On Friday September 22, the day we were to open our Elkton office, MATClinics received a notice from the Town of Elkton that prohibits us from opening our office in the town. NIMBYism is a fact of life, and we probably shouldn’t be surprised that there is concern that a business like ours would attract the “wrong kind of people” to Main Street and potentially exacerbate the issues that the town faces with addiction.
Unfortunately, the outrage pointed at us was misplaced, founded on misconception, and fueled by individuals who have personal agendas contrary to the welfare of the residents. It may be too late for us to treat patients in Elkton, but we feel a need to tell our side of the story.
What is MATClinics?
- MATClinics—is a small group of doctor’s offices dedicated to treating people who are addicted to opioids. We chose the name to reflect our use of Medication Assisted Treatment, which is one of the only proven methods for treating the chronic disease of opioid use disorder. MATDoctor’sOffice was bulkier than MATClinics, although it would have been more accurate. We are no more a clinic than the Cheesecake Factory is a chain of factories.
- Treatment—MATClinics provides our patients with the treatment they need to curb their addiction. The treatment is a combination of medication (typically Suboxone, but always a buprenorphine based medicine) and counseling. Our medical staff focuses on medication management and our case management staff focuses on helping our patients find the best counseling alternative available for their individual needs.
- Intensity—We are the least intensive of all treatment options; we strive to get all of our patients to be stable enough to manage their own medication in four-week increments. Patients who cannot handle the limited structure inherent in our program are referred to more intensive treatment alternatives. At any given time ~90% of our patients visit our offices only once a month.
- Patients—Our patients have jobs and families that depend on them. Some are businessmen, some are stay at home moms, some are restaurant owners, managers, servers, tradesmen and salesmen, and some are professionals like teachers, lawyers and health care workers. They defy every stereotype.
- Office Hours—We were initially scheduled to be open 3 hours per week, 9am to Noon on Fridays. Our busiest office is in Dundalk and we are open three half-days a week there.
- Staffing—Our Elkton office would be staffed by a physician with years of experience treating addiction. During office hours we would typically have a case manager, a medical assistant and an administrative assistant in the office.
- Patient Volume—Our physician could never see more than 4-5 patients an hour, at the absolute maximum. If a case manager is working in parallel, she would likely see 2-3 patients per hour. Based on the size and layout of the office suite, it is not possible for us to see more than 5-10 patients an hour during the hours we are open.
- Additional Employment—The office space we leased is modest in size (~1,700 sq feet), but larger than we need to provide patient care. It was our intent to add up to four full-time medical billing staff who would work out of the Main Street office and who would be responsible for the billing for all of MATClinics’ offices.
- Pedestrian Traffic—The office suite we leased is in a building that has a parking lot out back, and an entrance from that lot. There is a handicap accessible elevator, allowing all patients to enter from the rear of the building, not Main Street. In our effort to be a good neighbor, on our website, we encouraged our patients to use the “back door”.
Campaign Against MATClinics
- The County Executive—According to the Cecil Whig on September 22, 2017, County Executive Alan McCarthy said that, “These people are doing nothing more than dispensing illicit products under the auspices of having a license.” In fact, our providers, all of whom have specific addiction training and have obtained DEA waivers to prescribe buprenorphine, write prescriptions for opioid replacement therapy. Mr. McCarthy, a public official, chose to make inaccurate and damaging statements instead of gathering facts.
- The Pharmacist—On Wednesday of this week, we introduced ourselves to an Elkton pharmacist. Far from hiding, we were hoping to find a partner. But to our disappointment, the pharmacist made clear to us that she believes that our patients are solely responsible for their plight and that she does not support efforts to treat them.
- The Doctor and His Wife—Dr. and Mrs. Katz run a Suboxone clinic across Main Street from the office suite we leased. Their treatment methods may be stylistically different from MATClinics, but they are legally and medically identical. They have been the most vocal in their opposition to MATClinics, as their quotes in the Cecil Whig illustrate. Instead of welcoming additional medical care to a needy community, they have mischaracterized our medical practice and worked to block our efforts to open what they perceive to be a competing office.
Our nation is fighting an opioid crisis. MATClinics is dedicated to being part of the solution. The anti-competitive, discriminatory and fear-generating response to our attempts to treat patients in Elkton will not serve the community well. It will only result in prolonging the opioid crisis, by denying those addicted to opioids an additional alternative.