Careers in Family Medicine: Addiction Medicine

We’re continuing our Careers in Family Medicine series spotlighting physicians whose career paths show just how versatile and rewarding this specialty can be.

This week, we explore Addiction Medicine with Dr. Judy Chertok, a family physician whose commitment to caring for vulnerable populations led her to build bridges between primary care and addiction treatment. From co-founding integrated care models in Philadelphia to founding and leading an Addiction Medicine Fellowship at Penn, Dr. Chertok has built a career rooted in compassion, collaboration, and the belief that relationship-centered care can transform some of the most challenging moments in medicine into some of the most meaningful.

Enjoy the conversation below.

1. Tell us about your clinical and teaching journey. How did you get to your current roles in addiction medicine?

I went to medical school with an interest in primary care for medically underserved and vulnerable communities. I began my career first working in an FQHC and Healthcare for the Homeless site and then at a large academic family medicine practice.

As a practicing family doctor in Philadelphia as the opioid overdose crisis unfolded, I began to see the impacts of Opioid Use Disorder (OUD) on my patients and community and wanted to be part of the solution.  I joined with other champions in my health system, and we co-created our now large primary care-addiction medicine co-located clinics and then later our hospital-based addiction medicine consult services. 

At the same time, I've always had a passion for medical education and worked in our medical school on curriculum around communication, primary care and addiction medicine and the family medicine residency as Associate Program Director. Three years ago I started the addiction medicine fellowship in family medicine as a way to expand the reach of our programs by training future leaders in addiction medicine and to personally combine my passions for addiction medicine and medical education.

2. What made addiction medicine feel like a natural extension, or new direction, within family medicine?

In family medicine we are taught to holistically, and often creatively, address the person, family unit and community we work with.  We have the skills of motivational interviewing, developing longitudinal relationships, employing harm reduction, and addressing social determinants of health.  In addiction medicine we apply these same techniques to patients with substance use disorders (SUDs). 

I will never forget one of the first times I had a family medicine resident work with me in the addiction-primary care clinic and she said "Wow, this is like all of family medicine in one concentrated half day!"

3. What lessons have you taken from your previous roles in clinical practice, teaching, or leadership?

Being a family medicine doctor is excellent training for being a clinician educator and clinician leader. We learn to partner with our patients, find alignment around shared goals, have patience when change is slow, work around barriers, and share in the joy of small incremental successes. These experiences have been invaluable as I’ve helped grow our programs in education and clinical care.

4. What are the biggest challenges you face in your current role, and more specifically, in addiction medicine?

SUD is one of the medical conditions with the highest morbidity and mortality in medicine. It is a tragedy every time we lose someone to overdose or complications of their addiction, and it is heartbreaking how often this still happens.

I have personally grieved for so many colleagues and patients over the years.  

There are also so many social, political and economic factors that influence people with SUDs. We try our best to advocate within the medical and political system on behalf of our patients, but change is slow, and the challenges are entrenched and complex. Some days I feel so hopeful, and some days it feels hard to make a difference.

5. What are the greatest rewards or sources of joy you find in doing this work?

My greatest joy is my relationships with my patients, especially those with SUDs.  So many people with SUDs have had difficult experiences with institutions and health care, and when we can create a positive experience and relationship, we can transform the interaction. Often having one positive interaction provides some hope that new relationships are possible. 

I certainly celebrate my patients who've achieved their personal goals of long term recovery and have regained joy in their own lives, but I also appreciate the role I can play for someone who might not be in recovery, but knows they have a home and support with me as their physician. 

As a family doctor and addiction medicine specialist, it's a good day when most of encounters include a hug. 

I also love to share my passion for this work.  I love to help to build out systems to amplify impact. I also love to work with so many passionate individuals on my interdisciplinary teams and with medical students, residents and fellows to reach their full potential as clinicians and advocates.  

7. What tips would you share with family physicians who are considering their first job, or deciding whether to pursue fellowship training in addiction medicine?

Addiction medicine is one of the most exciting and cutting-edge areas of medicine, and by joining this field you have the ability to make a huge difference in people's lives.  Join us — you will find the most passionate advocates, creative thinkers, and exceptional clinicians!

But, you do NOT have to be fellowship trained to care for people with SUDs in family medicine!  Seek out educational opportunities to learn about the medical management of common addictions and support the patients within primary care. You already have the training you need!

8. How do you stay joyful and grounded amid the demands of teaching, leadership, and patient care?

Especially as my responsibilities have grown, I have found that there are less and less natural slow periods.  I've had to intentionally create an "end" to the work and the day, often when the work isn't done. 

Scheduling and protecting my non-work time has been so important so that I can return to work refreshed. 

I try to prioritize family time; I like to cook and eat dinner with my husband and teenage sons nearly every day of the week and to spend quality time together in the evening. I want to model to my children that family is important, and so is meaningful work.

9. Anything else you’d like to share with readers about finding meaning or sustainability in this kind of work?

Find your team, and try to be as inclusive as possible! For any project or endeavor find others who share you passion and work on it together. You will support each other when things are difficult and celebrate your accomplishments together. You will learn so much from everyone's unique perspective.

10. How can people find you if they’d like to connect or learn more?

Feel free to email me at [email protected] or visit the Addiction Medicine Fellowship – Penn Medicine website.

Dr. Chertok reminds us that addiction medicine doesn’t stand apart from family medicine. It magnifies its impact. In this field, breadth becomes depth, and the theraupeutic relationship sustains and fulfills both patients, physicians and educators. 

Where do you see the same values of relationship, hope, and healing showing up in your own practice?

Next week, I’ll wrap up the current series with a reflection on key themes, mindset shifts, and takeaways from the many stories shared. 

Until then, have a joy-filled week! Tonya