National Toxicology Services
3 Baldwin Green Cmn
Woburn, MA 01801
Punyamurtula Kishore, MD MPH FASAM
SOUTH SHORE INSIDER: Local doctor treats addiction.
By Alex Spanko
The Patriot Ledger
Posted Aug 04, 2011 @ 12:14 PM
Last update Aug 05, 2011 @ 10:10 AM
Dr. Punyamurtula Kishore started out in addiction medicine in traditional, institutional settings. But since 1996, he's been at the helm of Preventive Medicine Associates, a for-profit firm he owns that provides outpatient treatment for addiction in regular doctor's offices.
Kishore compared addiction to chronic diseases like diabetes and hypertension: Addiction can't be cured, he said, but it can be managed with long-term care.
Kishore, 61, launched his practice with a center in Brighton. The Brookline resident now has 26 primary-care centers across the state, including locations in Quincy and Weymouth, and employs about 320 people. Most of his job involves management and training responsibilities, although he still sees patients on Sundays.
What are some challenges in running a practice like yours?
I was lucky because I'm one of the few people in the state that are board-certified in addiction medicine. Addiction medicine is a new field. . Addiction happened for a long time, but as a science it's relatively new.
In this country, we have close to one million doctors, but my specialty is still a very small number: 2,000 or so. Of those people, most of my colleagues worked in hospital systems. Very few people set foot into the outpatient world. And the ones who set foot in, basically controlled a methadone clinic, or a Suboxone clinic. Those became the standards of outpatient care.
Addicts (were) always treated inpatient because of the complexity of the illness. ... Doctors might have biological skills, but not psychological skills. They might have psychological skills, but not social skills. Somebody has to case-manage the whole case, so nobody had the skills. So what we decided to do is do it through primary care. Reimbursements are low, but we have control of the patient's care for a long period of time.
Do most insurance companies cover your kind of care?
Yes. It took a while for them because they always budget money for addiction care through mental health. ... They understand primary care is cheaper, so they have been pretty good to me. .We brought it into the mainstream of medicine. It's not been easy, but we did it.
Have you seen an increase in the number of your patients after the passage of health care reform in Massachusetts?
Absolutely right. That's what happened. The health care reform drove a lot of people for care. It opened up more pipelines to us. In the beginning, when we first started practicing in '96, my practice was all - 100 percent MassHealth - people who were down and out. .But over a period of time, many insurance companies joined the bandwagon, so now we take all comers.
So what kind of specialists do you employ?
We have 39 physicians in our practice, so I trained them all one by one. We have about 70 to 80 professionals. We have pharmacologists, psychologists, social workers, psychiatrists, primary care doctors, neurologists. . We have counselors. So we've got a fairly large cluster.
What are some of the most common addictions you see?
Young adults are on OxyContin, oxycodone, roxicet, roxicodone - all variations on the same theme. It's a very powerful opiate in the sense (that) each pill is like 10 bags of heroin. It's the same fix, but it's all in one pill. So it's breaking the brain chemistry pretty quick.
A lot of the young fellas who play on school teams, football teams or whatever, they're angling for a scholarship. They've got to do better than everybody else, so they're all taking performance-enhancing drugs, whether it be opiates, so that they don't have the pain in the shoulder or the knee when they're playing, or steroids - all of this is a mess that eventually leads to . addictions.
Society sometimes has a blind spot. A lot of the baby boom generation that grew up in the '60s, who are now adults, they have children or grandchildren: "Oh, I smoked marijuana, it's OK for my kid to smoke." So you have condoning behaviors in the family systems.
Years In Practice
Preventive Medicine Specialist
Andhra University-MD 1974
Harvard School of Public Health- MPH 1979
Bridgewater State University -Certificate in Forensic Psychology - 1991
Caritas Carney Hospital - Redidency in Preventive Medicine 1993
Caritas Carney Hosppital - Fellow in Community Oriented Primary Care 1974
Brigham Faulkner HospitalBethIsrael Deaconnes Hospital
Certified Addiction Medicine Specialist - American Board of Addiction Medicine 2010