822 Boylston St
Chestnut Hill, MA 02467
About
Punyamurtula Kishore, MD
Massachusetts Model: Description of Primary Care Approach
1. OVERVIEW, DESCRIPTION, AND RATIONALE
1.1 General Description of Approach
Punyamurtula S. Kishore, M.D., M.P.H. served as the Acting Medical Director at the Washingtonian Center for Addictions situated in Jamaica Plain Massachusetts before it closed in 1980. This experience with one of the few remaing vestiges of the Washingtonian Movement changed his entire medical career plan. Dr. Benjamin Rush's concept of a therapeutic approach to addiction had influenced the Movement's founders and attracted Dr. Kishore to the field of Addiction Medicine.
Over the next decade, he worked in most of the major addiction programs in Massachusetts. He had experience in every phase of treatment whether inpatient, outpatient, or residential and a variety of philosophies from sobriety based to maintenance or twelve step to therapeutic community based.
In 1990 while the Associate Medical Director for the Department of Corrections at Bridgewater State Hospital he founded "Home Free" a pilot home detoxification program in cooperation with the local Visiting Nurses Association. This innovative model was recognized in 1994 by an award from AMERSA (Association of Medical Education and Research on Substance Abuse).
In 1996, he opened the first office of Preventive Medicine Associates (PMA) a private medical practice focused on Addiction Medicine. It was a quaint one-room office in Brighton Massachusetts with a small library in another room to host community meetings. The practice was built around a model of primary care rather than an addiction treatment program using the construct of community oriented primary care (COPC) as the model for the office. He chose this model based on his fellowship at Carney Hospital in the early 1990s. He found early on that using this model made it possible to survive as a private practice but require continual modifications of the practice to meet the frequently changing demands of the current health care system.
The practice was successful and required additional office space after a few years. As the practice grew it became apparent that additional sites were necessary to provide easier access for patients traveling long distances to reach the office. Request came from community members, physicians, or the political structure of various communities requesting additional sites be developed in their community.
The current network of sites developed by Preventive Medicine Associates is based on the principles of Preventive Medicine and Community Responsive Care (CRC) and focuses on the health of individuals, communities, and defined populations. Its goal is to protect, promote, and maintain health and wellbeing and to prevent disease, disability, and death. The emphasis is on how communities can work collaboratively with the healthcare sector, such as physicians, public health officials, insurers, and providers to develop cooperative strategies that promote health. It provides the link between defining the community, health care needs, and program development.
The practice has become a statewide network of sites offering a full spectrum of services, available to all patients at all sites. In addition, by providing access to sober housing in all areas of the Commonwealth, the network enhanced the continuity of care. Each practice location consists of a multi-disciplinary team, which typically includes a mix of physicians, psychiatrists, nurse practitioners, physician assistants, counselors, office managers and medical assistants. From this experience he developed a model of care which he called the Massachusetts Model of Addiction Recovery.
The Massachusetts Model approach is characterized by a thorough and ongoing medical assessment of patients and of multimodal therapeutic approaches. It may include full and comprehensive physical examinations, laboratory testing, toxicology, cardiac, neurological and pulmonary evaluations, education and support, and other methods.
A multidisciplinary team of professionals (e.g., nurse practitioners, physicians, physician assistants, psychologists, nurses, peer group counselors) plan and assist in the treatment process. The physician or nurse practitioner meets individually with the patient to conduct an interview, review the client's test results, and plan medical goals and objectives. The assumption is that abstinence is ideal.
Treatment provides tools and a context for the client to learn new ways of living without alcohol and other drugs. This type of treatment can be employed on an outpatient basis.
Years In Practice
50
Primary Specialty
Preventive Medicine Specialist
Gender
Male
Education
Andhra Med Coll, Univ Hlth Sci, Visakhapatnam, Ap, India
Training
Caritas Carney Hosp, General Preventive Medicine91-94
-Residency in Preventive Medicine
-Fellowship in Community Oriented Primary Care
King George Hospital,73-74
- Internship
All India Institute of Medical Sciences, 75-76
-Residency in General Surgery
Affiliations
Brigham-Faulkner Hospital
Beth Israel Deaconess Hospital
Certification
American Board of Addiction Medicine 2010