She thanked me for saving her son’s life because we were able to get him the help he needed to get better. There is nothing more rewarding than that.

Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?

We at Acadia are making every effort to be on the cutting edge of science. We are interested in new technology as it relates to genomics, pharmacology and healthcare technology. In doing so, our hope is to deliver more effective and productive healthcare. By treating addiction, depression and the like as brain diseases and focusing on the latest science and technology to inform treatment, we can deliver better care and help save lives.

Are you working on any exciting new projects now? How do you think that will help people?

At Acadia Healthcare, we have recently partnered with The Jason Foundation, a nonprofit teen suicide awareness and prevention organization, to launch the Crisis Support Team. Regretfully, suicide is now the second leading cause of death among young people in the U.S. Our hope is the implementation of this new initiative will help change that. The Crisis Support Team is comprised of a group of volunteer psychiatrists and therapists who will act as “sounding boards” for teachers and youth workers who find themselves under-resourced to help students and young people who are dealing with the aftereffects of traumas. No two people will respond to the same trauma in the same way. What is traumatic to one person, may not be traumatic to someone else. This new program will provide information to teachers and youth educators about how to spot the warning signs of a mental health struggle and guide them on the appropriate next steps to help those students. By educating community leaders about the risk factors and warning signs, we can help prevent suicide.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. Earn the trust of people and patients as opposed to focusing solely on impressing them with clinical knowledge. I remember what it felt like to be a young doctor and wanting to showcase my knowledge about the field of psychiatry. Throughout my experience in medicine, I have learned that while knowledge is important, it is more important to practice empathy and earn the trust of your patients.
  2. Effectuating a cultural change can take some time. If you push something too fast, sometimes you can break it. If a doctor wants to introduce new treatment modalities, he or she must recognize that hospitals or patients who are used to a different method of treatment may take a while to adapt.
  3. Focus less on the “cure” and more on healing. Many of the diseases we manage are chronic in nature and don’t have a definitive beginning or end. Sometimes it’s more of a marathon than a sprint.
  4. It is okay to not always know the answer. As medical professionals, it is in our nature to want to find the answer or the cure. Sometimes it is okay to say, “I don’t know,” as long as we also say, “I’ll find out.” The answer will come with experience and a willingness to ask the right questions.
  5. Learn from people who are not doctors. Afterall, as a medical professional, I work within a healthcare system. Learn from nurses, CEOs and other people within the healthcare industry and be curious about what they do. You may be surprised to find what they can teach you.

Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. The U.S. healthcare system could do more on the side of preventative care. Medical professionals are experts at addressing acute diseases as they are diagnosed, but we must be better at trying to avoid those diagnoses from occurring in the first place.
  2. Insurance disparities within the U.S. healthcare system have contributed to a decrease in access to care. As mental health professionals especially, we must be willing to work with insurance providers to guarantee patients get the treatment and care they need.
  3. Doctor shortages, specifically psychiatrist shortages, are causing some patients to wait for months just to get care. With depression and suicide rates on the rise among all demographics in the U.S., communities and mental health professionals need to work together to ensure one of our most vulnerable populations is getting the help it needs.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

  1. Prioritize: We tell patients to take care of themselves, yet do not prioritize our own health. We must make healthy lifestyle changes — including those we recommend to patients — such as exercising 30+ minutes per day and eating right.
  2. Incentivize: Tackle burnout by incentivizing healthy behaviors, such as the use of mental health days to alleviate job-related stresses. Available resources and recommended treatment protocols also should be readily accessible.
  3. Educate: The brain is an organ of the body, and a critical piece of overall health. Since mental health conditions are not traditionally seen as the diseases they are, a recurring dialogue grounded in misunderstanding and mischaracterization remains, further complicating the issue.
  4. Encourage: Physicians refrain from accessing care for fear of losing their license. Establishing a network where doctors can receive confidential, nonpunitive treatment allows them to seek help without fear of retribution.
  5. Create: Leaders can effectuate change and put a cultural shift into motion by creating policies, providing resources and talking openly about the issue.

Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?

As medical professionals, it would be beneficial to learn more about self-care during training. We learn all about the care we render to our patients and nothing about the toll it can take on our own health. As it stands, we are focused solely on things like being up to date on the latest journal and knowing what treatment/medications to use, that it can be easy to lose ourselves.

What are your favorite books, podcasts, or resources that inspire you?

I listen to the Medscape Psychiatry Podcast on occasion and enjoy it, but I prefer reading. I look forward to receiving my hard copies of The American Journal of Psychiatry, The Journal of the American Medical Association and The Journal of Addiction Medicine in the mail. I also like reading books about the history of medicine, the evolution of healing. One of my favorites is Doctors, The Biography of Medicine by Sherwin B. Nuland. My latest fictional read was Daniel Mason’s The Winter Soldier, which was about a medical student from Vienna who was thrust into real medical practice at a field hospital during World War I. Books have a way of reminding me of why I got into medicine in the first place.

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