Preparing Physicians to Treat Addiction
A Data-Driven Model for Building Physician Capacity to Treat Substance Use Disorder
Preparing Physicians to Treat Addiction asked Sedgwick County physicians what keeps them from treating substance use disorder, built the training and patient-facing resources physicians said they needed, and used the same grant to stand up Wichita's first Addiction Medicine fellowship, which has now graduated its first physician who will carry that expertise into rural Kansas communities.
The Challenge They Were Addressing
Sedgwick County physicians had the capability to treat substance use disorder, but few did so. Some screened patients, some only by instinct rather than universally with a validated tool. Many did not know which local treatment resources existed or whom to call. Few offered medications for opioid use disorder, and the reasons they gave ranged from having a clinic partner who said 'no,' to discomfort raising the subject with patients, to a worry that prescribing would draw a steady stream of new patients they were not staffed to treat.
Underneath the practical barriers sat a question of regard. The project's leads, co-principal investigators from the medical school's psychiatry and population health faculty, suspected that how physicians viewed patients with substance use disorder shaped the level of care those patients received. They wanted to measure that directly rather than assume it. The University of Kansas School of Medicine-Wichita is a community-based medical school without its own hospital. Hence, its physicians, residents, and students train across the hospitals and clinics where county and regional residents receive care, which made the school well-positioned to ask the question and act on the answer.
There was also a supply problem. Kansas had very few addiction medicine physicians and no fellowship in the state to train more of them. Without a local training pathway, the county had no reliable way to grow the specialized workforce that patients with substance use disorder need. The grant was designed to address both gaps at once: to understand and shift how practicing physicians treat these patients, and to create a fellowship that produces new addiction medicine physicians for the state.
What They Built
PPTA ran on two tracks funded under a single grant submission. The first track started with listening. Population health staff completed a review of the research literature on what helps and what prevents physicians from treating substance use disorder, then used those findings to write an interview script and conducted 26 interviews with physicians, residents, and medical students in early 2024. The interviews probed beliefs that rarely surface in a chart audit: whether physicians held patients responsible for their disorder, where patients encounter bias, and what would make a provider more willing to screen, intervene, treat, or refer.
The qualitative findings shaped a county-wide survey. Working with the Sedgwick County Medical Society, which counts roughly 97% to 98% of county physicians as members, the team reached a population of about 1,480 physicians, residents, and students and collected 253 responses, with 229 completing the full survey. That 15-17% response rate is strong for a physician survey. The instrument included the Medical Condition Regard Scale, a validated measure of clinicians' willingness to work with a given patient population. The data showed that medical students had greater regard than residents and attendings, and older physicians/trainees had less regard than their younger counterparts. The team then built what physicians asked for. Respondents wanted a way to look up local treatment resources, a patient-facing resource sheet they could hand to patients, the ability to consult an addiction medicine physician, and short, practical guidance on how to facilitate a brief intervention. PPTA developed a directory of local substance use disorder resources designed for clinicians and for direct patient use, along with webinars and training tailored to the specific barriers the survey surfaced, rather than a generic curriculum. This link will take you to the resource guide: https://www.kumc.edu/ppta. The program has since been renamed Preparing Providers to Treat Addiction. The second track established the fellowship, a one-year, full-time, supervised clinical program for physicians who have already completed residency. The team commissioned a feasibility study, hired a coordinator to oversee the accreditation process, and secured the faculty, clinical training sites, and educational experiences required to meet accreditation standards through the Accreditation Council for Graduate Medical Education (ACGME). The Addiction Medicine Fellowship Program in Wichita received ACGME accreditation in 2025. Its first fellow, a rural family medicine physician with lived experience of substance use disorder, has graduated and is working in a rural community, and a second fellow started in July 2026.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
The required partners were essential to the project's ability to generate credible data and support a rigorous fellowship. The Sedgwick County Medical Society made the interviews and survey possible: a near-universal membership meant the team could reach almost every physician in the county and trust that the results represented local practice rather than a self-selected few. The medical school's faculty, including practicing physicians who volunteer their time, supplied both the research capacity and the clinical supervision a fellowship requires. The funder provided the strategic direction, dollars, and flexibility to let the team set outcome measures that fit the work rather than imposing a fixed template.
For this first phase, the work was conducted in Sedgwick County. Later iterations broadened to statewide partners, including the Kansas Hospital Association, the Kansas Board of Pharmacy, and DCCCA, a regional behavioral health provider. A replicating community could treat those wider partnerships as the growth path, not the starting point.
Budget Breakdown
What is the minimum viable budget to replicate this?
What is achievable on a small budget depends on the goal. A community with about $75,000 and a single year can realistically complete the assessment of half of this model: interviews, a survey of local physicians, and a resource directory built from the survey findings. A community could even contract a university to conduct the interviews and survey on its behalf. A fellowship is a different order of commitment. A single small grant can support personnel, time spent on essential processes to develop an ACGME-accredited fellowship, such as researching requirements, appointing faculty, establishing partnerships with affiliate clinical sites, developing a robust curriculum, and curating accreditation documents. However, the pursuit of diverse and sustainable funding options may be a priority to support the ongoing expenses of maintaining the fellowship once established. Neighboring counties or localities can also pool funds to support a shared fellowship anchored at a regional academic medical center, allowing a smaller place to reach the workforce-building goal without bearing the full cost.
What Worked and Why
Specific decisions or design features that drove success
Asking physicians directly before designing anything was the decision that shaped the whole project. Rather than guessing what training doctors needed, the team interviewed 26 of them and surveyed hundreds more, then built the directory, webinars, and consultant option to address the barriers that participant physicians identified. The resources landed because they answered questions physicians had actually raised.
Measuring regard, not just knowledge, gave the project an intervention focus it would not otherwise have had. The Medical Condition Regard Scale showed that medical students reported higher regard toward patients with substance use disorders than practicing physicians. That finding points to opportunities for intervention, especially with more established practicing physicians.
Pairing assessment with a fellowship meant the grant did more than describe a problem. The same award that documented low regard and insufficient screening also created a pathway to produce physicians trained specifically to treat substance use disorder. One funded effort both diagnosed the gap and started closing it.
Designing the fellowship as an accredited program protected its value. Accreditation means that a physician trained in the program is eligible to sit for the Addiction Medicine board exam upon successful program completion. Board-certification establishes a physician as a credible expert in that field, which is essential for future employment and quality patient care. The team treated that standard as non-negotiable.
Letting the funder-approved metrics fit the work kept the reporting useful. Because the team could define its own primary outcomes within the funder's requirements, it collected data that reflected what the project was trying to change, instead of forcing the work to fit a generic measurement set.
Early outcomes and data
26 interviews with physicians, residents, and students were conducted in early 2024 to map local barriers and facilitators.
253 survey responses collected (229 complete) from a population of about 1,480, a 15% to 17% response rate.
Regard for patients with substance use disorder was measured with a validated scale, suggesting the need for intervention especially among more established physicians.
The top-reported barriers identified were a lack of knowledge of local resources, patient resistance, and time constraints.
Patient-facing resource directory, webinars, and training developed in direct response to survey findings.
Wichita's first Addiction Medicine Fellowship Program is accredited and operating, with its first fellow having graduated and a second who started the following July.
Each fellow treats roughly 1,000 patients with substance use disorder during the fellowship year.
Lessons Learned
Let the data design the program. The interviews and survey were not a formality preceding the real work; they were the blueprint. Every resource the team built traces back to something physicians said they lacked. A replicator who does the assessment first avoids looking back later and realizing they should have asked.
Measure attitudes, because they drive behavior. Knowledge gaps are easier to talk about than regard, but regard is what determines whether a patient with substance use disorder gets treated. Measuring it gave the project a clear, defensible focus and showed exactly where in a medical career to intervene.
Build the workforce, not just the awareness. Training practicing physicians matters, but a fellowship shapes physicians whose whole specialty is this population. The first graduate is already carrying that capacity into a rural community that had none, which is the kind of durable change a single grant can seed.
Accreditation is the part you cannot improvise. A locally trained physician needs a credential that is recognized the same way everywhere. Holding the fellowship to that standard from the outset is what makes both the position and the graduate credible.