Ethics: treatment claims must match reality, says CEO: Memorial-Hermann PaRC CEO warns against unethical practices in addiction treatment.
Author: Grantham, Dennis
Pub Date: 11/01/2012
Publication: Name: Behavioral Healthcare Publisher: Vendome Group LLC Audience: Academic; Trade Format: Magazine/Journal Subject: Health; Health care industry; Psychology and mental health Copyright: COPYRIGHT 2012 Vendome Group LLC ISSN: 1931-7093
Issue: Date: Nov-Dec, 2012 Source Volume: 32 Source Issue: 6
Accession Number: 313161178
Full Text: "I've sat through innumerable ethics seminars, and I already know that I can't sleep with my clients," joked Matt Feehery, CEO of Memorial-Herrmann Health Systems' Prevention and Recovery Center (PaRC, Houston, Tex.), in opening his presentation, "The ethics of customer satisfaction," at the Behavioral Healthcare Leadership Summit, part of the 2012 National Conference on Addiction Disorders held recently in Orlando.

In an engaging and often funny 90-minute presentation, Feehery asked participants to consider "the ethics of providing a good treatment environment and keeping a healthy and honest business." But first, he sought to stake out a clear definition of the term "ethics."

"What do we mean by ethical?" he asked, musing, "Do we mean marginally ethical, semi-ethical, or appearing to be ethical? The humor was not lost on participants, who through a series of definitions came to see that behaving ethically has little to do with outward appearances. Feehery pointed to the words of an 18th century English barrister who equated ethics with honest practices that people take without requirement or observation--when no one else is looking.

Measure feedback, or await complaints

He suggested that monitoring customer feedback is an essential part of maintaining ethical treatment. With the help of feedback, he said that "If you move in the wrong way, if you fail to deliver, your customers will keep you honest. If you're not doing the job, people will let you know--or will let others know--via social media." So, he explained, "you must either measure feedback or you must wait for complaints."

While noting the widespread practice of measuring against industry benchmarks, Feehery challenged participants to take the process further. "It's not just about your mean score or your ranking versus your peers." While some are tempted to disregard or dismiss the negative comments of those in addiction treatment, Feehery asserted that "most patients are just regular, reasonable folks and their opinions count. You can't dismiss them by saying 'that person is 'sick' or that one is "borderline.'"


At the PaRC, Feehery said that their customer satisfaction survey is built around elements that cover all aspects of the treatment experience:

* Clinical and support staff

* Visitors and family experience

* Food and environment

* Privacy

* Admissions processes

* Confidentiality

* Courtesy, friendliness

* Security

* Treatment experience

* Spiritual, emotional and cultural factors, needs

* Program schedule and activities

* Overall impressions of treatment experience

* Discharge planning

Feehery said that he relishes frank customer comments, saying that they tell a story that goes beyond any numerical rankings. But the measurements alone are only the first part, he explained. "If you're going to collect this information, you had better share it, or it won't make a difference." This means letting staff know and track overall progress in satisfaction and key areas for improvement. It also means offering individualized criticism and feedback, continuing individual conversations with each staff member that balances the positive with customer observations, criticisms, and suggestions.

"Just sayin' what's out there ..."

In the next part of his presentation, Feehery elaborated on the theme of ethical treatment by asserting that the treatment provider is ethically bound to do two things:

* Set appropriate and honest expectations for customers/clients seeking treatment.

* Deliver on expectations, with delivery quality based in part on customer measures.

In half-joking tones, Feehery stated (without naming names) that some treatment providers have been said to "exaggerate" the treatment capabilities, facilities, and services they offer in the name of attracting more patients. "These are things I've heard," he said. "I'm not saying they're all true. I'm just sayin' that this is what's out there." The implication was clear.

Feehery stated that all of the following practices are clearly unethical and potentially illegal in addiction treatment:

* Faking or borrowing an address in a city so as to appear in a local web search engine result.

* Making claims, showing photographs, or representing the material elements of your treatment staff, facilities, or capabilities in an exaggerated, inaccurate, or misleading manner.

* Treating a celebrity and leaking elements of information about it to attract publicity or calls from prospective clients.

* Cooperating with laboratories to conduct routine drug tests that are billed to insurers at high prices, then splitting the profits.

* Failing to comply with licensure regulations, which might involve inappropriate use of staff or falsification of details, such as:

* Failing to staff to guideline minimums

* Using staff interns inappropriately

* Faking the program schedule or activities

* Paying for referrals from a treatment marketer. Such payments and referrals are improper unless they are based solely on the interests of the would-be treatment customer.

* Offering treatment through a business that is insufficiently capitalized and therefore unlikely to be able to deliver on treatment expectations.

* Operating a call center or advertising online as though you are an independent clearing-house or referral assistance service if in fact you are operated or funded by one or more organizations with an interest in treatment.

Feehery went on to say that in numerous cases, unethical behavior clearly crosses the line into illegal behavior, citing "pill mills and doc shops," partial hospitalization program scams, fraudulent insurance billings for cancelled sessions or non-scheduled visits, and the like.

"We work in a profession that is built on trust. We must be stewards of that trust," Feehery concluded, noting that "if we don't monitor and pay attention to what we say and what our customers say, we are doomed to have someone else provide that information to us."

Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.