Interview with Brian S. Taylor, MD

taylor md portrait

Tell us about your involvement with the Ventura County Rx & Heroin Abuse Workgroup. What is a specific project that you are working on?

Since assuming my role as Medical Director for Ventura County Behavioral Health's adult division and Alcohol & Drug Programs last year, I have taken a seat at the table alongside my colleague, Dr. Celia Woods, who has been a prominent member of the workgroup, as an educator to our community of physicians. Dr. Woods, our pharmacist, Patti Yoshida, PharmD, and I began work on a clinical performance improvement project – Safe Alprazolam Prescribing – in November 2014. This project has evolved into our ongoing benzodiazepine monitoring program. It is important for the community and healthcare professionals in Ventura to know that VCBH is using evidence-based tools to reduce the morbidity, mortality and drug diversion associated with controlled substances.

How does it work?

Our providers get quarterly report cards about their prescribing practice of a selected benzodiazepine, currently lorazepam (Ativan). Prescribers are to have their patients sign medication treatment agreements (contracts) for any controlled substance and run a CURES report on California’s prescription drug monitoring program database prior to the initial prescribing of any controlled substance. Reports are then run no less frequently than every 120 days if the medication continues to be prescribed. Providers also request random urine drug screens from patients as a best practice. Over the past years, data from drug screens reveals that two-thirds of the time, patients aren’t taking what the provider thinks they’re taking and/or there is evidence of substance use. 

What motivates you to do what you do?

So many things, both personal and professional, get me up in the morning. As a psychiatrist, it is a privilege to be of service to those who seek relief from their disabling mental illness and stability in order to lead productive and fulfilling lives. As an administrator and member of our executive team here at VCBH, I appreciate being part of a team tasked to formulate solutions to health care dilemmas. As an educator and mentor to colleagues, I am inspired to be the best I can be, always a student myself.

Did you have any life-changing experiences that put you on the path that led you to be doing what you're doing today?

From treating family members with my play doctor kit as a kid, to volunteering in hospital emergency departments as a teenager, then spending several years doing basic science research studying the pathogenesis of Alzheimer's disease in both college and medical school, I knew I had made the right career pick. What I didn't know was what field I would pursue. I found myself drawn to both psychiatry and surgery, ultimately beginning my training as a surgeon at UCSF.  If there were one pivotal moment that had me deciding to make the switch to psychiatry, it was the culmination of experiencing the horror stories we only heard about as medical students and endured as surgical residents. I was on call for the neurosurgery service, sick with a high fever, awakening to yet another page to the emergency department and being up all night assisting in two surgeries, then putting in a full morning and getting home by early afternoon. Frankly, I loved taking care of my patients and being in the operating room, but had to make the decision to favor self-preservation and life balance. As to how I've arrived in the roles I play today, I would say a fair amount of selfless hard work, an eye on quality, always looking to find a way to be better and do things better. Having the confidence of others is earned and is of high value to me.

When you think of the future of the kind of work you've talked about here, what gives you a sense of hope?

First and foremost, I do not think a physician could do what he or she does without their holding on to hope. My patients must know I possess hope. It's at the core of their trust in me and in our plan for their recovery. If I were to lose hope, I don't see how I could practice medicine. What I believe we can all agree on is that science and technology will only continue to move forward. Ongoing basic science and clinical research striving to better understand the nature of mental illness and discover definitive treatments are in our future. Figuring out how to better manage mental illness with all of its social, occupational, financial and legal consequences, is up to all of us. If more people care about reducing stigma, and if more people make more noise about ensuring we all have access to quality health care, then those in a position to apportion the necessary funds to help those who, every year, cost our nation the most with loss of productivity, will do it.  

Brian S. Taylor, MD
Diplomate, American Board of Psychiatry and Neurology

Medical Director, Adult Services & ADP, Ventura County Behavioral Health
Past Chief of Staff, Ventura County Medical Center

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