After leaving the Navy in 2005, Dr. Talbot settled in the New Orleans area and established The Medical Care Center. The primary goal of the Care Center was to increase access to affordable primary care services for insured and uninsured members of South East Louisiana and surrounding areas.
The Medical Care Center has evolved since its establishment in 2005 from a part-time General practice to a full-time General practice offering services in Mental Health, Substance use disorders and drug screening services for the Court System and The State of Louisiana Office of Community services(OCS). The practice has grown exponentially in the aftermath of Hurricane Katrina. The Care Center was the only pre Katrina southeast Louisiana private medical facility up and running within days of the storm. The Care Center and its limited but tireless staff evaluated and treated thousands of displaced Southeast Louisiana Residents. Care was provided at no cost to those who had no financial means at the time.
In the aftermath of the Storm, emerged a complex mix of primary and urgent care issues further complicated by obvious mental health and substance use disorders. To effectively treat this traumatized population of patients, every patient had to be screened for psycho-social and substance use issues. The biggest challenge was the fact that very few patients seen after the Hurricane could afford to pay for medical care, and even fewer had the means to afford additional diagnostic studies such as lab work, psychological evaluation and treatment, substance abuse screening or drug screens. The only moral and ethical solution, at the time, was to cover the cost of any additional diagnostic study needed to provide the highest quality of care under the circumstances to those who could least afford it.
The care center covered the cost of thousands of mental health evaluations; thousands of substance abuse screenings, labs, drug screens, and MRIs. In cases where surgical issues were diagnosed, the Medical Care Center covered the cost of any surgical intervention for several patients. Mental health issues were also evaluated and treated at no additional cost to patients. Patients struggling with substance use disorders received treatment with Suboxone and treatment for all co-existing medical issues at no cost.
The Medical Care Center has a diverse patient population consisting of blue collar workers, attorneys, law enforcement officers, active duty and retired military. The Medical Care Center is committed to establishing and preserving the physical, psychological and emotional health of anyone in need of care. The care center staff is especially committed to those in the community with limited financial resources. The Medical Management Program was established to ensure access to care for patients without health insurance and limited financial means. This program provides access to care based on individual income. Eligible patients pay a monthly fee based on income in exchange for unlimited outpatient medical services, including assistance with the cost of medications, diagnostic studies and procedures.
Many of The Medical Care Center’s patients are being monitored for Mental Health issues stemming from emotional and psychological trauma associated with Hurricane Katrina. All patients are being closely tracked and monitored for compliance and outcomes. The Medical Care Center is also treating and monitoring a large number of Substance use disorder patients. Drug addiction, like diabetes and hypertension, is a treatable disease. Dr. Talbot is committed to helping all patients achieve sustainable disease management and recovery to become more productive members of our community.
In addition to primary care and Certified Medical Review Officer (MRO) services, The Care Center was the only private practice in the country providing free addiction evaluation and treatment. Many patients were treated with Suboxone, the cost of which was covered by the Care Center. All substance use disorder patients were also provided mental health and primary care services as long as they remained “In Recovery.” All patients are being tracked and monitored for compliance and outcomes. The Care Center is a DATA 2000 Government (SAMHSA) authorized out patient substance use disorder treatment Practice.
The practice, like many of our patients, is a perpetual work in progress. Dr. Talbot’s vision is to eventually create a self sustaining, Multidisciplinary system of Medical, Mental Health and substance abuse care that fully embraces the core principles of Health, Wellness and Recovery:
1. Patient Education: to increase the awareness of mental health as an integral and essential part of overall health.
2. Collaboration: working with other disciplines and specialties to formulate collaborative care approaches to dealing with a variety of mental health disorders in the primary care environment.
3. Screenings: screenings for depression, anxiety, PTSD and substance use disorders.
4. Universal coverage: Eliminating disparities in Medical, Mental Health and Substance use disorder care by providing services including medications and procedures to the uninsured and those who can otherwise not afford adequate care.
5. Electronic Medical Records: Maximizing use of Technology to improve access, coordinate care and track outcomes.
6. Financing: We have developed a self sustaining business model. Reimbursements for services to the insured and revenue generated from cash paying patients cover operating expenses and services provided to the uninsured non paying patients.
This is a system that can be easily duplicated and incorporated into any private or government care system. The benefits are multi-factorial:
A. All patients are screened, re-screened and re-evaluated regularly for medical, mental health and substance use disorders. Everyone is evaluated and treated equally: active duty, retirees, and civilians. Some patients are poor historians and some intentionally omit or misrepresent out of fear or embarrassment. Our screening process captures all significant medical, mental health and substance use disorders.
B. The process becomes routine to all patients in the system; no different than a baseline EKG, Chest X-Ray or Annual Mammogram.
C. The fact that evaluations and treatment of substance use disorders take place in a Primary Care setting, helps to “de-stigmatize” the experience, leading more people come to The Care Center for help and support.