"Once we get them into the center they stay because they realize the approach we take is different," he says. "We don't fire them and we tell them straight up we don't care what they are doing that may have irritated other doctors in the past. We just need to know it so we can come together with a plan."
The center's treatment team uses addiction specialists, psychologist, RN case managers, and social workers to confront not only the medical issues—often pain, addiction, or both—that are driving these patients into the ED, but also the psychological and social issues that may be exacerbating the problems.
"Most of these patients don't know what do to. They really want someone to guide them through this," Waller says. "There are times when the RN case manager or social worker is able to guide them better than I do. We work together with each of the patients after we do our intake. Any plan I come up with has to be in line with the psychological side and the social side. We manipulate our plans so they work together and we present that to the patient before we finalize the plan."