In this Dec. 23, 2015 photo, Dr. Michael Merrick talks to a patient about her addiction as she comes in to get her prescription of Suboxone, a medicine used to treat opioid addictions, in Merrick’s office in Kenai, Alaska. (Clarion file photo)

In this Dec. 23, 2015 photo, Dr. Michael Merrick talks to a patient about her addiction as she comes in to get her prescription of Suboxone, a medicine used to treat opioid addictions, in Merrick’s office in Kenai, Alaska. (Clarion file photo)

Longtime Kenai doctor sells practice to addiction medicine provider

A longtime Kenai doctor has sold his practice to a company operating clinics focused on medically assisted opioid treatment.

Ideal Option, a Washington-based health care company, will take over Dr. Michael Merrick’s practice in Kenai effective today. The company focuses on helping people quit using opioids under medical supervision. Medically assisted opioid treatment involves the use of opioid-like drugs, such as Suboxone or buprenorphine, to gradually bring an addicted person down from high usage of drugs like heroin or prescription opiates.

Merrick has been practicing medicine in a small clinic on Frontage Road across from the Kenai Senior Center for about 36 years. Though he provides primary care services, he is also the primary medically assisted opioid treatment physician on the Kenai Peninsula, with around 100 patients. The Drug Enforcement Administration uses a waiver system to limit the number of patients doctors can treat this way.

However, last year, Merrick’s own health took a turn for the worse. He said he was diagnosed with idiopathic pulmonary fibrosis in January, a type of progressive lung disease that gradually reduces a person’s ability to breathe. After hearing about Ideal Option at a medical conference and some consideration, he said he made the decision to sell.

It’s not the last his patients will see of him, though — he said he’ll take some time off and then come back to practice one day a week or so, continuing to see patients as long as his health allows. Ideal Option only takes addiction patients, so his nonaddiction patients will be directed to the Redoubt Medical Clinic, only a few doors down from Merrick’s clinic.

“I’m going to retire more than I am now, but I’m not completely retiring,” he said.

Ideal Option opened its first clinic in Kennewick, Washington in 2012. The co-owners, Jeffrey Allgaier and Kenneth Egli, were both emergency room physicians and saw the need for more medically assisted opioid treatment providers and decided to open their own clinic. Egli, the executive vice president and medical director of the company, said it took off from there, with the company expanding to 27 clinics in seven states, including four in Alaska.

“We’re basically a doctor’s office,” he said. “We do the medical management of addiction. In Washington we do have our own counseling agency.”

The company is a full addiction medicine specialty clinic, treating anyone with a substance abuse disorder or chemical dependency, but has focused particularly on opioids because of the ongoing national crisis of heroin and prescription drug abuse, Egli said.

The clinics work with patients individually to develop treatment plans using both medication and counseling, Egli said. The traditional substance abuse counseling method required in many states, particularly for those on Medicaid, has shown little success, so Ideal Option’s counseling system is based on an individual’s need, he said.

“A lot of our clients (have jobs) — we have lawyers, we have teachers, we have bus drivers, we have nurses, we have engineers, and these folks can’t keep a productive life if they have to sit in six hours of class split up into three days a week,” he said.

One of the barriers to patient access to treatment has been the Drug Enforcement Administration’s waiver system — the first waiver medical providers can obtain is a 30-prescription waiver, which they have to have for a year before applying to the Substance Abuse and Mental Health Administration to expand to 100. Providers just getting started may not want to take on that small of a patient base and may not bother getting the waiver, Egli said.

The DEA has made several changes recently, though. After former president Barack Obama signed the Comprehensive Addiction and Recovery Act in July 2016, nurse practitioners and physician’s assistants were able to apply for the waiver after completing training from 2017–2021, according to the American Society of Addiction Medicine. Physicians practicing in a qualified setting who have had the 100-patient limit can now apply to expand their treatment base to 275.

Egli said Ideal Option is a qualifying center, meeting criteria such as having a nurse on call, providing case management services and using electronic medical records, among other requirements. That allows the practice to take more patients.

“We have always been a qualified practice,” he said. “Our providers can go up to 275 for (medical doctors) and (doctors of osteopathy). As of yet, we don’t know if next year they’ll expand (physician’s assistants) and (nurse practitioners) to 275, but right now we’re happy with 100.”

Ideal Option has expanded with a combination of buying small practices and setting up clinics, Egli said. They’ve targeted states with friendly Medicaid policies — the majority of the clinics’ patients have Medicaid, though they’re also in-network with major private insurers, he said — and are generally welcomed by the communities, he said. Alaska’s medical community has been very welcoming in Anchorage and Fairbanks so far, he said.

“Dr. Merrick has been doing a fabulous job providing service (in Kenai),” he said. “It’s challenging for him to turn the reins over because of this capacity limitation with the buprenorphine waivers. He’s just so insightful and thinking ahead… if you’re going to retire or get sick, there isn’t enough capacity in the area to absorb those patients. We’re already licensed and working in Alaska.”

Merrick said he saw the sale of the clinic as part of the larger picture of privately practicing physicians selling to larger companies nationally. Many private practices have chosen to sell to companies because of the complexity and expense involved in the heavily regulated medical business, particularly in technology and insurance requirements.

Having the terminal diagnosis is something he’s coming to terms with as well.

“This time seemed as good as any,” he said.

Reach Elizabeth Earl at elizabeth.earl@peninsulaclarion.com.

More in News

Bradley Walters leads the pack up Angle Hill on Wednesday, July 18, 2018, at the Salmon Run Series at Tsalteshi Trails. (Photo by Jeff Helminiak/Peninsula Clarion)
Summer races kick off at Tsalteshi

The annual Salmon Run Series 5K races start on July 6 and continue every Wednesday through Aug. 3

Central Emergency Services staff wait to receive doses of Pfizer’s COVID-19 vaccine on Friday, Dec. 18, 2020, in Soldotna, Alaska. (Ashlyn O’Hara/Peninsula Clarion)
Assembly mulls bond for new CES fire station

Replacement of the current station is estimated to cost $16.5 million

Buldozers sit outside of the former Kenai Bowling Alley on Thursday, June 23, 2022, in Kenai, Alaska. (Ashlyn O’Hara/Peninsula Clarion)
Old Kenai bowling alley comes down

The business closed in 2015

Landslide debris surrounds part of Lowell Point Road on Friday, June 3, 2022, in Seward, Alaska. (Ashlyn O’Hara/Peninsula Clarion)
Assembly looks to mitigate future Lowell Point Road dangers

Assembly members approved legislation supporting agencies working to address the “repetitive hazards”

The Alaska Department of Health And Social Services building in Juneau has no visible signs indicating the department is splitting into two agencies as of Friday. Top officials at the department said many of the changes, both physical and in services, are likely weeks and in some cases months away. (Mark Sabbatini / Juneau Empire)
Little sign of big change for DHSS

No commissioner at new department, other Department of Health and Social Services changes may take months

Nate Rochon cleans fish after dipnetting in the Kasilof River, on June 25, 2019, in Kasilof, Alaska. (Photo by Victoria Petersen/Peninsula Clarion)
King closures continue; Kasilof dipnet opens Saturday

The early-run Kenai River king sport fishery remains closed, and fishing for kings of any size is prohibited

An "Al Gross for Congress" sign sits near the driveway to Gross’ home in Anchorage, Alaska, on Tuesday, June 21, 2022, after he announced plans to withdraw from the U.S. House race. Gross has given little explanation in two statements for why he is ending his campaign, and a woman who answered the door at the Gross home asked a reporter to leave the property. (AP Photo/Mark Thiessen)
Alaska judge rules Sweeney won’t advance to special election

JUNEAU — A state court judge ruled Friday that Alaska elections officials… Continue reading

Ashlyn O’Hara/Peninsula Clarion 
Soldotna City Manager Stephanie Queen listens to a presentation from Alaska Communications during a meeting of the Soldotna City Council on Wednesday, March 9, 2022 in Soldotna, Alaska.
ACS pilots fiber program in certain peninsula neighborhoods

The fiber to the home service will make available the fastest internet home speeds on the peninsula

Most Read