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Ethics: Treatment CEO says treatment claims must match reality

October 2, 2012
by Dennis Grantham, Editor-in-Chief
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Matt Feehery ‘just says’ what he’s heard, then warns against unethical practices in the addiction treatment industry
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“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 during the NCAD ’12 in Orlando.

In an engaging and often humorous 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 clearly define what he meant by “ethics.”

“What do we mean by ethical?” he mused.  “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 being ethical has nothing to do with 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.  

Feehery suggested that monitoring customer feedback is an essential part of maintaining ethical treatment.  With it, he said, “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 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 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.

“I’m just sayin’ ”

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 are clearly unethical and potentially illegal:

·         Faking or borrowing an address in a city so as to appear in a local search 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 attention or attract callers.

·         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:

o   Using interns inappropriately

o   Failing to staff to guideline minimums

o   Faking the program schedule    

·         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 clearinghouse or referral assistance service if in fact you are operated or funded by one or more organizations with an interest in treatment.