Job Shadowing 1

Running head: JOB SHADOWING

Job Shadowing

Má rcio Padilha

College of Southern Idaho

ALLH 202 – Janak

Spring/2010
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JOB SHADOWING

On April 29, 2010, I had the opportunity to job shadow Dr. David Reed Hadlock. A

Doctor of Osteopathic Medicine, Doctor Hadlock is Board Certified in Reproductive

Endocrinology and Infertility, Gynecology and Obstetrics as well as in Addictions Medicine

besides being a Certified Medical Review Officer, Certified Correctional Health Professional,

Certified Addictions Professional and DUI Evaluator. He has his own private small-size

practice, geared to Women’s Health, Family Practice and Addictions Medicine, at 496 Shoup

Avenue in Twin Falls, Idaho, (208) 735-0000.

With six examination rooms, four of which are equipped for different gynecological

and obstetrical procedures, the facility is well-structured, clean and organized. The staff is

made up of the Doctor, one Registered Nurse, two Certified Nursing Assistants and an

Office Manager, all of whom are professional yet relaxed, friendly and welcoming. Both

CNA’s and the office manager function as the patients’ first contact, both on the phone and

in person, into the office. As usual in these practices, the patient is called in by the CNA who

checks the vitals and, in case of addiction-related follow-up appointments, administers a

urine analysis screening panel for a number of common drugs and inventories the patient’s

substance abuse since their last appointment. Although the RN also carries out these

functions, her presence is intended to provide monitoring for walk-in acute detox patients

who, in light of the condition, do not necessarily schedule appointments, but rather just

drop in needing immediate help.

Doctor Hadlock runs a voluntary drugs and alcohol detox program and is one of two

physicians in the area who can provide opioids detox, which, as per federal regulations,

must be achieved via Suboxone (buprenorphine) which, while demonstrating the depth of
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his training simultaneously affords him a guaranteed share of the local addiction business.

On the flipside, as an independent practitioner, Dr. Hadlock stands to take any loss should a

client default in payment or file for bankruptcy. Detox clients are referred in by word of

mouth, professional counselors and other medical professionals, who, in addition to the

patients’ families, are integral to each individualized treatment plan.

I had the opportunity to sit in on four Suboxone follow-up consultations. To my

surprise, the patients, upon knowing of my intent to become a Drugs and Alcohol

Counselor, promptly accepted my presence, disclosed their personal medical/addiction

issues to me and allowed me to take part in their treatment session. Whereas three of the

four patients seen were conscientiously engaged positively in their treatments, one was

defiant and, as such, demonstrated denial, reframing and rationalizations, all negatively

impacting the outcome of the treatment. For the one patient in question, the doctor held a

family session where he requested that the patient submit to a greater level of care or

accept prompt discharge. Despite no paperwork increase, the doctor exceeded by far the

time allotted for this patient’s consultation in order to covey that no rationalizations would

justify the intermittent use of an assortment of drugs other than the primary drug of choice

and that the drug screening tests were accurate despite the patient’s denial.

Although the financial rewards are evident, I do not believe that one would provide

such services without an intrinsic component of altruism at some level because the nature

of therapeutic alliance in the addiction recovery process seems to be very contentious,

highly legalized and potentially dangerous.

This job shadowing experience is not within the scope of practice I seek to obtain,

but it is congruent to the nature of the business I want to get into. Having the opportunity
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to be an integral part of someone else’s treatment was very interesting as it brings the

academics to life in the form of hands-on practice. Despite the fact it will not bear an impact

to the outcome of this class, I have left my contact information with Dr. Hadlock, who has

agreed to call me to come back in and observe different detox proceedings, i.e. alcohol

detox, opioid detox and so on, and I am looking forward to the experience.