Addiction medicine doctor embarks on solo career after decades long career with local hospitals, talks about own addiction and how he got hooked on pain medication
By Chris Motola
Q: You’ve recently started your own practice. What made you want to go solo? The trend seems to be running in the other direction?
A: I officially opened it in January. I was working for Rochester Regional Health and my particular PCP was a group of doctors who have since left and gone into concierge medicine because of the excessive demands of the hospital system. So I think there’s a trend of more and more doctors doing this. For me, I’m 68 and could retire, but I like doing this work and hope I’m going to like doing it without the trappings of the hospital system.
Q: Are you offering concierge services now?
A: It’s self-pay. I’m not taking insurance. That’s another way I’m getting away from the system. Being involved with the insurers is complicated and since I’m doing this entirely by myself with no administrative person it’s just easier for me to do it this way.
Q: Have you found patients are able to work with a self-pay model?
A: Yeah, I mean, I’m new in the sense that I’m not sure there are that many addiction medicine board-certified physicians doing this in the community on a solo basis. A number of colleagues in different parts of the state and country have told me that this type of practice is usually well-received.
Q: How would a patient find you or be referred to you?
A: My goal is to help people who are just realizing that they have substance use issues — either alcohol or other drugs — to learn how to approach it, because denial is a big part of having an addiction. Getting through that and addressing the problem can sometimes be pretty difficult. In my advertisement I say that I’ve been in recovery for my own addiction issues for over 21 years. Having been through treatment and getting boarded in addiction medicine, I really know the disease inside and out. So the type of patients I hope to attract are medical, legal and other professionals who are notorious for trying to avoid any possibility of anybody finding out. This just allows the disease to continue to get worse.
Q: Interesting that you say that. Talking to physicians over the years, and you definitely get the sense that there’s a culture of stoicism with regard to the number of hours being put in and overall demands. Do you think that may contribute to unhealthy coping mechanisms?
A: Absolutely. If you go through the signs of physician burnout, one of them is turning to substance use. In retrospect that was likely what happened to me. I was an emergency room doctor for 12 years and the usual burnout time for an ER doc is 10 years. I didn’t realize what was happening to me. A new drug came on the market in the mid-’90s called Tramadol. At the time it was marketed as a non addictive pain reliever. The drug company representatives would bring samples to the ER, doctors’ offices. I tried it at some point. It wasn’t a good pain reliever, at least not for me, but it did seem to make my 12- to 14-hour ER shifts go better. It was like turning on a switch. I’d never been addicted to any substances, but it took off: one was good, two was better. In retrospect it could have very well been the stress of the job for as long as I was in it. Even after getting treatment, I stayed in emergency medicine for three or four more years before I realized I needed to find something else to do.
Q: How did you overcome your addiction?
A: There’s a state organization that’s part of the New York State Medical Society. It’s called the Committee for Physician Health. I signed a five-year contract with them that I would participate in whatever treatment they recommended. I did that and it was very helpful. I haven’t, knock on wood, returned to using substances ever since.
Q: Do the treatments you offer have a psychiatric component?
A: I’m not a psychiatrist, but with my background in family medicine I will occasionally prescribe psychotropic medications like anti depressants and anti anxiety drugs. But usually when somebody is still getting sober it takes time for whatever substances they’ve been using to work out of their system and to determine if there’s any underlying psychiatric issue. I might feel comfortable dealing with some of them, some of them not, in which case I’d refer them. Being boarded in addiction medicine also means that I can prescribe a number of medications that are useful in decreasing cravings for opioids, cocaine, alcohol. They’re helpful, but they’re not cures. Recovery requires a lot more than just a pill.
Q: For patients who are interested in your services what’s your intake process?
A: I have a website, winsbergmd.com. They can call or email me from the site. If I don’t answer immediately, they can leave a message and I’ll get back them, usually within 24 hours.
Q: How does pricing work?
A: It’s a set rate. $400 for an evaluation, which usually takes an hour, hour and a half. Follow-up visits are $200 and usually around half an hour. How often someone needs to follow up is based entirely on their own needs and how they’re coming to acceptance of their disease. I have a patient who I’ve seen maybe three or four times. They seem to be doing well, so I’m spacing out the appointments. It starts at once a week, then every two weeks, then every four, then as needed after that.
Lifelines
Name: Mark Winsberg, MD
Position: Addiction medicine physician, solo practice
Hometown: Delray Beach, Florida
Education: University of Miami School of Medicine, Stanford University School of Medicine, Highland Hospital family medicine residency program
Career: Addiction medicine specialist clinician, Rochester Regional Health; medical director, Chemical Dependency Services, Rochester Regional Health; clinical director, Chemical Dependency Services, Unity Hospital; medical director at Clifton Springs Hospital and Clinic
Membership: American Academy of Family Physicians; American Society of Addiction Medicine; American Board of Family Medicine; American Board of Addiction Medicine; Monroe County Opioid Task Force
Family: Wife, two daughters
Hobbies: Racquetball, drums, biking, hiking