Do you recommend doing an addiction fellowship to work at a luxury rehab?

[executivewaffle]

I was browsing luxury rehab psychiatrist positions (not many openings) and some straight up say you don't need a fellowship. Some say: "addiction competence". My sample isn't big enough to make a conclusion. Is it generally recommended to do a fellowship for these positions or would you be fine without one?

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[littlefred]

You'll be fine.

 

[dl2dp2]

Luxury rehab psychiatrist positions are unfortunately not usually great jobs. Reason being that luxury rehabs are not really contexts where the quality of medical services is of high value. I used to have similar ideas but after some investigation, it appears that the luxury rehab industry has more overlap with luxury hospitality than with concierge medical practices, as the involvement of medical professionals in addiction recovery is relatively recent a phenomenon. The well-known luxury rehabs are often older than the existence of buprenorphine, for example, and are often hostile to medications. This aspect is often touted as a selling point. These jobs are therefore not competitive as the facilities don't care much about credentials and they don't pay much, and the on-site doctors are rarely more than contract labor.

That having been said, a fellowship makes it easier to get these jobs, if you decide to get one.

 

[jbomba]

I work at a very high end luxury detox facility. Fellowship definitely not needed.

 

[Sushirolls]

Another thing to consider, is the prospect of their location. In middle of nowhere.

Several years back I was on track to be the med director at one of these such facilities that was converting a resort. That stopped half way through for some reason and never opened. I was thrilled at the prospect of this place, not so much the job details, but the ability to truly live in the middle of nowhere. Mountains, trees, rivers, hunting, fishing, etc. THE BOSS was not pleased and wanted some population, so I would have had to do a longer daily commute.

In summary, be aware of their geographic location in relation to population centers.

 

[1edyfirel]

Absolutely not. Agree these jobs almost always sound better than they are; most are owned/run by people who think they are business geniuses (they aren’t) and goal is $$$. The residential addiction world can be pretty gross and shady, and that includes the luxury ones. Anyway, that’s not what you were asking. No, do not do a fellowship just to work there. A lot of them are employing NPs with little experience in … anything.

 

[littlefred]

To also add to the conversation and to echo what one person said above, when I worked at a "luxury rehab" they were against MAT. So in a way one of our most powerful tools were not allowed and it was kind of sad when the patients would come back to treatment after relapse (but made more money for the rehab if you think about it).

 

[jbomba]

I think these places vary significantly. The one I am at, they are very for MAT. They utilize evidence based treatments. Some of their consulting docs are very well known and regarded in the field of addiction medicine. There are no NP on staff. They're a small operation with no more than 7 patients at a given time. The patients they do have however pay a LOT to be there.

I fell into this role through a personal connection. Definitely didn't find it on a job board.

 

[Bartelby]

I'm surprised any psychiatrist agrees to work for any residential facility that bans MAT.

 

[smalltownpsych]

I have worked in the private pay residential industry for a number of years and most places are typically run by people with little formal training or credentials and I have learned that I cannot work in a place where clinical decisions are made by non-licensed healthcare providers. The last place I worked was owned by a psychiatrists and the day he sold it was the day I started my exit plan. The example of banning MAT is a prime example of this. They also tend to ban stimulants. Although I might agree to an extent with that philosophy it is still not my decision as to what a psychiatrist prescribes as it is outside my scope of practice and the people who run these places don’t even have a scope of practice and are not accountable to licensing boards.

 

[littlefred]

I'm surprised any psychiatrist agrees to work for any residential facility that bans MAT.

Have you heard of this thing called money? lol

I want to believe I was trying my best given my limitations by the employer. We offered Naltrexone, I just did not prescribe any scheduled meds.

 

[OldPsychDoc]

The very thought of these places makes me want to hurl.

 

[smalltownpsych]

Have you heard of this thing called money? lol

I want to believe I was trying my best given my limitations by the employer. We offered Naltrexone, I just did not prescribe any scheduled meds.

For a lot of the addiction work, this would probably be fairly appropriate not prescribe many controlled meds. Most people with addiction and mild to moderate symptoms during early abstinence don’t need any medication and though they will complain that their symptoms are severe, that’s often just the lack of distress tolerance. However, you should be the one determining that and not the non-clinicians.

 

[executivewaffle]

I work at a very high end luxury detox facility. Fellowship definitely not needed.

How are you liking it? If you've worked elsewhere, how does it compare?

 

[jbomba]

How are you liking it? If you've worked elsewhere, how does it compare?

I do like it. I'm allowed to pull patients into a private practice when I deem appropriate so that's a nice bonus. It's also interesting interacting with nationally recognizable names or their family members and getting a look at how their lives can be so much different than what you might guess by outwards appearance.

 

[executivewaffle]

I do like it. I'm allowed to pull patients into a private practice when I deem appropriate so that's a nice bonus. It's also interesting interacting with nationally recognizable names or their family members and getting a look at how their lives can be so much different than what you might guess by outwards appearance.

I'd like to learn more about what you do/how you got there/other relevant info. I can't seem to privately message you. Could you message me?

 

[Shikima]

Something to consider with doing an addictions fellowship, go do a pain fellowship right afterwards.

 

[Shikima]

I just got my FL license. I didn't need one.
NM on the other hand, they require 5!! And want to check work references too!

 

[comp1]

Was anyone else's first reaction to the subject title, "I think doing an addiction fellowship would actually make it harder to practice in a luxury rehab?"

 

[bGMx]

I just got my FL license. I didn't need one.
NM on the other hand, they require 5!! And want to check work references too!

New Mexico needs 5... what.... addictions fellowships???

 

[Shikima]

New Mexico needs 5... what.... addictions fellowships???

No, references.

 

[executivewaffle]

Something to consider with doing an addictions fellowship, go do a pain fellowship right afterwards.

Can you explain why?

 

[Shikima]

Can you explain why?

Because they're often linked. And there are many cases of iatrogenic injury with the stupid pain in the 5th symptoms pushed by PhDs and Nurses.